The Pandemic Continues

Angie Szumlinski Health, Studies

Skilled nursing facilities (SNFs) have been a focal point for COVID-19 outbreaks, with rapid transmission noted soon after the first cases are recognized. Early recognition of persons with COVID-19 in SNFs will remain critical to halting infection transmission and ensuring appropriate clinical care even after residents and staff are vaccinated. In a study published in JAMDA, confirmed COVID-19 cases at an SNF were assessed to identify early indications of COVID-19 infection.

The study evaluated early clinical signs and symptoms associated with COVID-19 in residents of an SNF in King County, Washington. The results of the study support the current CDC recommendations for monitoring persons with signs or symptoms consistent with COVID-19. CDC guidance indicates that changes in vital signs and pulse oximetry are important tools for screening and measuring the severity of illness for SNF residents with known or suspected COVID-19.  Only a small number of residents in the study were identified as asymptomatic.

Early detection is critical for rapid implementation of infection prevention and control measures, diagnostic evaluation, and treatment of residents with suspected COVID-19. CDC guidance recommends the following:

  1. Active monitoring for all residents on admission to a SNF at least daily for fever and symptoms consistent with COVID-19;
  2. Increased monitoring of ill residents at least 3 times daily for symptoms, vital signs, oxygen saturation assessed by pulse oximetry, and respiratory exam;
  3. If COVID-19 cases are suspected in the facility, consideration of more frequent monitoring of asymptomatic residents to enhance identification of COVID-19 illness.

Remember, frequent, daily resident monitoring will require increased staff training, access to appropriate equipment, and increased access to clinical providers. Stay the course, stay well, mask up, get vaccinated, and stay tuned!