COVID in care homes: Many are asymptomatic or have ‘atypical’ symptoms

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Many care dwelling residents who have COVID-19 an infection are both asymptomatic or expertise “atypical” symptoms—in keeping with a brand new examine from the University of East Anglia (UEA) and North Norfolk Primary Care, supported by UEA Health and Social Care Partners.

Due to the rapid-response nature of this analysis, it has not but been peer reviewed.

In response to COVID-19, a brand new “intelligent” testing service was applied in in North Norfolk. The service, applied by the improved care workforce (ECHT) with North Norfolk , recognized COVID-19 symptoms amongst residents. They discovered that round half of residents who examined constructive for COVID-19 have been asymptomatic, however some went on to develop symptoms.

They additionally discovered that in many circumstances symptoms weren’t typical and didn’t embrace a excessive temperature, cough or lack of odor. Instead, residents who examined constructive for COVID-19 usually introduced as “generally unwell.”

The workforce say that efficient testing and screening of residents and in care properties is important for figuring out circumstances and controlling the unfold of the virus.

Dr. Paul Everden, from UEA’s Norwich Medical School and Innovation Lead for North Norfolk Primary Care, mentioned: “The COVID-19 pandemic is disproportionately affecting older people, especially in care homes. We wanted to develop a service with our local GP’s, implemented by our ECHT, to keep residents and staff safe by early identification of infection.”

ECHT examined 518 residents in 44 care properties and 340 workers in 10 care properties for COVID-19 utilizing nostril and throat swabs between April 7 and June 29. Test outcomes and symptoms have been in contrast for residents. Positive asymptomatic residents have been adopted for as much as 14 days after testing.

The ECHT discovered that 103 residents examined constructive in 14 properties and 49 workers in seven properties. However, of the residents, solely 38 (37 %) had typical symptoms on the time of the take a look at.

More than half (54 residents) have been utterly asymptomatic when examined, and 12 developed symptoms inside 14 days. Some of these with a constructive end result did expertise typical symptoms corresponding to a cough or fever, however feeling usually unwell was additionally frequent.

Dr. Everden mentioned: “We found that older people in care homes are frequently asymptomatic, but can go on to become symptomatic, i.e presymptomatic. We also found that of those who tested positive, some were just ‘generally unwell. We carried out this service evaluation in North Norfolk but we would expect to see similar results nationally. All UK care homes are at high risk of COVID-19 infection and residents are extremely vulnerable to infection and death. Older people in care homes have multiple co-morbidities including dementia, lung disease, a reduced sense of smell, and may have communication problems too. Together this means it is difficult for staff to identify typical listed COVID-19 symptoms—a temperature, cough and anosmia. It may also be difficult for some patients to recognize or communicate that they are feeling unwell.”

He continued, “At the time of launching this service there was no testing in the community, let alone in care homes. It was therefore vital that we put into place an ‘intelligent’ testing service that allowed the earliest ‘pick up’ of infection with the least use of a precious resource. It was through this process that we identified asymptomatic and presymptomatic people who could potentially infect other residents and staff. Our trigger for testing a was any general deterioration in health status with isolation and then, if positive, testing of all other residents and staff. These findings are really vital for protecting care home communities and we hope they will help keep residents and staff safe—particularly if we are to face future waves of the pandemic in the UK where resources will again indeed be precious.”


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More data:
Emma Smith et al. Testing for SARS-CoV-2 in care dwelling workers and residents in English care properties: A service analysis, (2020). DOI: 10.1101/2020.08.04.20165928

Citation:
COVID in care properties: Many are asymptomatic or have ‘atypical’ symptoms (2020, August 12)
retrieved 12 August 2020
from https://medicalxpress.com/information/2020-08-covid-homes-asymptomatic-atypical-symptoms.html

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