Hospitals should stop mass testing for Covid, says influential group of infectious disease experts

An influential panel of infectious disease experts has recommended that hospitals stop testing all new admissions for Covid, a move they say costs patients and providers too much.

Revised guidelines from the Society for Healthcare Epidemiology of America reversed course from early pandemic guidelines that urged hospitals to closely monitor who enters their homes with Covid-19.

But such a policy has little or no benefit when other mitigating measures such as masking and adequate ventilation are followed and increase the financial burden on health systems.

They included mention of studies that show pre-admission screening can actually hamper a patient’s ability to get the care they need and does little to prevent transmission.

This comes shortly after the Centers for Disease Control and Prevention rescinded Covid-19 isolation guidelines, announcing that vaccinated Americans exposed to the virus no longer need to self-isolate for five days as long as they wear a mask indoors.

They also noted that a hospital policy of universal Covid-19 testing creates a ripple effect of delays in emergency departments, with patients having to wait longer for care. Hospitals dealing with an influx of flu, RSV and Covid patients cannot afford to have an overcrowded emergency department with people who cannot access specialist care.

The expert panel wrote: “The use of asymptomatic screening is a unique but resource-intensive tool that has arguably been overused.

The new guidelines were published in the journal Infection Control & Hospital Epidemiology.

“While preventing the spread of healthcare-associated respiratory pathogens is imperative, we need to critically evaluate interventions that, when added to core layers of infection prevention, may not achieve the intended impact and may have unintended consequences for patients and the healthcare professional.”

The new guidelines are bound to be controversial as they encourage the removal of an early pillar of viral attenuation. A wide range of hospitals across the United States have been testing new admissions as well as patients awaiting surgery to reduce the risk of complications.

But with the arrival of highly effective vaccines and antiviral treatments, hospital admissions for Covid-19 have dropped drastically from their level less than two years ago this time.

“With increased population immunity to SARS-CoV-2, milder clinical outcomes, better access to effective vaccines and treatments, and increased published experience regarding asymptomatic testing, it is important to assess the impact of this intervention and how it should fit into infection prevention programs moving forward,” the group wrote.

Pre-admission Covid screening adds heavy delays to providing the medical care that sick patients need. A May 2022 study by the Cook County Department of Emergency Medicine in Illinois reported that routine asymptomatic Covid testing extended patients’ time in the emergency department waiting room by about seven. hours on average.

The policy is also costly. Each test costs approximately $54 to administer. Testing every patient that walks through the hospital doors is a cost-prohibitive undertaking. The authors cited an encouraging study published by Spanish scientists that found testing only a quarter of new patients had no adverse effect on viral transmission.

Dr Thomas Talbot, epidemiologist at Vanderbilt University and SHEA board member, said: ‘The small benefits that could come from asymptomatic testing at this stage of the pandemic are outweighed by the potential harms of delays in procedures, delays in patient transfers and strains on laboratory capacity and staffing.’

The council did not, however, recommend a universal end to pre-admission screening, saying patients who are at higher risk of developing severe Covid-19, such as organ transplants and cancer patients, should still be tested. .