Hospitals should stop mass testing for Covid, says influential panel 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 argue comes at too high a cost to patients and providers.

Revised guidelines from the Society for Healthcare Epidemiology of America reversed course from initial pandemic guidance that urged hospitals to keep a close eye on who comes through their doors with Covid-19.

But such a policy has little or no benefit when other mitigation measures, such as mask use and proper ventilation, are followed, and it increases the cost burden on health care systems.

They included mention of studies showing that pre-admission screening can actually hinder 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 reversed Covid-19 isolation guidance, announcing that vaccinated Americans exposed to the virus no longer need to 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 and patients having to wait longer for care. Hospitals dealing with an influx of flu, RSV and Covid patients cannot afford to have a crowded emergency department with people who cannot access specialized care.

The expert panel wrote: ‘The use of asymptomatic screening is a unique but resource-intensive tool and has possibly been overused.

The new guide was published in the journal Infection Control and Hospital Epidemiology.

“Although it is imperative to prevent the spread of healthcare-associated respiratory pathogens, we must critically evaluate interventions that, when added to core layers of infection prevention, may not achieve their intended impact and may have unintended consequences for patients.” and the HCP”.

The new guidelines are sure to be controversial, as they promote the removal of an initial pillar of viral mitigation. A wide swath of hospitals in the US have been evaluating new admissions as well as patients in line for surgery in order to reduce the risk of complications.

But with the advent of highly effective vaccines and antiviral treatments, Covid-19 hospitalizations have fallen sharply from their levels this time less than two years ago.

‘With increased population immunity to SARS-CoV-2, milder clinical outcomes, increased access to effective vaccines and therapies, and increased published experience on asymptomatic detection, it is important to assess the impact of this intervention and how it should fit into the infection. prevention programs advance,’ the group wrote.

Pre-admission screening for Covid adds onerous delays in the provision of medical care that sick patients require. A May 2022 study by the Cook County Department of Emergency Medicine in Illinois reported that routine testing for asymptomatic covid extended patients’ time in the emergency department waiting room by an average of about seven hours.

The policy is also expensive. Each test costs about $54 to administer. Testing every patient who walks through the hospital doors is a prohibitively expensive undertaking. The authors cited an encouraging study published by Spanish scientists which said that screening only a quarter of new patients had no adverse effect on viral transmission.

Dr. Thomas Talbot, epidemiologist at Vanderbilt University and member of the SHEA Board of Directors said: ‘The small benefits that could be derived from asymptomatic testing at this stage of the pandemic are offset by the potential harms of procedural delays, delays in patient transfers, and strains on laboratory capacity and staff ‘.

However, the board did not recommend a universal end to preadmission screening, saying patients who are at higher risk of developing severe COVID-19, such as organ transplant and cancer patients, should still undergo to tests.