COVID-19 in long-term care facilities for the elderly: laboratory screening and disease dissemination prevention strategies

Abstract An infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the 2019 Novel Coronavirus Disease (COVID-19) pandemic has unveiled a hitherto hidden reality: the vulnerability of the population living in long-term care facilities for the elderly (LTCF). To date, several scientific publications have revealed a concentration of up to 60% of deaths attributed to COVID-19 in such institutions. Most LTFC residents share the primary risk factors currently associated with increased morbimortality due to the COVID-19 infection. It is crucial to define actions to prevent SARS-CoV-2 spread in this environment, besides the usual measures of social distancing and isolation of the carriers of this disease. This paper proposes strategies for the investigation of this infection in LTCF residents and workers using laboratory tests available in Brazil. The early identification of individuals with SARS-CoV-2, who may actively and continuously spread the virus, allows adopting measures aimed at interrupting the local transmission cycle of this infection.

摘要 由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引发的感染，即2019新型冠状病毒病（COVID-19）大流行，揭示了一个此前未被认知的现实：老年长期护理机构（long-term care facilities for the elderly，以下简称LTCF）内居住人群的脆弱性。迄今为止，多项科学研究已证实，新冠相关死亡病例中多达60%集中于此类机构。绝大多数LTCF的入住者，均存在目前公认的、与新冠感染后发病与死亡风险升高相关的核心危险因素。除常规的社交距离管控与病毒感染者隔离措施外，明确可阻断该病毒在此类环境中传播的防控策略至关重要。本文基于巴西可获取的实验室检测手段，提出针对LTCF入住者及工作人员的感染调查策略。及早识别出可能持续活跃传播病毒的新冠感染者，有助于采取针对性措施中断该感染的本地传播循环。