This report describes how universal, serial reverse transcription-polymerase chain reaction testing of residents in a long-term care skilled nursing facility in Los Angeles, California, helped to interrupt transmission of coronavirus disease 2019 in the facility.
On March 28, 2020, two residents of a long-term care skilled nursing facility (SNF) at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS) had positive test results for SARS-CoV-2.
During March 29–April 23, all SNF residents, regardless of symptoms, underwent serial (approximately weekly) nasopharyngeal SARS-CoV-2 RT-PCR testing, and positive results were communicated to the county health department. All SNF clinical and nonclinical staff members were also screened during March 29–April 10.
During this time, 19 of 99 (19%) residents and 8 of 136 (6%) staff members had positive test results; no further resident cases were identified on subsequent testing on April 13, April 22, and April 23. At the time of diagnosis, 14 of 19 residents were asymptomatic, eight of whom were presymptomatic; one patient died.
This report demonstrates the high prevalence of asymptomatic SARS-CoV-2 infection that can occur in SNFs, highlighting the potential for widespread transmission among residents and staff members before illness is recognized and demonstrating the utility of universal RT-PCR testing for COVID-19 after case identification in this setting.