Virus Outbeak Nursing Homes

Mandatory COVID-19 testing for staff is coming to long-term care centers after universal, voluntary testing initially saw weak results.

At Friday's coronavirus news conference, Dr. Karyl Rattay, director of the Division of Public Health, said the mandatory testing, for staff, would begin June 1, giving long-term care centers time to ramp up.

"This is very important that we are monitoring infection in long-term care, but also is representative of what is going on in the community," she said.

On May 5, the state declared testing--supported by DPH-voluntary, but Rattay said after just 15 percent of centers returned COVID-19 tests, a mandate was coming. Shortly after that, Rattay said 75 percent of centers submitted tests.

Through the process, Rattay learned centers were worried that if employees tested positive, they'd see staff shortages; she noted provisions were in place to assist with staffing.

Cheryl Heiks, executive director of the Delaware Health Care Facilities Association called the testing for staff "key" to protecting residents, who are among the most vulnerable to contracting and dying from COVID-19. Nearly 89 percent of Delaware's 332 deaths from COVID-19, as of Tuesday morning, have been in long-term care centers.

“Mandated testing will give us an advantage in that we will be able to count on additional support from our state partners to identify asymptomatic staff and residents, to help provide treatment earlier and prevent them from spreading the virus in the long-term-care setting and in their communities. We stand with the American Health Care Association (AHCA) in that we will continue to work closely with state and federal health officials to ensure that we are meeting all guidance and taking each and every action possible to protect our residents the most vulnerable population in the country as well as our healthcare workers - the heroes on the front lines," said Heiks.

But she cautioned no test is 100 percent accurate.

"Because of incubation periods, test results do not always identify when a person is actually infected – therefore infection control procedures including masks are still required in long term care settings. The public should realize, that increased testing may demonstrate an increase in confirmed cases – providing important new information about existing conditions – it does not necessarily mean the facility is experiencing an increase in the number of new cases of the virus," said Heiks.

Rattay said cost was an additional barrier to the testing as well. A recent analysis by the American Health Care Association found that testing all staff  and residents of nursing homes in Delaware, just once, would cost $1.3 million. That figure did not include testing at assisted living facilities.

"We will be doing the testing in our [state public health] lab as long as supplies allow for the long-term care staff testing," she said.

Governor John Carney said testing needs to occur on a regular basis--not just once--and data will be used to drive testing.

"We'll continue to do broad-based community testing and then respond to hot spots," he said. "More intense testing, globally, symptomatic and asymptomatic, and then contact tracing and so figuring out where those people are--much like it was at the very beginning with the little group at the University of Delaware that had traveled out-of-state and came back with the virus."

Rattay said the testing will occur weekly, for staff, in long-term care facilities.

"It really is the best way to protect individuals in these facilities, and we were hearing that this is something staff would like as well, they would like to know," said Rattay.

The testing will be supported, at least in part, by a $67 million grant from the Centers for Disease Control for epidemiology and laboratory capacity. 

"It includes, for us, hiring staff to enhance our laboratory, and our surveillance, and our data system...that we need. These funds will enable us to stand up the testing to strengthen that testing, and the electronic reporting systems that are needed for laboratory testing as well as for surveillance," said Rattay.