Researchers Tell Hospitals to Stop Testing Admissions for COVID-19

A health care professional prepares to enter a COVID-19 patient's room in a file photo. Megan Jelinger/AFP via Getty Images

A committee of infectious disease researchers issued a statement this week urging hospitals to stop testing new admissions for COVID-19, saying that doing so will extend patients’ wait times.

Researchers and doctors affiliated with the Society for Healthcare Epidemiology of America, a nonprofit organization, stated that hospitals shouldn’t automatically test for the virus because it can cause “delays in patient placement” and “postponement of necessary procedures” unrelated to COVID-19, according to a research paper published online by Cambridge University.

“As the pandemic evolved, asymptomatic patient screening had some unintended consequences,” they wrote. “Adverse outcomes related to asymptomatic testing include [those aforementioned delays as well as] strains on laboratory and testing personnel and resources, and increased costs.

“Importantly, assessments of the costs associated with asymptomatic screening are affected by the prevalence of infection in the population tested and the type of test utilized. ... An increasing number of studies have noted the relatively low yield of identification of so-called ’silent' infections, with positivity rates from such testing often falling below 1%.”

A summary of the article stated that “the use of asymptomatic screening is a unique yet resource-intensive tool that arguably has been overused“ and that although it’s imperative to prevent healthcare-associated spread of respiratory pathogens, ”we must critically assess interventions that, when added upon core layers of infection prevention, may not attain the intended impact and may have unintended consequences for patients and [health care personnel].”

A patient registers with administration staff at St George Hospital in Sydney on May 15, 2020. Lisa Maree Williams/Getty Images

A study released in May by the Cook County Department of Emergency Medicine in Illinois shows that routine testing for asymptomatic COVID-19 extended patients’ wait times in emergency rooms by about seven hours on average.

The authors of the Cambridge paper cited previous research that found that testing added 1.89 hours to the length of an emergency department stay. Another study they cited found that it cost about $12,500, on average, to identify one asymptomatic COVID-19 patient via asymptomatic testing policies.

Such testing regimes, they concluded, have little to no benefit if other prevention measures are intact in hospitals and other facilities. That includes proper ventilation and hand hygiene, according to the paper.

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

SARS-CoV-2 is the virus that causes COVID-19.

A member of the group, Dr. Thomas Talbot—an epidemiologist at Vanderbilt University—described the benefits of routine COVID-19 testing as “small” and easily overridden by potential harms.

“The small benefits that could come from asymptomatic testing at this stage in the pandemic are overridden by potential harms from delays in procedures, delays in patient transfers, and strains on laboratory capacity and personnel,” Talbot said. “Since some tests can detect residual virus for a long period, patients who test positive may not be contagious.”