2318. Utility of Routine Asymptomatic Post-Admission SARS-CoV-2 Screening in a Rehabilitation Facility
Bibliographic record
Abstract
Abstract Background SARS-CoV-2 testing is recommended for symptomatic patients, and asymptomatic testing following known exposure or on admission during periods of high community incidence. The role of post-admission asymptomatic screening is less clear. We evaluated the impact of routine weekly asymptomatic testing in a 178 bed rehabilitation setting that was experiencing frequent COVID-19 outbreaks following the emergence of the Omicron variant. Methods At baseline (April 1, 2021 to March 31, 2022), all patients were tested for SARS-CoV-2 in 4 situations: 1) routinely on admission (≤5 days); 2) in response to the development of new symptoms consistent with COVID-19 infection; 3) following exposure to a patient with COVID-19; and 4) as part of unit wide prevalence testing during suspected or confirmed outbreak. Routine weekly unit wide asymptomatic prevalence screening was introduced April 1, 2022 to March 31, 2023. An uncontrolled before-after study was performed assessing yield of these testing strategies and the incidence of healthcare associated-COVID-19 (HA-COVID). A case was defined as a patient testing positive for SARS-CoV-2 who had not been previously infected with COVID-19 within the preceding 90 days. Patients deemed to be recovered positive based on prospective assessment were excluded. Results The intervention was associated with nearly double the number of SARS-CoV-2 tests (8857 vs. 4672), of which 8513 (96.1%) and 4582 (98.1%) were eligible for inclusion during intervention and baseline, respectively. The before-after comparison of testing positivity was similar for overall, admission, and suspect/confirmed outbreaks with yield of 1.4%/0.5%/3.2% versus 2.6%/1.8%/4.9%, respectively. The addition of routine weekly testing had extremely low yield of 0.2% (8/4022). The incidence of HA-COVID increased during the intervention period (3.4 vs. 1.1 per 1000 patient-days; p< 0.001). Conclusion In a rehabilitation setting, the addition of routine weekly asymptomatic prevalence testing of patients was of low yield when added to surveillance in place on admission, and for symptomatic or exposed patients. Despite the increased risk of HA-COVID associated with the emergence of the Omicron variant, these findings do not support routine weekly post-admission testing. Disclosures Jerome A. Leis, MD MSc FRCPC, Ontario Hospital Association, Ministry of Attorney General of Ontario, Seneca College: Expert Testimony
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".