Environmental sampling for SARS-CoV-2 in long term care facilities: lessons from a pilot study

Area of Science:

• Infection Prevention and Control
• Environmental Microbiology
• Epidemiology

Background:

• Long-term care facilities (LTCF) are high-risk settings for SARS-CoV-2 transmission.
• Residents of LTCF are particularly vulnerable to severe outcomes from infection.
• Environmental surveillance offers a potential strategy for early pathogen detection and informing control measures.

Purpose of the Study:

• To pilot environmental sampling for SARS-CoV-2 in LTCF during outbreaks.
• To assess the feasibility and utility of detecting SARS-CoV-2 RNA on various surfaces.
• To collect contextual data on LTCF infrastructure, behaviors, and infection control measures.

Main Methods:

• Three LTCF in South West England participated in the pilot study.
• Investigators swabbed common touch-points and elevated surfaces (>1.5m) for SARS-CoV-2 RNA.
• Clinical, epidemiological, and IPC data were collected for context.

Main Results:

• SARS-CoV-2 RNA was detected across sampled LTCF, with higher positivity rates in rooms of infected residents.
• A greater proportion of elevated surfaces tested positive compared to common touch-points.
• Lower contamination levels were observed in a facility with enhanced Infection Prevention and Control (IPC) measures.

Conclusions:

• SARS-CoV-2 RNA is detectable on both frequently touched and elevated surfaces within LTCF during outbreaks.
• Environmental sampling shows promise for infection surveillance in LTCF.
• Further research is warranted to evaluate the feasibility and utility of this approach for IPC.