SARS-COV-2 SURVEILLANCE IN LONG-TERM CARE FACILITIES: FEASIBILITY AND OUTCOMES OF AN ITALIAN WEEKLY-BASED SERVICE

Abstract

Intro: A weekly-based service was hypothesized as feasible and usable for surveillance, to monitoring cases in Long-Term Care Facilities (LTCFs) in the SARS-CoV-2 emergency in Italy. Methods: A web-based platform was set-up at the Italian National Institute of Health (ISS) at mid-2020. Protocols were validated and people trained to guarantee the delivery of a reliable weekly report to the Reference person of each participating Region, including the most relevant SARS-CoV-2 data and criticalities, i.e. new infections and outbreaks, deaths, hospitalization, isolations, vaccination coverage (VC), personal protective equipment and swabs. Findings: The service has been working at regimen since October 2020, available 24/7, the ISS database being fed by 7 Regions. In the period January 2021 – June 2022, 852 LCTFs (with over 22.000 residents) contributed to the service, with high adherence rate (92% on average in January 2021, 82% in March 2022 - end of emergency in Italy - and 77% in June 2022). Reports are delivered on Thursdays to inform Regional Contacts. So far, weekly data inconsistencies ranged between 6% and 10%; they were all solved by variables cross-check, comparisons with previous information, and direct interviews with the LCTFs’ operators. Regularly, data are processed to monitor trends, with focus on waves of infections. In particular, prevalence of infections reached 1.4% and SARS-CoV-2 positive deaths 0.4% in January 2021 (vaccination campaign just started), 5.5% and 0.2% respectively in January 2022 (VC ≈ 97%), 4.0% and <0.1% respectively in March 2022 (VC ≈ 97.5%). Discussion: Collected data allowed to monitoring impact of the measures taken to combat the pandemic, and resilience of LCTFs with respect to the most critical waves of infection. Conclusion: The weekly-based service was proved feasible with one ISS fulltime person required and usable for surveillance of SARS-CoV-2 cases and criticalities in LTCFs even after the declared end of the national emergency.