How SNFs Can Identify Asymptomatic COVID Carriers with Surface Testing

A picture is becoming all too common with the renewed rise in COVID cases in SNFs and other senior care facilities: a staff member at your SNF tests positive for COVID-19, thus triggering the facility’s testing protocols including immediate contact tracing. This is a time-intensive process, leading to increased testing and anxiety among residents and staff alike. Diagnostic testing often can be an invasive, unpleasant procedure like deep nasal swabbing. What’s more, these tests might result in false negatives for some, which only adds stress and uncertainty to the community during an already stressful time.

Identifying positive cases as early as possible is a senior community’s best case scenario. More commonly, an asymptomatic person does not know he or she is infected, and in turn spreads the virus to other people within the community.


A great way for a SNF or senior community to avoid the problems in any scenario is through environmental surface testing. Rather than contact tracing based on one infected person, surface testing does just what it sounds like: it tests surfaces first to detect the presence of COVID, which in turn helps prioritize diagnostic testing for a small group of people who came in contact with the infected surface.


One company that has been making a difference within hundreds of senior facilities nationwide is Enviral Tech. This Oregon-based company, founded by scientists, is using surface testing to help skilled nursing providers and other businesses gain more visibility into the prevalence of pathogens like COVID and influenza within their facilities, while reducing cost and increasing the sense of safety among residents and staff.


How surface testing identifies COVID a week earlier than otherwise possible


Inspired by co-founder Dr. Stephen Turner’s work from a decade ago of detecting influenza in buildings, Enviral Tech was formed as the COVID-19 crisis emerged to provide accessible, alternative testing for senior care communities. The focus in senior care came directly from the founders’ passion to help prevent further outbreaks in these hard-hit communities, which have seen a mortality rate of over 40% and more than 100,000 deaths by late November.


To get started, the company ran a study with 52 different SNFs, senior care, long-term care and assisted living facilities in six states, testing those facilities twice a week over a three- to five-week period. After testing more than 2,600 individual samples from more than 600 high-touch surfaces, Enviral Tech detected an overall COVID-positivity rate of 2.46%. Additionally, about 35% of facilities were found to have some presence of COVID within their buildings.


“Even in that short amount of time, we observed not only a presence of COVID coming into a number of facilities, but in at least four of those cases the facilities didn’t know COVID was in their facilities until they had the surface test results,” CEO Shula Jaron says.


This is because the surface testing detects asymptomatic carriers in these facilities long before anyone shows symptoms.


“Our testing gives the facilities up to a week’s worth of early warning, which allows them to take immediate action and stop further outbreak within their facility,” she says.


As noted in their study, “The use of environmental surfaces as sentinels of viral presence allows cost reduction by aggregating the effect of testing many people in a single test. The detection of the virus in surfaces rather than directly from people avoids compliance issues related to consent and privacy.”


In short, surfaces in a building are great collectors of the viral status of everyone within that space.


Benefits of surface testing

As a result of Enviral Tech’s proactive approach, hundreds of facilities are now benefiting by being able to identify a smaller cohort of people who should undergo new or additional diagnostic testing. The frontend benefits include the need for fewer tests, which is cost and time savings for the facility. The backend benefits include greater trust and confidence among staff and residents alike.


“Surface testing gives data that tells operators whether their infection control processes are working,” Jaron says. “This reassures them that they are taking care of their residents and employees.”


The residents and employees know it, too. For staff members and residents, surface testing lifts an emotional burden, as they gain greater confidence that they are protected with a multi-pronged surveillance strategy. Enviral Tech recognizes the need for a rapid response and has committed to returning results to its customers within 24 hours of samples arriving in their lab.


There are marketing wins here as well. For all customers, Enviral Tech has created an Environmental COVID Testing web badge that can be used to let the community know the provider’s commitment to lowering risk. Those facilities who test COVID-free receive an electronic “no-COVID” certificate, which can be printed and displayed throughout the facility for staff, residents, and visitors to see. Altogether, Enviral Tech provides a competitive advantage for facilities wanting to demonstrate to families and the broader community that they are doing all they can to keep their residents and staff safe.


“Infection control is, of course, top of mind,” Sarah Silva, division president of Avamere, said in a recent Enviral Tech webinar. “So to be able to say, ‘This is what we’re doing, and this is how we’re doing it, and these are the tools and resources that we had available, and these are the outcomes that we are seeing’ — that has been incredibly powerful. Because if you’re unable to come and see your loved one, the most important thing was to be able to communicate with that family and tell them that we have protocols in place, and that if we were making adjustments, we could keep them informed.”


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