NIHR London In-Vitro Diagnostics Cooperative, Imperial College London, London, UK.
Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Age Ageing. 2021 Sep 11;50(5):1442-1444. doi: 10.1093/ageing/afab101.
COVID-19 has devastated care homes. Point-of-care tests (POCTs), mainly using lateral flow devices (LFDs), have been deployed hurriedly without much consideration of their usability or impact on care workflow. Even after the pandemic, POCTs, particularly multiplex tests, may be an important control against spread of SARS-CoV-2 and other respiratory infections in care homes by enabling identification of cases. They should not, however, replace other infection control measures such as barrier methods and quarantine. Adherence to LFDs as implemented among care home staff is suboptimal. Other tests-such as point-of-care polymerase chain reaction and automated antigen tests-would also need to be accommodated into care home workflows to improve adherence. The up-front costs of POCTs are straightforward but additional costs, including staffing preparation and reporting processes and the impacts of false positive and negative tests on absence rates and infection days, are more complex and as yet unquantified. A detailed appraisal is needed as the future of testing in care homes is considered.
COVID-19 重创了养老院。床边即时检测（POCT）主要使用侧向流动设备（LFD），在没有充分考虑其可用性或对护理工作流程影响的情况下匆忙部署。即使在大流行之后，POCT，特别是多重检测，也可能通过识别病例成为控制养老院中 SARS-CoV-2 和其他呼吸道感染传播的重要手段。然而，它们不应替代其他感染控制措施，如屏障方法和隔离。护理人员对 LFD 的依从性并不理想。其他检测方法，如即时聚合酶链反应和自动抗原检测，也需要纳入护理院的工作流程，以提高依从性。POCT 的前期成本很简单，但其他成本，包括人员配备准备和报告流程，以及假阳性和假阴性测试对缺勤率和感染天数的影响，更为复杂，目前尚未量化。在考虑养老院检测的未来时，需要进行详细评估。
