Pre-Procedure and Pre-Admission COVID-19 Testing No Longer Recommended for Asymptomatic Patients

Society for Healthcare Epidemiology of America says layers of protection are more effective and have fewer unintended harms
December 21, 2022

ARLINGTON, VA (December 21, 2022) — Healthcare facilities should no longer routinely screen symptom-free patients for COVID-19 upon admission or before procedures and rely instead on enhanced layers of infection prevention interventions, according to a recommendation from the Society for Healthcare Epidemiology of America (SHEA) published today in Infection Control & Hospital Epidemiology.  

“The small benefits that could come from asymptomatic testing at this stage in the pandemic are overridden by potential harms from delays in procedures, delays in patient transfers, and strains on laboratory capacity and personnel,” said Thomas R. Talbot, MD, MPH, the Chief Hospital Epidemiologist at Vanderbilt University Medical Center, and a member of the SHEA Board of Directors. “Since some tests can detect residual virus for a long period, patients who test positive may not be contagious.” 

The authors, members of the SHEA Board of Directors, noted a lack of evidence that asymptomatic testing reduces healthcare-associated COVID infections and suggest such testing requirements may disproportionally impact disadvantaged populations who have limited access to care and testing resources.

The authors also cited research that shows asymptomatic COVID testing added 1.89 hours to the length of stay in the emergency department of an academic health system, and another study from a specialty hospital showed it cost more than $12,500 to identify one asymptomatic COVID patient.

Facility risk assessments that include targeted scenarios, patient populations, or locations that may require added interventions along with community COVID-19 metrics should drive whether asymptomatic screening is part of institutional practices. While it is imperative to prevent healthcare-associated spread of respiratory pathogens, it is critical to examine which methods, when added upon core layers of infection prevention, work best to protect patients and healthcare providers.

A hierarchy of controls to prevent infections can include universal use of N95 respirators when performing certain procedures, active screening of healthcare providers for signs of COVID-19, unit layouts that reduce shared patient spaces, and enhanced cleaning and ventilation. 

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About ICHE
Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 41st out of 89 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at shea-online.orgfacebook.com/SHEApreventingHAIs and twitter.com/SHEA_Epi.

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