Hebrew SeniorLife Advocates Universal Testing Response to COVID-19

BOSTON – In a letter to the editor in the Journal of the American Geriatrics Society, Harvard Medical School Affiliate Hebrew SeniorLife (HSL) medical staff Innokentiy Bakaev, M.D., Tammy Retalic, M.S., R.N., and Helen Chen, M.D., outlined the need for universal testing to prevent the spread of COVID-19 in post-acute and long-term chronic care hospitals.

Hebrew Rehabilitation Center (HRC), part of Hebrew SeniorLife, is a 723-bed multi-campus organization that provides both long-term chronic care and post-acute rehabilitation services. In many ways, HRC is not a typical long-term chronic care organization as it operates within an integrated senior health care organization with a continuum of care that includes home health services, assisted living, and independent living units. The average age of HRC’s patients is 89 years, which increases their risk for worse outcomes from COVID-19 infections.

In February 2020, after confirmed cases were reported at a Washington state nursing home, HRC began taking steps to prepare. Clinical and operational leaders convened with two major goals – avoidance or delay in emergence of COVID-19 infections and preparedness for possible outbreaks at any of its sites. HSL closely followed recommendations from the Centers for Disease Control and Prevention (CDC) and the Massachusetts Department of Public Health, building on already strict infection control procedures. Within two weeks, visitors were restricted from all campuses, nonclinical staff began working remotely, daily staff temperatures and symptom screenings were performed, and social distancing procedures were instituted at all sites.

Although strong infection protocols were helpful in delaying the first case, what was critical in mitigating the spread of the virus was the development of testing protocols in partnership with Beth Israel Deaconess Medical Center, a major acute-care Boston teaching hospital. This partnership enabled HSL to deploy universal testing in its inpatient facilities. This allowed HSL to assess the penetration of infection on each unit, which helped our decisions moving forward. Identification of asymptomatic COVID-19 positive cases was a major advantage delivered by the universal testing approach.

“Our rapid implementation of extensive testing procedures enabled appropriate clinical management, cohorting of patients, and education of staff,” said Dr. Chen, HSL Chief Medical Officer. “Our experience highlights the importance of careful planning, universal testing, cohorting, and an acute hospital and long-term care facility partnership to limit the effects of disease outbreaks during a pandemic.” 

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Based in Boston, the nonprofit organization has provided communities and health care for seniors, research into aging, and education for geriatric care providers since 1903. For more information about Hebrew SeniorLife, visit http://www.hebrewseniorlife.org and our blog, or follow us on Facebook, Instagram, Twitter, and LinkedIn.