Surveillance of COVID-19 at long-term care facilities in the EU/EEA

Abstract

The high COVID-19 morbidity and mortality observed among residents in long-term care facilities (LTCF) in EU/EEA countries poses a major challenge for disease prevention and control in such settings. Furthermore, the lack of special surveillance systems and the differences in testing strategies and capacities among countries may have led to a significant under-ascertainment and under-reporting of cases, contributing to a general underestimation of the disease burden and mortality in LTCFs. One factor that may have contributed to the spread of COVID-19 within and between LTCFs relates to staff working while infectious, including symptomatic, pre-symptomatic, and asymptomatic cases. Other contributing factors may have been staff working in more than one facility, lac k of personal protective equipment (PPE), lack of training and testing and testing being limited to symptomatic individuals. Limited testing may have played a disproportionate role in under-ascertaining cases among this population. The high prevalence of neurological conditions such as dementia and neuropathic disorders among LTCF residents may result in atypical COVID-19 clinical presentations or the absence of evident signs or symptoms until the patients’ conditions deteriorate