Abstract
BACKGROUND: Healthcare workers (HCWs) can be a source of SARS-CoV-2 within long-term care facilities (LTCFs); therefore, we analysed the data from a testing programme among LTCF employees. AIMS: The aim of this study was to investigate the prevalence of SARS-CoV-2 and its determinants among employees of LTCFs and the risk for fellow workers and residents. METHODS: Testing started at week 15, the first wave's peak, using nasopharyngeal swabs for PCR up to week 23. At the start of the second wave (week 32), testing resumed. RESULTS: A total of 32 457 test results were available from 446 LTCFs: 2% were positive: 1% in men, 2% in women, 2% in HCWs (=having patient contact), 1% in non-HCWs, higher in younger age groups. In total, 30 729 employees were tested once, 823 twice, 66 thrice and 4 four times. Prevalence was 13% during the first week of testing (week 15) and declined to 7% (week 16) to stay at around 1% (from week 17 until week 23). At the start of the second wave (week 31-33), the prevalence was around 3%. In 70% of positive tests, the employee was asymptomatic. CONCLUSIONS: Our study confirms the presence of HCWs with SARS-CoV-2 as a possible source of infection in LTCFs even when the incidence in the general population was low; 70% were asymptomatic. To control the spread of SARS-CoV-2 in LTCFs vaccination, infection prevention and control measures are necessary as well as testing of all LTCF HCWs during possible outbreaks, even if asymptomatic.