Evidence map›Paper›PMID 40177370›Full record

ArticleBMJ public health2025

Mass testing for discovery and control of COVID-19 outbreaks in adult social care: an observational study and cost-effectiveness analysis of 14 805 care homes in England.

Siyu Chen, Richard Creswell, Rachel Hounsell, Liberty Cantrell, Sumali Bajaj, Prabin Dahal, Joseph Tsui Lok Hei, Olumide Kolade, Ma'ayan Amswych, Reshania Naidoo and 8 more

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Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Siyu ChenPrinceton University High Meadows Environmental Institute, Princeton, New Jersey, USA.ORCID 0000-0001-9418-2527
Richard CreswellDepartment of Computer Science, University of Oxford, Oxford, UK.
Rachel HounsellNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0003-1393-4294
Liberty CantrellDepartment of Paediatrics, University of Oxford, Oxford, UK.ORCID 0000-0001-5413-7641
Sumali BajajDepartment of Biology, University of Oxford, Oxford, UK.
Prabin DahalNuffield Department of Medicine, University of Oxford, Oxford, UK.
Joseph Tsui Lok HeiDepartment of Biology, University of Oxford, Oxford, UK.
Olumide KoladeUK Health Security Agency, London, UK.
Ma'ayan AmswychErnst & Young, London, UK.
Reshania NaidooNuffield Department of Medicine, University of Oxford, Oxford, UK.
Tom FowlerUK Health Security Agency, London, UK.
Susan HopkinsUK Health Security Agency, London, UK.
Kasia StepniewskaUniversity of Oxford, Oxford, UK.
Merryn VoyseyDepartment of Paediatrics, University of Oxford, Oxford, UK.
Lisa WhiteDepartment of Biology, University of Oxford, Oxford, UK.
Rima ShrettaNuffield Department of Medicine, University of Oxford, Oxford, UK.
Ben LambertDepartment of Statistics; Pandemic Sciences Institute, University of Oxford, Oxford, UK.
EY-Oxford Health Analytics Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: We retrospectively evaluated the impact of COVID-19 testing among residents and staff in social care homes in England. Methods: We obtained 80 million reported PCR and lateral flow device (LFD) test results, from 14 805 care homes (residents and staff) in England, conducted between October 2020 and March 2022. These testing data were then linked to care home characteristics, test costs and 24 500 COVID-19-related deaths of residents. We decomposed the mechanism of outbreak mitigation into outbreak discovery and outbreak control and used Poisson regressions to investigate how reported testing intensity was associated with the size of outbreak discovered and to uncover its association with outbreak control. We used negative binomial regressions to determine the factors influencing COVID-19-related deaths subsequent to outbreaks. We performed a cost-effectiveness analysis of the impact of testing on preventing COVID-19-related deaths of residents. Results: Reported testing intensity generally reflected changes in testing policy over time, although there was considerable heterogeneity among care homes. Client type was the strongest determinant of whether COVID-19-related deaths in residents occurred subsequent to testing positive. Higher staff-to-resident ratios were associated with larger outbreak sizes but rapid outbreak control and a decreased risk of COVID-19-related deaths. Assuming our regression estimates represent causal effects, care home testing in England was cost-effective at preventing COVID-19-related deaths among residents during the pandemic and approximately 3.5 times more cost-effective prior to the vaccine rollout. Conclusions: PCR and LFD testing was likely an impactful intervention for detecting and controlling COVID-19 outbreaks in care homes in England and cost-effective for preventing COVID-19-related deaths among residents. In future pandemics, testing must be prioritised for care homes, especially if severe illness and death particularly affect older people or individuals with characteristics similar to care home residents, and an efficacious vaccine is unavailable.

Indexed as

COVID-19EpidemicsPublic Health

Identifiers

PMID40177370
PMCPMC11962772

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.