Home Health & Hospice Week

Beware of overreliance on the tool.

The Department of Health and Human Services is following through on its commitment to include home health and hospice agencies in the pool of frontline workers who are receiving 150 million rapid response COVID-19 tests. But the recent White House outbreak illustrates how this type of testing is far from a solution to the pandemic.

HHS announced the plan to distribute the tests last month (see HCW by AAPC, Vol. XXIX, No. 34). “Those home health agencies and hospices set to receive some of the Abbott BinaxNOW tests for COVID-19 should have received them the week of September 28,” notes the National Association for Home Care & Hospice.

Providers hoping the cheap and easy tests would serve to protect staff and patients from spreading the virus should heed the cautionary tale of the recent infection of President Trump and many associates at the White House.

“From the early days of the pandemic, federal officials have relied too heavily on … rapid tests, with little or no mechanism to identify and contain cases that fell through the diagnostic cracks,” the New York Times says in an Oct. 6 report. The rapid response tests are less accurate than lab tests that use a polymerase chain reaction (PCR) and they more frequently miss infections or mistakenly designate healthy people as infected, the newspaper highlights.

In a Sept. 25 webinar providing education about the test, Abbott told participants that the tests could be used for asymptomatic as well as symptomatic staff, an off-label practice. But in the Times piece, medical experts take issue with that assumption.

“We don’t have data to show how this test is going to perform in [the asymptomatic] population,” infectious disease physician Krutika Kuppalli told the Times.

Studies are underway evaluating the rapid test’s effectiveness in asymptomatic subjects. Abbot has told experts that it thinks asymptomatic testing is likely to be successful, the newspaper adds.

Regardless of the tests’ efficacy, they should not be used as the only tool to combat the spread of COVID-19, health experts agree.

Nonetheless, regular testing of visiting staff may help potential patients feel more at ease with receiving in-home care.

For example: The Waco Tribune-Herald recently profiled home health worker Cindy Shepherd with Visiting Angels in Waco, Texas. To enter facilities, Shepherd has been tested up to twice a week since the pandemic began, she told the newspaper.