A Retrospective Review of COVID-19 Testing and Mitigation Strategies at Psychiatric Hospital and Subsequent COVID-19 Acquisition

BACKGROUND: Behavioral health settings present increased challenges in preventing transmission of infectious agents. Characterizing the relative effectiveness of various strategies, including testing for asymptomatic carriage of SARS-CoV-2 virus, will inform transmission reduction efforts in behavioral health settings. METHODS: A single-center retrospective study was conducted in an inpatient behavioral health hospital by reviewing COVID-19 mitigation and testing strategies with information collected from discharges between July 1, 2020, and February 28, 2021. RESULTS: During the study period, there were 3,694 total discharges and 3,229 unique admitted patients, including 86 (2.7%) patients who had positive SARS-CoV-2 polymerase chain reaction (PCR) test results. Pre-admission testing from non-congregate care settings (38, 44.1%), and testing after an in-hospital exposure (27, 31.4%) were the most common indications for testing among patients with a positive test. Up to 29 (33.7%) potentially acquired the infection during their hospitalization. Asymptomatic screening tests identified approximately two-thirds (55, 64.0%) of potentially contagious patients. CONCLUSION: Asymptomatic screening testing on admission and after exposure and universal masking were strong interventions to prevent SARS-CoV-2 transmission in this investigation Future studies of SARS-CoV-2 and other pathogens in behavioral health settings should endeavor to characterize the effectiveness of infection prevention interventions.