The COVID-19 pandemic’s entrance into the United States took direct aim at vulnerable older adults. And although it hasn’t let up, some senior living providers have had success in keeping residents safe through quick and decisive action.

Louisville, KY-based Atria Senior Living collaborated with Mayo Clinic Laboratories in Rochester, NY, on a rigorous testing program that began in April. To date, Atria has conducted more than 150,000 coronavirus tests on staff, residents and caregivers across its more than 200 communities. 

During a recent virtual town hall meeting for residents, families and staff last, Atria Senior Living Chairman and CEO John Moore discussed the testing collaboration, the prospects of a COVID-19 vaccine, and how residents and their families should approach the upcoming holidays.

Turning point

Moore said that Atria, which has a heavy concentration of communities in the Northeast, was just coming out of heavy disease activity in mid-April when it was at a turning point in its ability to manage through the pandemic.

“We were trying to figure out how to continue to run a business and protect residents and staff,” Moore said. “We concluded we wanted to do testing — asymptomatic and surveillance testing. The right next step was to see if we could test our staff and isolate any positive cases they may not know are pre-symptomatic or asymptomatic.”

During that first round of surveillance testing, Atria identified 100 pre-symptomatic or asymptomatic staff members. The company was able to isolate those employees until they recovered and prevent the spread of illness in their communities. 

William Morice, M.D., Ph.D., president of Mayo Clinic Laboratories, was part of a group of lab testing leaders who met with the White House Coronavirus Task Force. It was clear early on, Morice said, that the country was facing an unprecedented situation and that testing was key to maintaining the spread of illness.

“We were tasked with creating a test for a disease that had never been seen before,” Morice said, adding it was a concerted effort to work with industry partners to make testing available, get test results back quickly, and ensure accuracy and meaningful test results. 

Morice said Atria showed a “real commitment” from the start to best understand how to use the tests to keep residents and staff safe. Atria initially discussed doing a total of 15,000 to 18,000 tests. This week, the senior living provider expects to push 10,000 tests to Mayo Clinic Laboratories.

Testing plan

Atria focused the majority of its testing on staff members, hoping to find and isolate pre-symptomatic and asymptomatic employees who couldn’t avoid exposure in their daily life. That philosophy, Moore said, protects the whole community. Atria has completed more than 40,000 tests to date with residents, too, adding random surveillance testing in areas where disease activity is high as well as testing new residents and residents who leave and return to communities. 

“We believe that collaborating with Mayo Clinic Laboratories and working with state and local agencies, testing has been one of our greatest weapons in fighting COVID-19. We always want our residents in a position to live their best lives in any circumstance,” Moore said. “We still have a wary eye on COVID, and we’re not claiming to have figured everything out yet with this disease. However, we do feel good enough about our experience-tested pandemic procedures that we ‘pity the flu’ that tries to rear its head this fall and winter.”

Atria uses polymerase chain reaction, or PCR, lab-based testing, which Morice said is more sensitive and specific than rapid-results antigen tests. Although Morice said antigen tests are important because they are convenient, the challenge is they are not as specific and are more prone to false positives. Moore said Atria is trying to find a way to use PCR molecular testing with the federally supplied rapid antigen tests.

Layers of protection

And although testing is an important tool, Morice said that no single test will provide 100% certainty that someone does not have COVID-19.

“Testing is critically important, but it’s not the only layer of protection we can rely on,” he said. “Having multiple layers of protection — hand washing and social distancing, masking and minimizing exposure — revolves around policies put in place to keep people safe. It’s about layers of protection and having testing on top of that as essentially the safety net, so if something makes it through one layer or protection, we still have a sense of where it is and how we can manage the spread of the virus.”

Moore said Atria has in place testing; protocols around PPE, masking and hand hygiene; as well as trackers to follow resident symptoms day to day.

“It’s all about trying to put together the right system to give them the life we can give them to make living in a community better than living alone,” Moore said. “Hopefully, we’ll get through Thanksgiving and the holidays and get to the other side and get to the point we can share each other’s company.”