{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:35:53Z","timestamp":1774460153498,"version":"3.50.1"},"reference-count":65,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T00:00:00Z","timestamp":1619049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SMWK SAB","award":["100257255"],"award-info":[{"award-number":["100257255"]}]},{"DOI":"10.13039\/501100001655","name":"DAAD","doi-asserted-by":"crossref","award":["57417782"],"award-info":[{"award-number":["57417782"]}],"id":[{"id":"10.13039\/501100001655","id-type":"DOI","asserted-by":"crossref"}]},{"name":"BMBF DLR","award":["01DQ20002"],"award-info":[{"award-number":["01DQ20002"]}]},{"DOI":"10.13039\/501100001655","name":"DAAD","doi-asserted-by":"crossref","award":["57479556"],"award-info":[{"award-number":["57479556"]}],"id":[{"id":"10.13039\/501100001655","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Different levels of control measures were introduced to contain the global COVID-19 pandemic, many of which have been controversial, particularly the comprehensive use of diagnostic tests. Regular testing of high-risk individuals (pre-existing conditions, older than 60 years of age) has been suggested by public health authorities. The WHO suggested the use of routine screening of residents, employees, and visitors of long-term care facilities (LTCF) to protect the resident risk group. Similar suggestions have been made by the WHO for other closed facilities including incarceration facilities (e.g., prisons or jails), wherein parts of the U.S., accelerated release of approved inmates is taken as a measure to mitigate COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>\n                      Here, the simulation model underlying the pandemic preparedness tool CovidSim 1.1 (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/covidsim.eu\/\" xlink:type=\"simple\">http:\/\/covidsim.eu\/<\/jats:ext-link>\n                      ) is extended to investigate the effect of regularly testing of employees to protect immobile resident risk groups in closed facilities. The reduction in the number of infections and deaths within the risk group is investigated. Our simulations are adjusted to reflect the situation of LTCFs in Germany, and incarceration facilities in the U.S.\n                    <\/jats:p>\n                    <jats:p>COVID-19 spreads in closed facilities due to contact with infected employees even under strict confinement of visitors in a pandemic scenario without targeted protective measures. Testing is only effective in conjunction with targeted contact reduction between the closed facility and the outside world\u2014and will be most inefficient under strategies aiming for herd immunity. The frequency of testing, the quality of tests, and the waiting time for obtaining test results have noticeable effects. The exact reduction in the number of cases depends on disease prevalence in the population and the levels of contact reductions. Testing every 5 days with a good quality test and a processing time of 24 hours can lead up to a 40% reduction in the number of infections. However, the effects of testing vary substantially among types of closed facilities and can even be counterproductive in U.S. IFs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The introduction of COVID-19 in closed facilities is unavoidable without a thorough screening of persons that can introduce the disease into the facility. Regular testing of employees in closed facilities can contribute to reducing the number of infections there, but is only meaningful as an accompanying measure, whose economic benefit needs to be assessed carefully.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0249588","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T15:33:33Z","timestamp":1619105613000},"page":"e0249588","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":26,"title":["Preventing COVID-19 spread in closed facilities by regular testing of employees\u2014An efficient intervention in long-term care facilities and prisons?"],"prefix":"10.1371","volume":"16","author":[{"given":"Henri Christian Junior","family":"Tsoungui Obama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nessma","family":"Adil Mahmoud Yousif","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Looli","family":"Alawam Nemer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre Marie","family":"Ngougoue Ngougoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon Akumah","family":"Ngwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-4969","authenticated-orcid":true,"given":"Miranda","family":"Teboh-Ewungkem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4138-1180","authenticated-orcid":true,"given":"Kristan Alexander","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,4,22]]},"reference":[{"key":"pone.0249588.ref001","article-title":"Coronavirus disease 2019 (COVID-19)","volume":"70","author":"WHO","year":"2020","journal-title":"Situation Report"},{"issue":"3","key":"pone.0249588.ref002","doi-asserted-by":"crossref","first-page":"105924","DOI":"10.1016\/j.ijantimicag.2020.105924","article-title":"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges","volume":"55","author":"CC Lai","year":"2020","journal-title":"Int J Antimicrob Agents"},{"issue":"10223","key":"pone.0249588.ref003","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"C Huang","year":"2020","journal-title":"Lancet"},{"key":"pone.0249588.ref004","doi-asserted-by":"crossref","unstructured":"Abdulamir AS, Hafidh RR. The possible immunological pathways for the variable immunopathogenesis of COVID\u201419 infections among healthy adults, elderly and children; 2020.","DOI":"10.29333\/ejgm\/7850"},{"key":"pone.0249588.ref005","doi-asserted-by":"crossref","unstructured":"Gao Z, Xu Y, Sun C, Wang X, Guo Y, Qiu S, et al. A systematic review of asymptomatic infections with COVID-19; 2020.","DOI":"10.1016\/j.jmii.2020.05.001"},{"key":"pone.0249588.ref006","first-page":"2020","author":"K Mizumoto","year":"2020","journal-title":"Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan"},{"key":"pone.0249588.ref007","article-title":"Ventilators are not the answer in Africa","author":"FD Madzimbamuto","year":"2020","journal-title":"African journal of primary health care & family medicine"},{"key":"pone.0249588.ref008","unstructured":"Nct. Hyperbaric Oxygen Therapy in Non-ventilated COVID-19 Patients. https:\/\/clinicaltrialsgov\/show\/NCT04409886. 2020."},{"key":"pone.0249588.ref009","doi-asserted-by":"crossref","unstructured":"Toniati P, Piva S, Cattalini M, Garrafa E, Regola F, Castelli F, et al. Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy; 2020.","DOI":"10.1016\/j.autrev.2020.102568"},{"key":"pone.0249588.ref010","article-title":"COVID-19 critical illness pathophysiology driven by diffuse pulmonary thrombi and pulmonary endothelial dysfunction responsive to thrombolysis","author":"HD Poor","year":"2020","journal-title":"Clinical and Translational Medicine"},{"key":"pone.0249588.ref011","article-title":"Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study","author":"H Shi","year":"2020","journal-title":"The Lancet Infectious Diseases"},{"key":"pone.0249588.ref012","article-title":"Causes of Death and Comorbidities in Patients with COVID-19","author":"S Elezkurtaj","year":"2020","journal-title":"medRxiv"},{"issue":"6","key":"pone.0249588.ref013","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S1473-3099(20)30243-7","article-title":"Estimates of the severity of coronavirus disease 2019: a model-based analysis","volume":"20","author":"R Verity","year":"2020","journal-title":"The Lancet Infectious Diseases"},{"key":"pone.0249588.ref014","article-title":"Covid-19: Impact of long term symptoms will be profound, warns BMA","author":"A Rimmer","year":"2020","journal-title":"BMJ"},{"key":"pone.0249588.ref015","article-title":"Risk factors for Covid-19 severity and fatality: a structured literature review","author":"D Wolff","year":"2020","journal-title":"Infection"},{"key":"pone.0249588.ref016","article-title":"Comparison of measures adopted to combat covid 19 pandemic by different countries in who regions","author":"S Davalgi","year":"2020","journal-title":"Indian Journal of Community Health"},{"key":"pone.0249588.ref017","article-title":"Differentiating COVID-19 Response Strategies","author":"H Liao","year":"2020","journal-title":"The Innovation"},{"key":"pone.0249588.ref018","article-title":"Analysing governmental response to the COVID-19 pandemic","author":"A Imtyaz","year":"2020","journal-title":"Journal of Oral Biology and Craniofacial Research"},{"issue":"8","key":"pone.0249588.ref019","first-page":"1","article-title":"Development and evaluation of a rapid CRISPR-based diagnostic for COVID-19","volume":"16","author":"T Hou","year":"2020","journal-title":"PLOS Pathogens"},{"key":"pone.0249588.ref020","article-title":"Clinical validation of a Cas13-based assay for the detection of SARS-CoV-2 RNA","author":"M Patchsung","year":"2020","journal-title":"Nature Biomedical Engineering"},{"key":"pone.0249588.ref021","unstructured":"Organization WH. Infection prevention and control guidance for long-term care facilities in the context of COVID-19: interim guidance, 21 March 2020; 2020."},{"key":"pone.0249588.ref022","unstructured":"of Public Health JHBS. Recommendations for a Metropolitan Covid-19 Response Special Emphasis Series -Guidance on Protecting Individuals Residing in Long-Term Care Facilities. Johns Hopkins Bloomberg School of Public Health; 2020."},{"key":"pone.0249588.ref023","article-title":"Epidemiology of covid-19 in a long-term care facility in King County, Washington","author":"TM McMichael","year":"2020","journal-title":"New England Journal of Medicine"},{"key":"pone.0249588.ref024","unstructured":"Beneker C. COVID-19 Jedes zweite Corona-Opfer lebte im Heim. ArzeZeitung. 2020."},{"key":"pone.0249588.ref025","article-title":"High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU\/EEA, May 2020","author":"C Adlhoch","year":"2020","journal-title":"Eurosurveillance"},{"key":"pone.0249588.ref026","article-title":"Characterization of COVID-19 in Assisted Living Facilities\u201439 States, October 2020","author":"SH Yi","year":"2020","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"key":"pone.0249588.ref027","unstructured":"Statistisches Bundesamt. Pflegestatistik\u2014Pflege im Rahmen der Pflegeversicherung Deutschlandergebnisse 2017. Statistisches Bundesamt (Destatis); 2018. Available from: https:\/\/www.destatis.de\/DE\/Themen\/Gesellschaft-Umwelt\/Gesundheit\/Pflege\/Publikationen\/Downloads-Pflege\/pflege-deutschlandergebnisse-5224001179004.pdf?__blob=publicationFile."},{"key":"pone.0249588.ref028","article-title":"COVID-19 in Correctional and Detention Facilities\u2014United States, February\u2013April 2020","author":"M Wallace","year":"2020","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"key":"pone.0249588.ref029","article-title":"How COVID-19\u2019s Disruption of the U.S. Correctional System Provides an Opportunity for Decarceration","author":"LA Abraham","year":"2020","journal-title":"American Journal of Criminal Justice"},{"key":"pone.0249588.ref030","doi-asserted-by":"crossref","unstructured":"Hawks L, Woolhandler S, McCormick D. COVID-19 in prisons and jails in the United States; 2020.","DOI":"10.1001\/jamainternmed.2020.1856"},{"key":"pone.0249588.ref031","article-title":"Incarceration And Its Disseminations: COVID-19 Pandemic Lessons From Chicago\u2019s Cook County Jail","author":"E Reinhart","year":"2020","journal-title":"Health affairs (Project Hope)"},{"key":"pone.0249588.ref032","unstructured":"E Carson A. Prisoners in 2019; 2020. Available from: https:\/\/www.bjs.gov\/content\/pub\/pdf\/p19.pdf."},{"key":"pone.0249588.ref033","unstructured":"Kaeble D, Cowhig M. Correctional Populations in the United States. Bureau of Justice Statistics. 2018."},{"key":"pone.0249588.ref034","first-page":"252157","article-title":"Correctional Populations in the United States, 2017-2018","author":"LM Maruschak","year":"2020","journal-title":"NCJ"},{"key":"pone.0249588.ref035","unstructured":"Carson AE, Sabol WJ. Aging of the State Prison Population, 1993\u20132013. Bureau of Justice Statistics Special Report. 2016."},{"key":"pone.0249588.ref036","doi-asserted-by":"crossref","unstructured":"The Marshall Project. 1 in 5 Prisoners in the US Has Had COVID-19; 2020. Available from: https:\/\/www.themarshallproject.org\/2020\/12\/18\/1-in-5-prisoners-in-the-u-s-has-had-covid-19.","DOI":"10.7748\/cnp.19.4.5.s1"},{"key":"pone.0249588.ref037","unstructured":"Maruschak LM, Berzofsky M, Unangst J. Medical Problems of State and Federal Prisoners and Jail Inmates, 2011\u201312. Bureau of Justice Statistics. 2015."},{"key":"pone.0249588.ref038","unstructured":"World Health Organization. Preventing and managing COVID-19 across long-term care services: policy brief, 24 July 2020; 2020."},{"key":"pone.0249588.ref039","volume-title":"European Organisation of Prison and Correctional Services","author":"EUROPRIS","year":"2020"},{"key":"pone.0249588.ref040","article-title":"The COVID-19 Pandemic Preparedness Simulation Tool: CovidSIM","author":"KA Schneider","year":"2020","journal-title":"SSRN"},{"key":"pone.0249588.ref041","article-title":"On the definition and the computation of the basic reproduction ratio R0 in models for infectious diseases in heterogeneous populations","author":"O Diekmann","year":"1990","journal-title":"Journal of Mathematical Biology"},{"key":"pone.0249588.ref042","article-title":"Global evidence for ultraviolet radiation decreasing COVID-19 growth rates","author":"T Carleton","year":"2020","journal-title":"Proceedings of the National Academy of Sciences of the United States of America"},{"key":"pone.0249588.ref043","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2019"},{"key":"pone.0249588.ref044","article-title":"Monitoring transmissibility and mortality of COVID-19 in Europe","author":"J Yuan","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0249588.ref045","doi-asserted-by":"crossref","first-page":"100","DOI":"10.15585\/mmwr.mm7003e3","article-title":"Evaluation of Abbott BinaxNOW Rapid Antigen Test for SARS-CoV-2 Infection at Two Community-Based Testing Sites-Pima County, Arizona, November 3-17, 2020","author":"JL Prince-Guerra","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0249588.ref046","article-title":"Performance Characteristics of a Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Antigen Detection Assay at a Public Plaza Testing Site in San Francisco","author":"G Pilarowski","year":"2021","journal-title":"The Journal of Infectious Diseases"},{"issue":"Issue 8","key":"pone.0249588.ref047","first-page":"CD013705","article-title":"Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection","author":"JAA Dinnes","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"pone.0249588.ref048","article-title":"Diagnostic accuracy of two commercial SARS-CoV-2 Antigen-detecting rapid tests at the point of care in community-based testing centers","author":"A Berger","year":"2020","journal-title":"medRxiv"},{"key":"pone.0249588.ref049","article-title":"Analytical and Clinical Performance of the Panbio COVID-19 Antigen-Detecting Rapid Diagnostic Test","author":"A Alemany","year":"2020","journal-title":"medRxiv"},{"key":"pone.0249588.ref050","article-title":"The evaluation of a newly developed antigen test (QuickNavi\u2122-COVID19 Ag) for SARS-CoV-2: A prospective observational study in Japan","author":"Y Takeuchi","year":"2021","journal-title":"medRxiv"},{"key":"pone.0249588.ref051","doi-asserted-by":"crossref","unstructured":"Petersen E, Koopmans M, Go U, Hamer DH, Petrosillo N, Castelli F, et al. Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics; 2020.","DOI":"10.1016\/S1473-3099(20)30484-9"},{"key":"pone.0249588.ref052","unstructured":"Statistisches Bundesamt (Destatis). Statistisches Jahrbuch\u2014Deutschland und Internationales 2019. Statistisches Bundesamt (Destatis); 2019. Available from: https:\/\/www.destatis.de\/DE\/Themen\/Querschnitt\/Jahrbuch\/statistisches-jahrbuch-2019-dl.pdf?__blob=publicationFile."},{"issue":"1","key":"pone.0249588.ref053","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1186\/s12889-019-7458-x","article-title":"Epidemiology and cost of seasonal influenza in Germany- A claims data analysis","volume":"19","author":"S Scholz","year":"2019","journal-title":"BMC Public Health"},{"key":"pone.0249588.ref054","first-page":"39","volume-title":"New Labor Forum","author":"HA Thompson","year":"2012"},{"key":"pone.0249588.ref055","volume-title":"Decarcerating correctional facilities during COVID-19: Advancing health, equity, and safety","year":"2021"},{"issue":"18","key":"pone.0249588.ref056","first-page":"1760","article-title":"The Challenge of Preventing COVID-19 Spread in Correctional Facilities","volume":"323","author":"R Rubin","year":"2020","journal-title":"JAMA"},{"key":"pone.0249588.ref057","doi-asserted-by":"crossref","first-page":"102363","DOI":"10.1016\/j.apgeog.2020.102363","article-title":"A country comparison of place-based activity response to COVID-19 policies","volume":"125","author":"G McKenzie","year":"2020","journal-title":"Applied geography (Sevenoaks, England)"},{"key":"pone.0249588.ref058","doi-asserted-by":"crossref","unstructured":"Scally G, Jacobson B, Abbasi K. The UK\u2019s public health response to covid-19; 2020.","DOI":"10.1136\/bmj.m1932"},{"key":"pone.0249588.ref059","doi-asserted-by":"crossref","unstructured":"Toomey EC, Conway Y, Burton C, Smith S, Smalle M, Chan XHS, et al. Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review; 2021.","DOI":"10.1017\/ice.2020.1243"},{"key":"pone.0249588.ref060","unstructured":"CDC NIOSH The National Institute for Occupational Safety and Health. Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings. Centers for Disease Control and Prevention. 2020."},{"key":"pone.0249588.ref061","article-title":"Fast-spreading COVID variant can elude immune responses","author":"E Callaway","year":"2021","journal-title":"Nature"},{"key":"pone.0249588.ref062","author":"KB Helle","year":"2020","journal-title":"Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?"},{"key":"pone.0249588.ref063","article-title":"Emergence of a new SARS-CoV-2 variant in the UK","author":"JW Tang","year":"2020","journal-title":"The Journal of infection"},{"issue":"46","key":"pone.0249588.ref064","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.15585\/mmwr.mm6946a3","article-title":"Characterization of COVID-19 in assisted living facilities\u201439 states, October 2020","volume":"69","author":"HY Sarah","year":"2020","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"pone.0249588.ref065","article-title":"The impact of COVID-19 vaccination campaigns accounting for antibody-dependent enhancement","author":"N Adil Mahmoud Yousif","year":"2021","journal-title":"bioRxiv"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0249588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T15:35:27Z","timestamp":1619105727000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0249588"}},"subtitle":[],"editor":[{"given":"Marco","family":"Cremonini","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,22]]},"references-count":65,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0249588","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.10.12.20211573","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,22]]}}}