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Abstract Introduction Respiratory viral illnesses (RVI) pose a serious threat to LTC residents. Those with frailty often experience non-specific presentations causing delayed diagnosis and treatment of infection. To facilitate early RVI detection, a screening protocol was developed to evaluate changes in cognitive and functional status of LTC residents using the Single Question in Delirium (SQiD) with new Single Question in Functioning (SQiF) and Single Question in Reduced Mobility (SQiRM). This study aims to address: (i) If novel (SQiD/SQiF/SQiRM) screening was superior to public health in detecting COVID-19 in LTC, and; (ii) Did combining the novel and public health screening improve detection of COVID-19. Methods The novel screening protocol was integrated into daily screening for RVI at three LTC homes in Nova Scotia, Canada. Daily assessments were recorded in consenting residents. If any of the novel protocol was positive, the 4As Test (4AT) and Hierarchal Assessment of Balance and Mobility (HABAM) were evaluated and a positive 4AT and/or HABAM triggered an RVI swab for COVID-19. Area under the curve (AUC,) sensitivity and specificity analysis using PCR tests as the reference criterion was utilised. Between October 2021 to February 2024, 378 LTC residents consented to participate, resulting in 142 positive COVID-19 PCR tests. Preliminary results show public health screening had a sensitivity of 68.3%, specificity of 52.1% and AUC of 0.60. Novel protocol exhibited sensitivity of 12.0%, specificity of 85.2% and AUC of 0.49. Combining public health and novel screening yielded a sensitivity of 80.3%, specificity of 32.3% with a AUC of 0.59. Conclusions Preliminary results suggest that incorporating public health and novel protocol screening for daily RVI assessments in LTC is advantageous. Predictive accuracy is slightly less with combined screening, but sensitivity of the combined screening protocols remains high. Other information Ethical approval obtained from Nova Scotia Health Research Ethics Board # 1026558.