期刊
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
卷 22, 期 10, 页码 2003-+出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2021.07.021
关键词
COVID-19; SARS-CoV-2; nursing home; long-term care
The COVID-19 outbreak in long-term care homes in Canada showed that the majority of residents exhibited typical COVID-19 symptoms, a high attack rate was linked to a high degree of interconnectedness exacerbated by staffing shortages, and clustering of infections within multibedded rooms was common.
Objectives: COVID-19 has had devastating effects on long-term care homes across much of the world, and especially within Canada, with more than 50% of the mortality from COVID-19 in 2020 in these homes. Understanding the way in which the virus spreads within these homes is critical to preventing further outbreaks. Design: Retrospective chart review. Settings and Participants: Long-term care home residents and staff in Ontario, Canada. Methods: We conducted a longitudinal study of a large long-term care home COVID-19 outbreak in Ontario, Canada, using electronic medical records, public health records, staff assignments, and resident room locations to spatially map the outbreak through the facility. Results: By analyzing the outbreak longitudinally, we were able to draw 3 important conclusions: (1) 84.5% had typical COVID-19 symptoms and only 15.5% of residents had asymptomatic infection; (2) there was a high attack rate of 85.8%, which appeared to be explained by a high degree of interconnectedness within the home exacerbated by staffing shortages; and (3) clustering of infections within multibedded rooms was common. Conclusion and Implications: Low rates of asymptomatic infection suggest that symptom-based screening in residents remains very important for detecting outbreaks, a high degree of interconnectedness explains the high attack rate, and there is a need for improved guidance for homes with multibedded rooms on optimizing resident room movement to mitigate spread of COVID-19 in long-term care homes. (c) 2021 AMDA -The Society for Post-Acute and Long-Term Care Medicine.
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