Characteristics of respiratory outbreaks in care homes during four influenza seasons, 2011–2015

Gallagher, Nancy; Johnston, Jillian; Crookshanks, H.; Nugent, Ciara; Irvine, Nathaniel J

doi:10.1016/j.jhin.2017.08.020

Cited by 11 publications

(4 citation statements)

References 11 publications

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“…Care homes that provided nursing care were more likely to contain test positive residents (RR 7.88, 95% CI 1.08e57.27). This finding, in line with findings from other studies looking into seasonal influenza and pneumonia in care homes [24,25], and this could be due to the higher level of dependency of nursing home residents [4], necessitating closer contact from those providing care which in turn facilitates transmission. Care homes employing agency staff were similarly at a greater risk of having residents test positive (RR 8.40, 95% CI 1.16e60.84).…”

Section: Discussionsupporting

confidence: 90%

COVID-19 testing in outbreak-free care homes: what are the public health benefits?

Green

Tulloch

Tunnah

et al. 2021

Journal of Hospital Infection

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Background: COVID-19 care home outbreaks represent a significant proportion of COVID-19 morbidity and mortality in the UK. National testing initially focused on symptomatic care home residents, before extending to asymptomatic cohorts. Aim: The aim was to describe the epidemiology and transmission of COVID-19 in outbreak free care homes. Methods: A two-point prevalence survey of COVID-19, in 34 Liverpool care homes, was performed in April and May 2020. Changes in prevalence were analysed. Associations between care home characteristics, reported infection, prevention and control interventions, and COVID-19 status were described and analysed. Findings: No resident developed COVID-19 symptoms during the study. There was no significant difference between: the number of care homes containing at least one test positive resident between the first (17.6%, 95% confidence interval (CI) 6.8e34.5) and second round (14.7%, 95% CI 5.0e31.1) of testing (p>0.99); and the number of residents testing positive between the first (2.1%, 95% CI 1.2e3.4) and second round (1.0%, 95% CI 0.5e2.1) of testing (P¼0.11). Care homes providing nursing care (risk ratio (RR) 7.99, 95% CI 1.1e57.3) and employing agency staff (RR 8.4, 95% CI 1.2e60.8) were more likely to contain test positive residents. Closing residents shared space was not associated with residents testing positive (RR 2.63, 95% CI 0.4e18.5). Conclusions: Asymptomatic COVID-19 care homes showed no evidence of disease transmission or development of outbreaks; suggesting that current infection prevention and control measures are effective in preventing transmission. Repeat testing at two to three weeks had limited or no public health benefits over regular daily monitoring of staff and DOI of companion article:

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Section: Discussionsupporting

confidence: 90%

COVID-19 testing in outbreak-free care homes: what are the public health benefits?

Green

Tulloch

Tunnah

et al. 2021

Journal of Hospital Infection

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“…That care homes are particularly vulnerable to the rapid spread of infectious diseases has been described for outbreaks of other infectious diseases, notably norovirus 26 , influenza and other respiratory infections27 . Fell28 investigated the preparedness of care homes and concluded that at the time care homes were inadequately prepared for coping with an influenza pandemic.…”

mentioning

confidence: 98%

Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK

Brainard

Rushton

Winters

et al. 2020

Journal of Public Health

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Background Residential care homes for the elderly are important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease. Methods We undertook secondary analysis of 248 care homes in Norfolk, UK. The dataset counted nurses, care workers and non-care workers, their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) and residents (if any) with suspected COVID-19 in the period 6 April to 6 May 2020. Concurrent descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and sanitizer) were in the data. PPE access was categorized as (most to least) green, amber or red. We undertook two-stage modelling, first for suspected COVID-19 cases amongst residents and second relating any increases in case counts after introduction to staffing or PPE levels. Results Counts of non-care workers had strongest relationships ( P < 0.05) to introduction of suspected SARS-CoV-2 to the homes. Higher staff levels and more severe PPE shortages were linked to higher case counts ( P < 0.05) during the monitoring period. Conclusion Managing aspects of staff interaction with residents and some working practices might reduce ingression to and spread of COVID-19-like illness within care homes.

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“…That care homes are particularly vulnerable to the rapid spread of infectious diseases has been described for outbreaks of other infectious diseases, especially norovirus [18], influenza and other respiratory infections [19]. In contrast to outbreaks in health care settings, outbreaks in care homes are relatively less well researched.…”

Section: Discussionmentioning

confidence: 99%

Introduction to and spread of COVID-19 in care homes in Norfolk, UK

Brainard

Rushton

Winters

et al. 2020

Preprint

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BACKGROUND: Residential care homes for the elderly have been important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease. METHODS: We undertook a secondary analysis of a dataset about 248 care homes in the county of Norfolk, eastern England. The dataset recorded categories of staff (nurses, care workers and non-care workers), their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) in the period 6 April -6 May 2020. Counts of residents (if any) at each care home with COVID-19 were also available, as well as descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and Sanitiser). PPE access was categorised as (most to least) green, amber or red. We undertook two stage modelling, first for any detection of COVID-19 in the homes, and a second model to relate any increases in case counts after introduction to staffing or PPE levels. RESULTS: We found that the counts of non-care workers had strongest relationships (and only link significant at p < 0.05) to any introduction of SARS-CoV-2 to the homes. After a home had at least one detected case, higher staff levels and more severe PPE shortages were most linked to higher case counts (p < 0.05) during the monitoring period. CONCLUSION: Better managing aspects of staff interaction with residents and some working practices should help reduce ingression to and spread of COVID-19 within residential homes for the elderly.

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Characteristics of respiratory outbreaks in care homes during four influenza seasons, 2011–2015

Cited by 11 publications

References 11 publications

COVID-19 testing in outbreak-free care homes: what are the public health benefits?

COVID-19 testing in outbreak-free care homes: what are the public health benefits?

Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK

Introduction to and spread of COVID-19 in care homes in Norfolk, UK

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