Preventing COVID-19 Outbreaks in Long-Term Care Facilities Through Preemptive Testing of Residents and Staff Members — Fulton County, Georgia, March–May 2020

Telford, Carson; Onwubiko, Udodirim; Holland, David; Turner, Kim; Prieto, Juliana; Smith, Sasha; Yoon, Jane; Brown, W. L.; Chamberlain, Allison T.; Gandhi, Neel R.; Williams, Steve; Khan, Fazle; Shah, Sarita

doi:10.15585/mmwr.mm6937a4

Cited by 63 publications

(60 citation statements)

References 3 publications

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“…10 The COVID-19 pandemic has highlighted the elevated risk of infectious disease outbreaks in LTCFs. 1,2,12 Efforts must be made to build, support, and monitor the capacity of LTCFs to protect the health and safety of residents through strict adherence to IPC recommendations. Guidelines for prevention and control of COVID-19 in LTCFs have been available since the early part of the epidemic.…”

Section: Discussionmentioning

confidence: 99%

“…Long-term care facility (LTCF) residents are among the populations at greatest risk of morbidity and mortality due to Coronavirus Disease 2019 (COVID-19). 1,2 As of July 29, 2020, Fulton County, Georgia, which covers the city of Atlanta, had received reports of 1, infections among residents from 45 LTCFs within its jurisdiction; 51% of COVID-19 deaths in Fulton County were attributed to LTCF residents. 3 In health care settings which require frequent and close contact between health care practitioners and patients, such as in LTCFs, infection prevention and control (IPC) measures such as the use of personal protective equipment (PPE), hand hygiene, and frequent cleaning and sanitization are essential to mitigate the spread of infectious disease.…”

Section: Introductionmentioning

confidence: 99%

“…Long‐term care facility (LTCF) residents are among the populations at greatest risk of morbidity and mortality due to Coronavirus Disease 2019 (COVID‐19) 1,2 . As of July 29, 2020, Fulton County, Georgia, which covers the city of Atlanta, had received reports of 1,183 COVID‐19 infections among residents from 45 LTCFs within its jurisdiction; 51% of COVID‐19 deaths in Fulton County were attributed to LTCF residents 3 .…”

Section: Introductionmentioning

confidence: 99%

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COVID‐19 Infection Prevention and Control Adherence in Long‐Term Care Facilities, Atlanta, Georgia

Telford

Bystrom

Fox

et al. 2021

J American Geriatrics Society

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Background/Objective Recommendations for infection prevention and control (IPC) of COVID‐19 in long‐term care settings were developed based on limited understanding of COVID‐19 and should be evaluated to determine their efficacy in reducing transmission among high‐risk populations. Design and Setting Site visits to 24 long‐term care facilities (LTCFs) in Fulton County, Georgia, were conducted between June and July 2020 to assess adherence to current guidelines, provide real‐time feedback on potential weaknesses, and identify specific indicators whose implementation or lack thereof was associated with higher or lower prevalence of COVID‐19. Participants Twenty‐four LTCFs were visited, representing 2,580 LTCF residents, among whom 1,004 (39%) were infected with COVID‐19. Measurements Overall IPC adherence in LTCFs was analyzed for 33 key indicators across five categories: Hand Hygiene, Disinfection, Social Distancing, PPE, and Symptom Screening. Facilities were divided into Higher‐ and Lower‐prevalence groups based on cumulative COVID‐19 infection prevalence to determine differences in IPC implementation. Results IPC implementation was lowest in the Disinfection category (32%) and highest in the Symptom Screening category (74%). Significant differences in IPC implementation between the Higher‐ and Lower‐prevalence groups were observed in the Social Distancing category (Higher‐prevalence group 54% vs Lower‐prevalence group 74%, P < .01) and the PPE category (Higher‐prevalence group 41% vs Lower‐prevalence group 72%, P < .01). Conclusion LTCFs with lower COVID‐19 prevalence among residents had significantly greater implementation of IPC recommendations compared to those with higher COVID‐19 prevalence, suggesting the utility in adhering to current guidelines to reduce transmission in this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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COVID‐19 Infection Prevention and Control Adherence in Long‐Term Care Facilities, Atlanta, Georgia

Telford

Bystrom

Fox

et al. 2021

J American Geriatrics Society

Self Cite

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“…The significance of COVID-19 outbreaks in nursing homes is widely known, and such outbreaks are often a result of a lack of testing and close contact with healthcare providers. A plausible measure could be to conduct consistent facility-wide testing, which has been shown to prevent outbreaks in nursing homes [23].…”

Section: Discussionmentioning

confidence: 99%

A Multiple Linear Regression Analysis of Rural-Urban COVID-19 Risk Disparities in Texas

Luo¹,

Zhong

Sun

et al. 2021

Preprint

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As the number of COVID-19 cases in the U.S. rises, the differential impact of the pandemic in urban and rural regions becomes more pronounced, and the major factors relating to this difference remain unclear. Using the 254 counties of Texas as units of analysis, we utilized multiple linear regression to investigate the influence of 83 county-level predictor variables including race demographics, age demographics, healthcare and financial status, and prevalence of and mortality rate from COVID-19 risk factors on the incidence rate and case fatality rate from COVID-19 in Texas on September 15, 2020. Here, we report that urban counties experience, on average, 41.1% higher incidence rates from COVID-19 than rural counties and 34.7% lower case fatality rates. Through comparisons between our models, we found that this difference was largely attributable to four major predictor variables: namely, the proportion of elderly residents, African American residents, and Hispanic residents, and the presence of large nursing homes. According to our models, counties with high incidence rates of COVID-19 are predicted to have high proportions of African American residents and Hispanic residents coupled with low proportions of elderly residents. Furthermore, we found that counties with the highest case fatality rates are predicted to have high proportions of elderly residents, obese residents, and Hispanic residents, coupled with low proportions of residents ages 20-39 and residents who report smoking cigarettes. In our study, major variables and their effects on COVID-19 risk are quantified, highlighting the most vulnerable populations and regions of Texas.

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“…During the beginning of the coronavirus disease 2019 (COVID-19) pandemic, nursing homes were identified as congregate settings at high risk for outbreaks of COVID-19 ( 1 , 2 ). Their residents also are at higher risk than the general population for morbidity and mortality associated with infection with SARS-CoV-2, the virus that causes COVID-19, in light of the association of severe outcomes with older age and certain underlying medical conditions ( 1 , 3 ).…”

mentioning

confidence: 99%

Rates of COVID-19 Among Residents and Staff Members in Nursing Homes — United States, May 25–November 22, 2020

Bagchi¹,

Mak²,

Li³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

112

108

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On January 8, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).During the beginning of the coronavirus disease 2019 (COVID-19) pandemic, nursing homes were identified as congregate settings at high risk for outbreaks of 2). Their residents also are at higher risk than the general population for morbidity and mortality associated with infection with SARS-CoV-2, the virus that causes COVID-19, in light of the association of severe outcomes with older age and certain underlying medical conditions (1,3). CDC's National Healthcare Safety Network (NHSN) launched nationwide, facility-level COVID-19 nursing home surveillance on April 26, 2020. A federal mandate issued by the Centers for Medicare & Medicaid Services (CMS), required nursing homes to commence enrollment and routine reporting of COVID-19 cases among residents and staff members by May 25, 2020. This report uses the NHSN nursing home COVID-19 data reported during May 25-November 22, 2020, to describe COVID-19 rates among nursing home residents and staff members and compares these with rates in surrounding communities by corresponding U.S. Department of Health and Human Services (HHS) region.* COVID-19 cases among nursing home residents increased during June and July 2020, reaching 11.5 cases per 1,000 resident-weeks (calculated as the total number of occupied beds on the day that weekly data were reported) (week of July 26). By mid-September, rates had declined to 6.3 per 1,000 resident-weeks (week of September 13) before increasing again, reaching 23.2 cases per 1,000 residentweeks by late November (week of November 22). COVID-19 cases among nursing home staff members also increased during June and July (week of July 26 = 10.9 cases per 1,000 resident-weeks) before declining during August-September (week of September 13 = 6.3 per 1,000 resident-weeks); rates increased by late November (week of November 22 = 21.3 cases per 1,000 resident-weeks). Rates of COVID-19 in the surrounding communities followed similar trends. Increases in community rates might be associated with increases in nursing home COVID-19 incidence, and nursing home mitigation strategies need to include a comprehensive plan to monitor local SARS-CoV-2 transmission and minimize highrisk exposures within facilities.

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Preventing COVID-19 Outbreaks in Long-Term Care Facilities Through Preemptive Testing of Residents and Staff Members — Fulton County, Georgia, March–May 2020

Cited by 63 publications

References 3 publications

COVID‐19 Infection Prevention and Control Adherence in Long‐Term Care Facilities, Atlanta, Georgia

COVID‐19 Infection Prevention and Control Adherence in Long‐Term Care Facilities, Atlanta, Georgia

A Multiple Linear Regression Analysis of Rural-Urban COVID-19 Risk Disparities in Texas

Rates of COVID-19 Among Residents and Staff Members in Nursing Homes — United States, May 25–November 22, 2020

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