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

Abstract

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.

Temporal Trends in COVID-19 Incidence in Two Healthcare Worker Cohorts

“…A national US study of COVID-19 rates over time among nursing home HCWs observed that these incidence data paralleled community trends. 8 The Toronto-based analysis cited previously also showed the HCW rates paralleled and even preceded wider population trends. 1 …”

Effectiveness of the Pfizer-BioNTech COVID-19 Vaccine Among Residents of Two Skilled Nursing Facilities Experiencing COVID-19 Outbreaks — Connecticut, December 2020–February 2021

“…Data on residents were abstracted starting on the date of their SNF's first vaccination clinic or their admission into the facility, whichever occurred later. Electronic medical record data included demographic characteristics, facility admission and discharge dates, vaccination dates, symptoms of COVID-19 occurring within 7 days before or 14 days after a positive test result, presence of underlying medical conditions associated with potential increased risk for severe COVID-19 illness, ¶ 1 ; Gordana Derado, PhD 1 ; Jennifer R. Verani, MD 1 ; Stephanie J. Schrag, DPhil 1 ; John A. Jernigan, MD 1 ; Vivian H. Leung, MD 3, † ; Sunil Parikh, MD 4, † and death. SARS-CoV-2 test dates, test types, and results were also obtained from the electronic medical record.…”

Early COVID-19 First-Dose Vaccination Coverage Among Residents and Staff Members of Skilled Nursing Facilities Participating in the Pharmacy Partnership for Long-Term Care Program — United States, December 2020–January 2021

“…Residents and staff members of long-term care facilities (LTCFs), because they live and work in congregate settings, are at increased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1,2). In particular, skilled nursing facilities (SNFs), LTCFs that provide skilled nursing care and rehabilitation services for persons with complex medical needs, have been documented settings of COVID-19 outbreaks (3).…”