Evaluating Policies to Decrease the Risk of Introducing SARS-CoV-2 Infections to Nursing Home Facilities

Adams, John W.; Jones, Kasey; Preiss, Sandy; Hadley, Emily; Segelman, Micah

doi:10.1177/07334648231155873

Cited by 1 publication

(1 citation statement)

References 46 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Researchers who have explored the impact of non-pharmaceutical interventions in models of COVID-19 spread with different age groups typically distinguish the age groups based on susceptibility to infection, contact rates, and the probability of severe outcome or death upon infection, but do not consider the impact of age-group-specific recovery rates [20][21][22][23][24][25][26][27]. When such models do allow for longer recovery times for older or more vulnerable individuals, including in models that specifically seek to represent vulnerable individuals residing in care homes, the models are highly-detailed in structure, involving many disease-state compartments and associated parameters [28][29][30][31][32][33][34][35][36][37][38]; the authors of these studies have not made comprehensive explorations of the model results across broad ranges of parameter values, but rather investigate model outcomes for different intervention scenarios using narrow ranges of epidemiological parameter values taken to be relevant to COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Predictions from standard epidemiological models of consequences of segregating and isolating vulnerable people into care facilities

Hickey,

Rancourt

2023

PLoS ONE

View full text Add to dashboard Cite

Objectives Since the declaration of the COVID-19 pandemic, many governments have imposed policies to reduce contacts between people who are presumed to be particularly vulnerable to dying from respiratory illnesses and the rest of the population. These policies typically address vulnerable individuals concentrated in centralized care facilities and entail limiting social contacts with visitors, staff members, and other care home residents. We use a standard epidemiological model to investigate the impact of such circumstances on the predicted infectious disease attack rates, for interacting robust and vulnerable populations. Methods We implement a general susceptible-infectious-recovered (SIR) compartmental model with two populations: robust and vulnerable. The key model parameters are the per-individual frequencies of within-group (robust-robust and vulnerable-vulnerable) and between-group (robust-vulnerable and vulnerable-robust) infectious-susceptible contacts and the recovery times of individuals in the two groups, which can be significantly longer for vulnerable people. Results Across a large range of possible model parameters including degrees of segregation versus intermingling of vulnerable and robust individuals, we find that concentrating the most vulnerable into centralized care facilities virtually always increases the infectious disease attack rate in the vulnerable group, without significant benefit to the robust group. Conclusions Isolated care homes of vulnerable residents are predicted to be the worst possible mixing circumstances for reducing harm in epidemic or pandemic conditions.

show abstract