Impact of visitation and cohorting policies to shield residents from covid-19 spread in care homes: an agent-based model

Nguyen, Le Khanh Ngan; Howick, Susan; McLafferty, Dennis; Anderson, Gillian; Pravinkumar, S. J.; Meer, R.B. Van Der; Megiddo, Itamar

doi:10.1016/j.ajic.2021.07.001

Cited by 16 publications

(19 citation statements)

References 17 publications

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“…These models [5][6][7] do not assess the relative impact of the different COVID-19 pathways into care homes. Nguyen et al [8] extend [6,7], using a hybrid ABM-System Dynamics model, to explore the conditions under which visitation, heterogeneous care homes sizes, and the cohorting of residents impacts COVID-19 outbreak severity. Rosello et al [9] model an individual care home with a stochastic compartmental model, using multiple FOI's to capture COVID-19 pathways, including visitors, hospital discharges, staff working at other homes, and staff infections from the community.…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 in Scottish care homes: A metapopulation model of spread among residents and staff

Baister

McTaggart

McMenemy

et al. 2021

Preprint

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Care homes in the UK were disproportionately affected by the first wave of the COVID–19 pandemic, accounting for almost half of COVID–19 deaths over the course of the period from 6th March – 15th June 2020. Understanding how infectious diseases establish themselves throughout vulnerable communities is crucial for minimising deaths and lowering the total stress on the National Health Service (NHS Scotland). We model the spread of COVID–19 in the health–of NHS Lothian, Scotland over the course of the first wave of the pandemic with a compartmental Susceptible – Exposed – Infected reported – Infected unreported – Recovered – Dead (SEIARD), metapopulation model. Care home residents, care home workers and the rest of the population are modelled as subpopulations, interacting on a network describing their mixing habits. We explicitly model the outbreak′s reproduction rate and care home visitation level over time for each subpopulation, and execute a data fit and sensitivity analysis, focusing on parameters responsible for intra–subpopulation mixing: staff sharing, staff shift patterns and visitation. The results suggest that hospital discharges were not predominantly responsible for the early outbreak in care homes, and that only a few such cases led to infection seeding in care homes by the 6th of March Sensitivity analysis show the main mode of entry into care homes are infections by staff interacting with the general population. Visitation (before cancellation) and staff sharing were less significant in affecting outbreak size. Focusing on the protection and monitoring of staff, followed by reductions in staff sharing and quick cancellations of visitation can significantly reduce future infection attack rates of COVID–19 in care homes.

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Section: Introductionmentioning

confidence: 99%

“…These models [5–7] do not assess the relative impact of the different COVID-19 pathways into care homes. Nguyen et al [8] extend [6, 7], using a hybrid ABM-System Dynamics model, to explore the conditions under which visitation, heterogeneous care homes sizes, and the cohorting of residents impacts COVID-19 outbreak severity.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 in Scottish care homes: A metapopulation model of spread among residents and staff

Baister

McTaggart

McMenemy

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

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“…Although some evidence from modeling studies suggests that nursing home visiting bans were associated with a decrease in the basic reproductive number using a mechanistic meta-population model, 134 other evidence suggests that "shielding" of residents is not as effective as other nonpharmacologic measures such as appropriate infection prevention and control measures, and may be less effective in nursing home residents than shielding vulnerable adults in the wider community at periods of high community transmission. 129,135 Thus, there is currently unclear evidence to support blanket visitor bans and shielding on older nursing home residents.…”

Section: Impact Of Wider Societal Measures and Visiting Bans On Mitig...mentioning

confidence: 99%

“…USA, meta-population modeling study: Reduction in infection rate in areas imposing visitation bans134 UK, agent-based modeling study: Reduced infections with visitation bans only when community prevalence where staff live considerably lower than prevalence where visitors live129 UK, N ¼ 57,713 individuals: "shielded" individuals had higher rates of infection, after…”

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confidence: 99%

Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update

Dyer

Fallon

Noonan

et al. 2022

Journal of the American Medical Directors Association

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“…Previous simulation studies have been developed to study transmission dynamics of COVID-19 in LTCFs and the effect of interventions such as: different testing strategies [ 15 – 19 ], vaccine efficacy and distribution [ 20 , 21 ], and use of PPE and other non-pharmaceutical interventions (NPIs) [ 21 , 22 ]. There is a strong consensus that combined interventions with a strong focus on early detection is required to mitigate transmission.…”

Section: Introductionmentioning

confidence: 99%

Testing and vaccination to reduce the impact of COVID-19 in nursing homes: an agent-based approach

et al. 2022

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Background Efforts to protect residents in nursing homes involve non-pharmaceutical interventions, testing, and vaccine. We sought to quantify the effect of testing and vaccine strategies on the attack rate, length of the epidemic, and hospitalization. Methods We developed an agent-based model to simulate the dynamics of SARS-CoV-2 transmission among resident and staff agents in a nursing home. Interactions between 172 residents and 170 staff based on data from a nursing home in Los Angeles, CA. Scenarios were simulated assuming different levels of non-pharmaceutical interventions, testing frequencies, and vaccine efficacy to reduce transmission. Results Under the hypothetical scenario of widespread SARS-CoV-2 in the community, 3-day testing frequency minimized the attack rate and the time to eradicate an outbreak. Prioritization of vaccine among staff or staff and residents minimized the cumulative number of infections and hospitalization, particularly in the scenario of high probability of an introduction. Reducing the probability of a viral introduction eased the demand on testing and vaccination rate to decrease infections and hospitalizations. Conclusions Improving frequency of testing from 7-days to 3-days minimized the number of infections and hospitalizations, despite widespread community transmission. Vaccine prioritization of staff provides the best protection strategy when the risk of viral introduction is high.

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Impact of visitation and cohorting policies to shield residents from covid-19 spread in care homes: an agent-based model

Cited by 16 publications

References 17 publications

COVID-19 in Scottish care homes: A metapopulation model of spread among residents and staff

COVID-19 in Scottish care homes: A metapopulation model of spread among residents and staff

Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update

Testing and vaccination to reduce the impact of COVID-19 in nursing homes: an agent-based approach

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