Register-based surveillance of COVID-19 in nursing homes

Danielsen, Anders Skyrud; Cyr, Pascale-Renée; Berg, Thale Cathrine; Jønsberg, Eirik; Eriksen-Volle, Hanne-Merete; Kacelnik, Oliver

doi:10.4045/tidsskr.21.0906

Cited by 4 publications

(3 citation statements)

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“…Of the 242 registered COVID deaths up to that date, 93 deaths (38%) occurred in hospitals, 143 deaths (59%) in other healthcare institutions (including LTC) and 1 death occurred at a patient's home. Danielsen et al (2022) confirmed that in the first year of the pandemic, 0.69% of all nursing home residents became infected by SARS-CoV-2 and 1.3% of all deaths in nursing homes were related to COVID-19.…”

Section: Elderly Mortality Rates -A Brief Description Of the Factsmentioning

confidence: 53%

Public Health Measures Enacted by the Norwegian Political Leadership to Protect the Elderly in Response to the SARS-CoV-2 Pandemic Crisis

Tokovská

Sørensen

Nour

et al. 2023

Central European Journal of Public Policy

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The SARS-CoV-2 pandemic crisis is ongoing, and the elderly are still affected by the virus, sometimes with fatal consequences. The political leaders are, inter alia, focussed on protecting citizens, including this vulnerable group. This article aims to describe the response of the Norwegian political leadership, with a focus on the public health measures enacted to protect the elderly during the SARS-CoV-2 pandemic crisis in the years 2020 and 2021. This study has a descriptive qualitative research design using thematic-content analysis as a methodology to evaluate data collected from official documents, national statistics and public health documents from Norway. Statistics show that the elderly mortality rate per 100,000 person-weeks during the first wave of the SARS-CoV-2 pandemic was 2.69 in Norway; during the second wave of the pandemic, it was 1.43. The public health measures the Norwegian political leadership instigated were more effective in containing the crisis when compared to other European countries, and this paper investigates the reasons. The results of our study provide public health policy decision-makers with insights into analytical material showing the usefulness of different measures enacted by the Norwegian government. The Norwegian government’s responses to the crisis, such as the public health measures, restrictions, social consequences for vulnerable groups such as the elderly, as well as cross-government and cross-community cooperation, will need further in-depth analysis.

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Section: Elderly Mortality Rates -A Brief Description Of the Factsmentioning

confidence: 53%

Public Health Measures Enacted by the Norwegian Political Leadership to Protect the Elderly in Response to the SARS-CoV-2 Pandemic Crisis

Tokovská

Sørensen

Nour

et al. 2023

Central European Journal of Public Policy

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“…The median age of residents is >85 years. 10 During the pandemic, guidelines from national authorities recommended that LTCF residents with COVID-19 should not be routinely transferred to hospitals and staff should only be employed in 1 LTCF at a time. 11 In June 2020, a new real-time population-wide Norwegian preparedness register for COVID-19, Beredt C19, was established as part of the legally mandated responsibilities of the NIPH during epidemics.…”

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confidence: 99%

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confidence: 99%

A new automated national register-based surveillance system for outbreaks in long-term care facilities in Norway detected three times more severe acute respiratory coronavirus virus 2 (SARS-CoV-2) clusters than traditional methods

Gravningen

Nymark

Wyller

et al. 2022

Infect. Control Hosp. Epidemiol.

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Objective: To develop and test a new automated surveillance system that can detect, define and characterize infection clusters, including coronavirus disease 2019 (COVID-19), in long-term care facilities (LTCFs) in Norway by combining existing national register data. Background: The numerous outbreaks in LTCFs during the COVID-19 pandemic highlighted the need for accurate and timely outbreak surveillance. As traditional methods were inadequate, we used severe acute respiratory coronavirus virus 2 (SARS-CoV-2) as a model to test automated surveillance. Methods: We conducted a nationwide study using data from the Norwegian preparedness register (Beredt C19) and defined the study population as an open cohort from January 2020 to December 2021. We analyzed clusters (≥3 individuals with positive SARS-CoV-2 test ≤14 days) by 4-month periods including cluster size, duration and composition, and residents’ mortality associated with clusters. Results: The study population included 173,907 individuals; 78% employees and 22% residents. Clusters were detected in 427 (43%) of 993 LTCFs. The median cluster size was 4–8 individuals (maximum, 50) by 4-month periods, with a median duration of 9–17 days. Employees represented 60%–82% of cases in clusters and were index cases in 60%–90%. In the last 4-month period of 2020, we detected 107 clusters (915 cases) versus 428 clusters (2,998 cases) in the last period of 2021. The 14-day all-cause mortality rate was higher in resident cases from the clusters. Varying the cluster definitions changed the number of clusters. Conclusion: Automated national surveillance for SARS-CoV-2 clusters in LTCFs is possible based on existing data sources and provides near real-time detailed information on size, duration, and composition of clusters. Thus, this system can assist in early outbreak detection and improve surveillance.

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All-cause mortality and hospital admissions for nursing home residents during the COVID-19 pandemic: a Norwegian register-based cohort study

Øien,

Gjesvik,

Skyrud

et al. 2024

BMC Med

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Background This paper investigates the consequences of the COVID-19 pandemic on mortality and hospitalization among nursing home residents in Norway. While existing evidence shows that nursing home residents were overrepresented among COVID-19-related deaths, suggesting inadequate protection measures, this study argues that the observed overrepresentation in mortality and hospitalization may partly stem from the inherent frailty of this demographic. Using nationwide administrative data, we assessed excess deaths and hospitalization by comparing pandemic-era rates to those of a pre-pandemic cohort. Methods We compared mortality and hospitalization rates between a pandemic cohort of nursing home residents as of September 2019 (N = 30,052), and a pre-pandemic cohort as of September 2017 (N = 30,429). Both cohorts were followed monthly for two years, beginning in September 2019 and 2017, respectively. This analysis was conducted at the national level and separately for nursing home residents in areas with low, medium, and high SARS-CoV-2 community transmission. Event studies and difference-in-difference models allowed us to separate the impact of the pandemic on mortality and hospitalization from secular and seasonal changes. Results The pandemic cohort experienced a non-significant 0.07 percentage points (95% confidence interval (CI): − 0.081 to 0.221) increase in all-cause mortality during the 18 months following pandemic onset, compared to the pre-pandemic cohort. Moreover, our findings indicate a substantial reduction in hospitalizations of 0.27 percentage points (95% CI: − 0.464 to − 0.135) and a non-significant decrease of 0.80 percentage points (95% CI: − 2.529 to 0.929) in the proportion of nursing home residents hospitalized before death. The effect on mortality remained consistent across regions with both high and low levels of SARS-CoV-2 community transmission. Conclusions Our findings indicate no clear evidence of excess all-cause mortality in Norway during the pandemic, neither nationally nor in areas with high infection rates. This suggests that early implementation of nationwide and nursing home-specific infection control measures during the pandemic effectively protected nursing home residents. Furthermore, our results revealed a decrease in hospitalizations, both overall and prior to death, suggesting that nursing homes adhered to national guidelines promoting on-site treatment for residents.

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Register-based surveillance of COVID-19 in nursing homes

Cited by 4 publications

References 1 publication

Public Health Measures Enacted by the Norwegian Political Leadership to Protect the Elderly in Response to the SARS-CoV-2 Pandemic Crisis

Public Health Measures Enacted by the Norwegian Political Leadership to Protect the Elderly in Response to the SARS-CoV-2 Pandemic Crisis

A new automated national register-based surveillance system for outbreaks in long-term care facilities in Norway detected three times more severe acute respiratory coronavirus virus 2 (SARS-CoV-2) clusters than traditional methods

All-cause mortality and hospital admissions for nursing home residents during the COVID-19 pandemic: a Norwegian register-based cohort study

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