<scp>COVID</scp>‐19 Epidemic: Regional Organization Centered on Nursing Homes

Cofais, Cécilia; Veillard, D.; Farges, C.; Baldeyrou, M.; Jarno, P.; Somme, Dominique; Corvol, Aline

doi:10.1111/jgs.16687

Cited by 5 publications

(8 citation statements)

References 6 publications

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“…There are examples of this type of collaboration in the United States as well as other countries. [60][61][62][63][64] Further development of units for viral-positive residents and those who require quarantine after hospitalization in wings of existing facilities, dedicated facilities, or repurposing existing locations in the community is essential. [65][66][67][68] Without this capacity, we may not be able to manage additional waves of COVID-19 that may occur (and are already occurring in some states), as well as for the surge in other respiratory illnesses that will add to the need during the upcoming fall and winter.…”

Section: Resourcesmentioning

confidence: 99%

“…Strengthening communication, collaboration, and resource sharing between nursing homes, hospitals, and health systems is another approach to making more resources available to calm the storm in the nursing home setting. There are examples of this type of collaboration in the United States as well as other countries 60‐64 …”

Section: Approaches To Calming the Stormmentioning

confidence: 99%

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COVID‐19 in Nursing Homes: Calming the Perfect Storm

Ouslander

Grabowski

2020

J American Geriatrics Society

262

246

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The pandemic of viral infection with the severe acute respiratory syndrome coronavirus-2 that causes COVID-19 disease has put the nursing home industry in crisis. The combination of a vulnerable population that manifests nonspecific and atypical presentations of COVID-19, staffing shortages due to viral infection, inadequate resources for and availability of rapid, accurate testing and personal protective equipment, and lack of effective treatments for COVID-19 among nursing home residents have created a "perfect storm" in our countryʼs nursing homes. This perfect storm will continue as society begins to reopen, resulting in more infections among nursing home staff and clinicians who acquire the virus outside of work, remain asymptomatic, and unknowingly perpetuate the spread of the virus in their workplaces. Because of the elements of the perfect storm, nursing homes are like a tinderbox, and it only takes one person to start a fire that could cause many deaths in a single facility. Several public health interventions and health policy strategies, adequate resources, and focused clinical quality improvement initiatives can help calm the storm. The saddest part of this perfect storm is that many years of inaction on the part of policy makers contributed to its impact. We now have an opportunity to improve nursing homes to protect residents and their caregivers ahead of the next storm. It is time to reimagine how we pay for and regulate nursing home care to achieve this goal.

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Section: Resourcesmentioning

confidence: 99%

Section: Approaches To Calming the Stormmentioning

confidence: 99%

COVID‐19 in Nursing Homes: Calming the Perfect Storm

Ouslander

Grabowski

2020

J American Geriatrics Society

262

246

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“…Visits from residents’ families were banned and general practitioners had great difficulty gaining admission to care for their patients, because of the risk of infection, particularly when the nursing home was the site of an outbreak. Usually on their own initiative, mobile geriatric teams (generally intra-hospital) were organized to offer help and support to nursing homes [ 28 29 ]. The health authorities quickly set up geriatric COVID-19 hotlines to provide support to the medical and care teams of nursing homes in terms of the clinical management of residents, but also organizationally, and in terms of reassurance regarding management of the epidemic.…”

Section: Perspectivesmentioning

confidence: 99%

“…The health authorities quickly set up geriatric COVID-19 hotlines to provide support to the medical and care teams of nursing homes in terms of the clinical management of residents, but also organizationally, and in terms of reassurance regarding management of the epidemic. Because of fragmentation between the health and social systems, home care services remain isolated, despite some local support initiatives (notably via the organization of web conferences for home care professionals and health, geriatrics, and infectious diseases experts, for dissemination of information, questions and answers, experience sharing) [ 28 ]. Lastly, the condition of some patients with chronic illnesses worsened because of numerous deferrals of hospital admissions during lockdown [ 30 31 ].…”

Section: Perspectivesmentioning

confidence: 99%

Integrated Care for Older People in France in 2020: Findings, Challenges, and Prospects

Bajeux¹,

Corvol

Somme

2021

International Journal of Integrated Care

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“…Until mid-April, RT-PCR tests were mainly performed by mobile teams that only intervened when there was a cluster of at least two suspected cases among residents. 17 When one of the tests was positive, all symptomatic residents of the same NH were considered “probable cases,” without a new test being performed. Symptoms have been defined in this study as “fever, respiratory signs or sudden fatigue.” There was no systematic testing of residents or of caregivers.…”

Section: Introductionmentioning

confidence: 99%

Structural and Managerial Risk Factors for COVID-19 Occurrence in French Nursing Homes

Corvol

Charras

Prud'Homm

et al. 2022

Int J Health Policy Manag

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Background: Nursing home (NH) residents accounted for half of the deaths during the 2020 spring wave of the COVID-19 epidemic in France. Our objective was to identify structural and managerial factors associated with COVID-19 outbreaks in NHs. Methods: We conducted in July 2020 a retrospective study by questionnaire addressed to NH directors in the Brittany region of France. The questions related to structural characteristics of the establishment, human resources, and crisis management decisions. The primary endpoint was the occurrence of at least one confirmed case of COVID-19 among residents between 1 March 1 and 31 May 2020. The secondary endpoint was total mortality during this period. We used multivariate regressions to identify factors associated with these outcomes. Results: Responses were collected from 231 NHs hosting 20,881 residents, representing a participation rate of 47%. In 24 (10%) NHs, at least one resident presented confirmed COVID-19. NHs often implemented stringent protective measures, with 65% of them choosing to confine residents to their rooms. In multivariate analysis, factors associated with a reduced risk of case occurrence were in-room meal service, early ban of family visits, and daily access to an outdoor space. No association was found between mortality and the factors studied. Our results show an early and strict implementation of lockdown measures, with good epidemiological results in a context of shortage of personal protective equipment and non-vaccination. Nevertheless, it raises ethical questions concerning respect of residents’ wellbeing and rights. Conclusion: Cessation of communal dining seems to be the main measure likely to be effective in preventive terms. It does not seem that room lockdown and cessation of group activities should be recommended, particularly if mask wearing is possible.

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COVID‐19 Epidemic: Regional Organization Centered on Nursing Homes

Cited by 5 publications

References 6 publications

COVID‐19 in Nursing Homes: Calming the Perfect Storm

COVID‐19 in Nursing Homes: Calming the Perfect Storm

Integrated Care for Older People in France in 2020: Findings, Challenges, and Prospects

Structural and Managerial Risk Factors for COVID-19 Occurrence in French Nursing Homes

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