The Italian national survey on Coronavirus disease 2019 epidemic spread in nursing homes

Abstract

Introduction Residents in facilities such as nursing homes (NHs) are particularly vulnerable to Coronavirus disease 2019 (COVID‐19). A national survey was carried out to collect information on the spreading and impact of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in nursing homes, and on how suspected and/or confirmed cases were managed. We carried out a survey between 25 March 2020 and 5 May 2020. Materials and Methods All Italian nursing homes either public or providing services both privately and within the NHS were included in the study. An on‐line questionnaire was sent to 3292 nursing homes across all Italian regions. Nursing homes were also contacted by telephone to provide assistance in completing the questionnaire. Results A total of 1356 nursing homes voluntarily participated to the survey, hosting a total of 100,806 residents. Overall, 9154 residents died due to any cause from February 1 to the time when the questionnaire was completed (from March 25 to May 5). Of these, 7.4% had COVID‐19 and 33.8% had flu‐like symptoms, corresponding to a cumulative incidence of 0.7 and 3.1, respectively. Lack of personnel, difficulty in transferring patients to hospital or other facility, isolating residents with COVID‐19, number of beds and geographical area were the main factor positively associated to the presence of COVID‐19 in nursing homes. Discussion This survey showed the dissemination and impact of SARS‐CoV‐2 infection in Italian nursing homes and on how older and potentially chronically ill people residing in these long‐term care facilities were managed.

Outbreaks of COVID-19 in Nursing Homes: A Cross-Sectional Survey of 74 Nursing Homes in a French Area

“…However, the nursing homes characteristics of the respondents were similar to those reported for the French Alps. Also, hospitalizations and mortality rates were comparable to other studies conducted in nursing homes and to national data [ 21 , 23 ]. Second, the ban of visits occurred 7 days before the studied period, and we cannot rule out the possibility that visitors introduced the virus prior to the ban.…”

“…This higher incidence is likely to be driven by the frailty and underlying conditions of nursing home residents, and the close living environment which may favor viral spread [ 4 , 20 ]. We observed that, as in Italy, ~30% of nursing homes faced an outbreak [ 21 ]. The hospitalization rate among residents (10% overall and 19% in facilities with outbreak) was lower than among the elderly population living in household (up to 38%) but similar to Italian reports for nursing homes [ 2 , 21 ].…”

“…We observed that, as in Italy, ~30% of nursing homes faced an outbreak [ 21 ]. The hospitalization rate among residents (10% overall and 19% in facilities with outbreak) was lower than among the elderly population living in household (up to 38%) but similar to Italian reports for nursing homes [ 2 , 21 ]. The contribution of geriatric and palliative care physicians could have avoided transfers to hospitals.…”

“…Such quality scales are not used in French nursing homes, and we thereby cannot provide insight regarding this potential confounder. Other studies have shown that a high number of beds or lower staffing ratios were associated with the occurrence of outbreaks [ 3 , 21 , 28 , 29 ]. However, in these studies incident cases among staff members were not accounted for.…”

Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study

“…Moreover, Italian nursing homes during the "first wave" of the pandemic had to cope with multiple operational hurdles and management difficulties (i.e., a lack of personal protective equipment, an inability to have swabs tested, a lack of healthcare staff, difficulties in isolating COVID-19-infected residents, etc. ), limiting the effective and timely application of measures that may have helped in containing the spread of the virus in these settings [18,59].…”