Abstract:The purpose of the study was to examine trends in COVID-19 cases, related deaths, and staffing shortages in nursing homes (NH) by rural and urban status from May 2020 to Feb 2021. Generalized linear mixed models with state-fixed effects were used to estimate the interaction effect of study period and rural/urban status on having at least: one COVID-19 case, one related death, and/or at least one week of staffing shortage using the NH COVID-19 data spanning the 40-week period. The findings revealed shortages in… Show more
“…One example can be seen with the comparison of rural versus urban nursing home establishments. Though rurality itself was not associated with COVID-19 infections or related deaths, a study involving the early pandemic period revealed that there was a higher degree of volatility in staffing shortages in rural nursing homes compared to their urban counterparts [ 40 ]. While rural nursing homes experienced a higher proportion of staffing shortages until mid-November 2020, staffing shortages in urban nursing homes were relatively stable over the same period, despite fluctuations in COVID-19 case volume.…”
Section: Staffing Structure and Workforce Alterationsmentioning
The novel SARS-CoV-2 (COVID-19) disrupted many facets of the healthcare industry throughout the pandemic and has likely permanently altered modern healthcare delivery. It has been shown that existing healthcare infrastructure influenced national responses to COVID-19, but the current implications and resultant sequelae of the pandemic on the organizational framework of healthcare remains largely unknown. This paper aims to review how aspects of contemporary medical systems – the physical environment of care delivery, global healthcare supply chains, workforce structures, information and communication systems, scientific collaboration, as well as policy frameworks – evolved in the initial response to the COVID-19 pandemic.
“…One example can be seen with the comparison of rural versus urban nursing home establishments. Though rurality itself was not associated with COVID-19 infections or related deaths, a study involving the early pandemic period revealed that there was a higher degree of volatility in staffing shortages in rural nursing homes compared to their urban counterparts [ 40 ]. While rural nursing homes experienced a higher proportion of staffing shortages until mid-November 2020, staffing shortages in urban nursing homes were relatively stable over the same period, despite fluctuations in COVID-19 case volume.…”
Section: Staffing Structure and Workforce Alterationsmentioning
The novel SARS-CoV-2 (COVID-19) disrupted many facets of the healthcare industry throughout the pandemic and has likely permanently altered modern healthcare delivery. It has been shown that existing healthcare infrastructure influenced national responses to COVID-19, but the current implications and resultant sequelae of the pandemic on the organizational framework of healthcare remains largely unknown. This paper aims to review how aspects of contemporary medical systems – the physical environment of care delivery, global healthcare supply chains, workforce structures, information and communication systems, scientific collaboration, as well as policy frameworks – evolved in the initial response to the COVID-19 pandemic.
“…Further, we did not specifically examine differences that might be present in rural as compared with urban settings despite the fact that staffing shortages and skill mix issues and COVID cases/deaths may differ by rural and urban location. 50 We focused primarily on frontline nursing staff rather than other personnel or administration because of their routine and prolonged proximity to residents during the provision of care as compared to other NH staff. Finally, this scan was conducted prior to the availability of COVID vaccine.…”
To examine processes and programmatic elements of infection prevention and control (IPC) efforts and identify themes and promising approaches in nursing homes (NHs), an environmental scan was conducted. Data sources included a literature search, relevant listservs and websites, and expert consensus based on a virtual summit of leaders in IPC in long-term care settings. Three thematic areas emerged which have the potential to improve overall IPC practices in the long-term care setting: staffing and resource availability, training and knowledge of IPC practices, and organizational culture. If improved IPC practices and reduced cross-transmission of infections in NHs are to be sustained, both short-term and long-term changes in these areas are essential to fully engage staff, build trust, and enhance a ‘just’ organizational culture.
“… 2 , 3 , 4 , 5 , 9 Moreover, many of these nursing home studies looked at primarily urban as opposed to rural NH populations. 10 , 11 This report analyzes the effect of prior vaccination of NH residents during recent outbreaks of SARS‐CoV‐2 in NHs in rural Manitoba, Canada. The dose‐response effect of mRNA vaccine in protection from infection was compared.…”
Section: Introductionmentioning
confidence: 99%
“…To date, most studies on vaccine efficacy in NHs were performed prior to the emergence of the BA.2 variant of SARS‐CoV‐2 (Omicron) as the dominant strain, and before a third vaccine dose was recommended 2–5,9 . Moreover, many of these nursing home studies looked at primarily urban as opposed to rural NH populations 10,11 . This report analyzes the effect of prior vaccination of NH residents during recent outbreaks of SARS‐CoV‐2 in NHs in rural Manitoba, Canada.…”
Background
In Canada, mortality due to SARS‐CoV‐2 disproportionately impacted residents of nursing homes (NH). In November 2021, NH residents in the Canadian province of Manitoba became eligible to receive three doses of mRNA vaccine but coverage with three doses has not been universal. The objective of this study was to compare the protection from infection conferred by one, two, and three doses of COVID‐19 mRNA vaccine compared to no vaccination among residents of nursing homes experiencing SARS‐CoV‐2 outbreaks.
Methods
Infection Prevention and Control reports from 8 rural nursing homes experiencing outbreaks of SARS‐CoV‐2 between January 6, 2022, and March 5, 2022, were analyzed. Attack rates and the number needed to vaccinate (NNV) were calculated.
Results
SARS‐CoV‐2 attack rate was 65% among NH residents not vaccinated, 58% among residents who received 1–2 doses of mRNA COVID‐19 vaccine, and 28% among residents who had received 3 vaccine doses. The NNV to prevent one nursing home resident from SARS‐CoV‐2 infection during an outbreak was 3 for a vaccination with 3 doses and 14 for 1–2 doses of COVID‐19 mRNA vaccine. The superiority of receiving the third dose was statistically significant compared to 1–2 doses (Chi‐Squared,
p
< 0.00001).
Conclusions
Nursing home residents who received three doses of COVID‐19 mRNA vaccine were at lower risk of SARS‐CoV‐2 infection compared to those who received 1–2 doses. Our analyses lend support to the protective effects of the third dose of mRNA vaccine for NH residents in the event of a SARS‐CoV‐2 outbreak.
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