Abstract
Objectives: COVID-19 has had devastating effects on long-term care homes across much of the world, and especially within Canada, with more than 50% of the mortality from COVID-19 in 2020 in these homes. Understanding the way in which the virus spreads within these homes is critical to preventing further outbreaks.
Design: Retrospective chart review.
Settings and participants: Long-term care home residents and staff in Ontario, Canada.
Methods: We conducted a longitudinal study of a large long-term care home COVID-19 outbreak in Ontario, Canada, using electronic medical records, public health records, staff assignments, and resident room locations to spatially map the outbreak through the facility.
Results: By analyzing the outbreak longitudinally, we were able to draw 3 important conclusions: (1) 84.5% had typical COVID-19 symptoms and only 15.5% of residents had asymptomatic infection; (2) there was a high attack rate of 85.8%, which appeared to be explained by a high degree of interconnectedness within the home exacerbated by staffing shortages; and (3) clustering of infections within multibedded rooms was common.
Conclusion and implications: Low rates of asymptomatic infection suggest that symptom-based screening in residents remains very important for detecting outbreaks, a high degree of interconnectedness explains the high attack rate, and there is a need for improved guidance for homes with multibedded rooms on optimizing resident room movement to mitigate spread of COVID-19 in long-term care homes.
Keywords: COVID-19; SARS-CoV-2; long-term care; nursing home.
【저자키워드】 COVID-19, SARS-CoV-2, nursing home, Long-term care, 【초록키워드】 public health, Mortality, nursing home, Infection, Outbreaks, Asymptomatic, COVID-19 outbreak, longitudinal study, outbreak, attack rate, asymptomatic infection, Long-term care, Clustering, understanding, electronic medical records, Canada, Care, Critical, Guidance, facility, COVID-19 symptom, virus spread, Effect, mitigate, setting, spread of COVID-19, exacerbated, conducted, explained, explain, 【제목키워드】 clinical, Long-term care, longitudinal, home,