COVID-19 in Nursing Homes

Older age and the presence of comorbidities are associated with increased risk of mortality in the current pandemic The high prevalence of functional and cognitive impairment and behavioural symptoms add to the risk posed to nursing home residents, as well as environments which present barriers to infection control In addition, healthcare professionals globally of all hues have neglected research, recruitment incentivisation and quality improvement in nursing home care relative to other areas of clinical practice The synergy of these factors is reflected in the first major study of COVID-19 in a nursing home Nearly two-thirds of residents were infected over a 3-week period, with a death rate of 33%: 50 staff members and 16 visitors were also infected In Spain, it has been reported that a significant proportion of COVID-19 associated deaths have been nursing home residents There is also a concern that many jurisdictions are not including nursing home deaths in the COVID-19 death toll Parallels may be drawn between challenges faced in nursing homes during the current pandemic and those seen in previous infectious outbreaks and epidemics Following the severe acute respiratory syndrome epidemic in 2003, a study showed that the majority of residents in a Hong Kong nursing home reported poor knowledge of the condition and staff reported concerns about contracting the condition themselves: the willingness and ability of staff to work, and remain at work, may be impacted upon by a disproportionate level of perceived threat during pandemics and disasters