Dataset Information

SARS-CoV-2 Epidemics in Retirement and Nursing Homes in Italy: A New Preparedness Assessment Model after the First Epidemic Wave.

ABSTRACT: The aim of the study is to evaluate the preparedness of retirement and nursing homes in the city of Sassari at the end of the first wave of the severe acute respiratory syndrome coronavirus 2 epidemic, first by investigating the risk perception of epidemic outbreaks by the facility managers and subsequently by carrying out a field assessment of these facilities. To perform the field assessment, a checklist developed by the CDC (Infection Prevention and Control Assessment Tool for Nursing Homes Preparing for COVID-19) and adapted to the Italian context was used. Fourteen facilities took part in the survey (87.5%). The application of good practices for each survey area was expressed as a percentage with the following median values: restriction policies (87.5%), staff training (53.8%), resident training (67.6%), availability of personal protective equipment (41.7%), infection control practices (73.5%) and communication (80%). Among the facilities, considerable variability was observed in these evaluation fields: only the restriction policies and communication activities were applied uniformly. A discrepancy was found between perceived risk and real danger in the facilities, requiring targeted communication actions. At present, it is necessary to promote a new approach based on the prediction of critical events, thereby providing the means to effectively address them.

SUBMITTER: Gugliotta C

PROVIDER: S-EPMC8199425 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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SARS-CoV-2 Epidemics in Retirement and Nursing Homes in Italy: A New Preparedness Assessment Model after the First Epidemic Wave.

Gugliotta Carmelo C Gentili Davide D Marras Silvia S Dettori Marco M Muglia Pietro Paolo PP Desole Maria Giuseppina MG Acciaro Marcello M Bellu Sabina S Azara Antonio A Castiglia Paolo P

International journal of environmental research and public health 20210526 11

The aim of the study is to evaluate the preparedness of retirement and nursing homes in the city of Sassari at the end of the first wave of the severe acute respiratory syndrome coronavirus 2 epidemic, first by investigating the risk perception of epidemic outbreaks by the facility managers and subsequently by carrying out a field assessment of these facilities. To perform the field assessment, a checklist developed by the CDC (Infection Prevention and Control Assessment Tool for Nursing Homes P ...[more]

PMID: 34073437

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Project description:BackgroundNursing homes (NHs) have been particularly affected by COVID-19. The aim of this study is to estimate the burden of COVID-19 and to investigate factors associated with mortality during the first epidemic wave in a large French NHs network.MethodsAn observational cross-sectional study was conducted in September-October 2020. 290 NHs were asked to complete an online questionnaire covering the first epidemic wave on facilities and resident characteristics, number of suspected/confirmed COVID-19 deaths, and preventive/control measures taken at the facility level. Data were crosschecked using routinely collected administrative data on the facilities. The statistical unit of the study was the NH. Overall COVID-19 mortality rate was estimated. Factors associated with COVID-19 mortality were investigated using a multivariable multinomial logistic regression. The outcome was classified in 3 categories: "no COVID-19 death in a given NH", occurrence of an "episode of concern" (at least 10% of the residents died from COVID-19), occurrence of a "moderate episode" (deaths of COVID-19, less than 10% of the residents).ResultsOf the 192 (66%) participating NHs, 28 (15%) were classified as having an "episode of concern". In the multinomial logistic regression, moderate epidemic magnitude in the NHs county (adjusted OR = 9.3; 95%CI=[2.6-33.3]), high number of healthcare and housekeeping staff (aOR = 3.7 [1.2-11.4]) and presence of an Alzheimer's unit (aOR = 0.2 [0.07-0.7]) were significantly associated with an "episode of concern".ConclusionsWe found a significant association between the occurrence of an "episode of concern" in a NH and some of its organizational characteristics and the epidemic magnitude in the area. These results can be used to improve the epidemic preparedness of NHs, particularly regarding the organization of NHs in small units with dedicated staff. Factors associated with COVID-19 mortality and preventive measures taken in nursing homes in France during the first epidemic wave.

Project description:BackgroundThe relationship between the risk of exposure to environmental hazards and the emergency preparedness of nursing homes is not well-understood. This study evaluates the association between wildfire exposure risk and nursing home emergency preparedness.MethodsFrom a sample of Centers for Medicare & Medicaid Services (CMS) certified nursing homes in California, we determined the prevalence of "exposed" facilities that were located within 5 km of a wildfire risk area, as informed by a field-tested model. Among the 1182 nursing homes, we identified emergency preparedness deficiencies from January 2017 to December 2019. We estimated associations between exposure and emergency preparedness deficiencies using unadjusted and adjusted generalized estimating equations with logistic and negative binomial distributions.ResultsA greater percentage of the 495 exposed facilities had at least one emergency preparedness deficiency than the 687 unexposed facilities (83.9% vs 76.9%). The mean (3.6 vs 3.2) and median (3 vs 2) numbers of emergency preparedness deficiencies were also greater for exposed facilities. In both the unadjusted and adjusted analyses, exposure to wildfire risk was significantly associated with the likelihood of at least one emergency preparedness deficiency (adjusted odds ratio 1.52, p-value 0.007). There was a positive but not statistically significant association between exposure and the number of emergency preparedness deficiencies assigned to a nursing home (adjusted rate ratio 1.12, p-value 0.062). These results were consistent in analyses that used more stringent distance- and severity-thresholds to define exposure status.ConclusionCalifornia nursing homes at heightened risk of exposure to wildfires have poorer emergency preparedness than unexposed facilities. These findings suggest that nursing home management and staff may be unaware of important environmental risks to which their facilities are exposed. Improved integration of nursing homes into community disaster planning may better align facility preparedness with surrounding wildfire risk.

Project description:BackgroundEstimates of SARS-CoV-2 infection fatality rates (IFRs) in developing countries remain poorly characterized. Mexico has one of the highest reported COVID-19 case-fatality rates worldwide, although available estimates do not consider serologic assessment of prior exposure nor all SARS-CoV-2-related deaths. We aimed to estimate sex- and age-specific IFRs for SARS-CoV-2 in Mexico.MethodsThe total number of people in Mexico with evidence of prior SARS-CoV-2 infection was derived from National Survey of Health and Nutrition-COVID-19 (ENSANUT 2020 Covid-19)-a nationally representative serosurvey conducted from August to November 2020. COVID-19 mortality data matched to ENSANUT's dates were retrieved from the death-certificate registry, which captures the majority of COVID-19 deaths in Mexico, and from the national surveillance system, which covers the subset of COVID-19 deaths that were identified by the health system and were confirmed through a positive polymerase chain reaction test. We analysed differences in IFRs by urbanization and region.ResultsThe national SARS-CoV-2 IFR was 0.47% (95% CI 0.44, 0.50) using death certificates and 0.30% (95% CI 0.28, 0.33) using surveillance-based deaths. The IFR increased with age, being close to zero at age <30 years, but increasing to 1% at ages 50-59 years in men and 60-69 years in women, and being the highest at ≥80 years for men (5.88%) and women (6.23%). Across Mexico's nine regions, Mexico City (0.99%) had the highest and the Peninsula (0.26%) the lowest certificate-based IFRs. Metropolitan areas had higher certificate-based IFR (0.63%) than rural areas (0.17%).ConclusionAfter the first wave of the COVID-19 pandemic, the overall IFR in Mexico was comparable with those of European countries. The IFR in Mexico increased with age and was higher in men than in women. The variations in IFRs across regions and places of residence within the country suggest that structural factors related to population characteristics, pandemic containment and healthcare capabilities could have influenced lethality at the local level.

Dataset Information

SARS-CoV-2 Epidemics in Retirement and Nursing Homes in Italy: A New Preparedness Assessment Model after the First Epidemic Wave.

Publications

SARS-CoV-2 Epidemics in Retirement and Nursing Homes in Italy: A New Preparedness Assessment Model after the First Epidemic Wave.

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