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J Public Health (Oxf) . Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK

tetano

Editor, Senior Moderator
J Public Health (Oxf)


. 2020 Dec 28;fdaa218.
doi: 10.1093/pubmed/fdaa218. Online ahead of print.
Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK


Julii Brainard[SUP] 1 [/SUP], Steven Rushton[SUP] 2 [/SUP], Tim Winters[SUP] 3 [/SUP], Paul R Hunter[SUP] 1 [/SUP]



Affiliations

Abstract

Background: Residential care homes for the elderly are important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease.
Methods: We undertook secondary analysis of 248 care homes in Norfolk, UK. The dataset counted nurses, care workers and non-care workers, their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) and residents (if any) with suspected COVID-19 in the period 6 April to 6 May 2020. Concurrent descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and sanitizer) were in the data. PPE access was categorized as (most to least) green, amber or red. We undertook two-stage modelling, first for suspected COVID-19 cases amongst residents and second relating any increases in case counts after introduction to staffing or PPE levels.
Results: Counts of non-care workers had strongest relationships (P < 0.05) to introduction of suspected SARS-CoV-2 to the homes. Higher staff levels and more severe PPE shortages were linked to higher case counts (P < 0.05) during the monitoring period.
Conclusion: Managing aspects of staff interaction with residents and some working practices might reduce ingression to and spread of COVID-19-like illness within care homes.

Keywords: COVID-19; Cox proportional hazards model; care homes; mixed effect models; personal protection equipment.
 
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