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January 11, 2021
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Rates of COVID-19 in nursing homes reflected in surrounding community

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Rates of COVID-19 in U.S. nursing homes fluctuated during a 6-month period last year and were reflected in the surrounding community, according to findings published in MMWR.

“These data suggest that increases in community rates might be associated with increases in nursing home COVID-19 incidence and that nursing home mitigation strategies need to include a comprehensive plan to monitor local SARS-CoV-2 transmission and minimize high-risk exposures within facilities,” Suparna Bagchi, DrPH, a health scientist for the CDC, and colleagues wrote. “Increased COVID-19 incidence in communities with nursing homes increases the risk for introduction of SARS CoV-2 by staff members.”

Bagchi and other researchers from the CDC COVID-19 Response Team and CMS analyzed COVID-19 case data from nursing home residents and staff from nursing homes in all U.S. states, Guam and Puerto Rico. They excluded facility data from specific weeks if case data, occupied beds or staffing information was not reported.

They estimated cases per 1,000 resident-weeks for residents and staff by using the number of COVID-19 cases reported each week. The researchers also calculated community COVID-19 rates per 100,000 population for all 10 HHS regions.

They found that during the study period of May 25, 2020, to Nov. 22, 2020, there were 572,135 COVID-19 cases reported in nursing homes. A total of 51.8% of these cases occurred in residents, with the remainder occurring in staff members. Cases among residents increased in June and July, rising to 11.5 cases per 1,000 resident-weeks. Cases also rose in July, increasing from more than 178 cases per 100,0000 in HHS regions 4, 6 and 9.

In every HHS region, rates of COVID-19 incidence in nursing homes were similar to case counts in the surrounding community.

“Prioritization of nursing home residents and staff members for SARS-CoV-2 vaccination, as recommended by the Advisory Committee on Immunization Practices, is an additional strategy to assist mitigation,” the authors wrote. “Guidance and federal requirements could be further improved through assessing factors associated with the incidence of COVID-19 among nursing home staff members and residents, including factors associated with community-acquired infections leading to transmission within nursing homes.”