How can pandemic spreads be contained in care homes?

Abstract

Care home settings serve a primarily elderly population with a diverse range of medical requirements. Care homes are unique in being both health-related institutions and people’s home. In available data the risk of dying from COVID-19 increases with age, and most of the deaths observed are in people older than 60. Studies of care home residents have shown that respiratory tract infection (RTIs) outbreaks are more frequent than gastrointestinal and spread more quickly amongst the population, with less autonomous residents being more severely affected by RTIs such as influenza. Introducing further complexity, residents may have diverse needs through health and functional status, potentially exhibiting behaviours that compromise infection control (e.g. spitting), carers vary in levels of training, and facilities themselves differ in how they are set up and run. In response to the COVID-19 pandemic many such settings have introduced restrictions on visitors to minimise the risk of spreading the infection to their residents. This rapid review evaluates available measures to minimise the risk of infection spread among residents and staff within care home settings.