Newly Developed COVID-19 Bundle Greatly Reduces the Infection Fatality Rate for a Highly Vulnerable Nursing Home...

Area of Science:

• Gerontology
• Infectious Disease Epidemiology
• Public Health Policy

Background:

• Nursing homes are high-risk environments for COVID-19 outbreaks.
• Early pandemic data showed high infection fatality rates (IFR) and new infection rates (IR) in these facilities.
• Effective interventions were urgently needed to protect vulnerable residents.

Purpose of the Study:

• To implement and evaluate a performance improvement bundle to reduce COVID-19 IFR and IR in a nursing home.
• To achieve a ≥33% reduction in COVID-19 IFR and maintain new IR below 1% among residents.
• To assess the sustainability of the intervention's impact over a 3-month period.

Main Methods:

• A multi-component intervention bundle was applied to all nursing home residents testing positive for COVID-19.
• Key components included close resident observation, vital signs monitoring (including O2 saturation), and frequent clinical assessments for symptomatic individuals.
• Ramped-up COVID-19 PCR testing was implemented for all residents.

Main Results:

• The average IFR decreased by 49.6% from the March baseline (12.3% from April-June, P < 0.05).
• The average new IR decreased by 29.9% from baseline (5.4% from April-June, P < 0.05).
• In the subsequent two months, zero deaths occurred, and the new IR remained below 1%, demonstrating sustained improvement.

Conclusions:

• The implemented bundle effectively reduced COVID-19 mortality and infection rates in a nursing home setting.
• The intervention's simplicity suggests potential for broad applicability in similar facilities.
• Continuous monitoring and targeted interventions are crucial for managing infectious diseases in long-term care.