[COVID-19 in nursing homes: structural factors and experiences that endorse a change of model in Spain]

The effects of COVID-19 pandemic on older people living in care homes have been devastating. In Spain approximately 3% of the cases and 40% of the deaths have occurred in this group. In addition, due to measures taken to control the crisis, the incidence of geriatric syndromes has increased, and residents' fundamental rights have been violated. In this article we describe structural factors of care homes and their relationship with public health services that have influenced the impact of the pandemic. We suggest different types of group homes, and models of provision/coordination with public health services that have given excellent results protecting nursing homes residents from COVID-19, as alternative models to conventional residences and to the regular provision of health care services. We recommend that these successful experiences are taken into account in the transformation of the social-health model (to one integrated and focused on people) that has begun to be implemented in some Autonomous Communities of Spain.