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Evaluating Policies to Decrease the Risk of Introducing SARS-CoV-2 Infections to Nursing Home Facilities.

Joëlla W Adams1, Kasey Jones1, Sandy Preiss1

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Implementing rapid testing or vaccination checks for nursing home visitors significantly reduces SARS-CoV-2 entry. These policies are key to preventing infections in long-term care facilities.

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Area of Science:

  • Epidemiology
  • Public Health Policy
  • Infectious Disease Modeling

Background:

  • Nursing home residents are highly vulnerable to severe outcomes from SARS-CoV-2 infection.
  • The Omicron variant surge presented a significant risk of viral introduction into these facilities.
  • Understanding the impact of facility-level policies is crucial for infection control.

Purpose of the Study:

  • To identify the most effective facility-level policies for reducing SARS-CoV-2 introduction into North Carolina nursing homes during the Omicron surge.
  • To quantify the potential reduction in infectious contacts through various policy interventions.

Main Methods:

  • An individual-based microsimulation model of North Carolina nursing homes was utilized.
  • The model simulated daily visitor and healthcare worker (HCW) interactions within facilities.
  • Policy impacts were assessed based on reductions in SARS-CoV-2 entry during a specific high-transmission period (12/15/2021–1/3/2022).

Main Results:

  • Requiring a negative rapid test for visitors reduced SARS-CoV-2 entry by 29.6%.
  • Requiring vaccinated status for visitors reduced entry by 24.0%.
  • Other policies like halving visits (21.2%), booster mandates for HCW (7.8%), and limiting to one primary visitor (6.5%) showed lesser reductions.

Conclusions:

  • Facility-level policies, particularly visitor testing and vaccination requirements, are effective in mitigating SARS-CoV-2 introduction into nursing homes.
  • Targeted interventions focusing on visitor screening offer the greatest potential for reducing infectious contacts.
  • Policy decisions should consider the varying effectiveness of different interventions in protecting vulnerable nursing home populations.