scholarly journals COVID-19 outbreaks in nursing homes: A strong link with the coronavirus spread in the surrounding population, France, March to July 2020

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261756
Author(s):  
Muriel Rabilloud ◽  
Benjamin Riche ◽  
Jean François Etard ◽  
Mad-Hélénie Elsensohn ◽  
Nicolas Voirin ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Disease Outbreaks ◽  
External Pressure ◽  
Spearman Correlation ◽  
Virus Spread ◽  
Tight Control ◽  
Outbreak Period ◽  
Cumulative Probabilities ◽  
Epidemic Wave ◽  
French Region

Background Worldwide, COVID-19 outbreaks in nursing homes have often been sudden and massive. The study investigated the role SARS-CoV-2 virus spread in nearby population plays in introducing the disease in nursing homes. Material and methods This was carried out through modelling the occurrences of first cases in each of 943 nursing homes of Auvergne-Rhône-Alpes French Region over the first epidemic wave (March-July, 2020). The cumulative probabilities of COVID-19 outbreak in the nursing homes and those of hospitalization for the disease in the population were modelled in each of the twelve Départements of the Region over period March-July 2020. This allowed estimating the duration of the active outbreak period, the dates and heights of the peaks of outbreak probabilities in nursing homes, and the dates and heights of the peaks of hospitalization probabilities in the population. Spearman coefficient estimated the correlation between the two peak series. Results The cumulative proportion of nursing homes with COVID-19 outbreaks was 52% (490/943; range: 22–70% acc. Département). The active outbreak period in the nursing homes lasted 11 to 21 days (acc. Département) and ended before lockdown end. Spearman correlation between outbreak probability peaks in nursing homes and hospitalization probability peaks in the population (surrogate of the incidence peaks) was estimated at 0.71 (95% CI: [0.66; 0.78]). Conclusion The modelling highlighted a strong correlation between the outbreak in nursing homes and the external pressure of the disease. It indicated that avoiding disease outbreaks in nursing homes requires a tight control of virus spread in the surrounding populations.

Ethical problems related to intravenous fluids in nursing homes

2014 ◽  
Vol 21 (8) ◽  
pp. 890-901 ◽  
Author(s):  
May-Elin T Horntvedt ◽  
Maria Romøren ◽  
Betty-Ann Solvoll
Keyword(s):  
Decision Making ◽  
Nursing Homes ◽  
Internal Pressure ◽  
Collaborative Research ◽  
Ethical Problem ◽  
Organizational Factors ◽  
External Pressure ◽  
Intravenous Fluids ◽  
Research Project ◽  
Ethical Problems

Background: Intravenous fluids and/or antibiotics are applied to only a limited extent in Norwegian nursing homes, and the patients are often sent to hospital in these situations. A transfer and a stay in hospital may be unnecessary strains for frail older patients. Given this background, a collaborative research project was initiated in a Norwegian county in 2009. A teaching programme was developed, which aimed to strengthen the awareness of ethics, assessments and practical procedures related to intravenous fluid and/or antibiotics among healthcare professionals. Objectives: This qualitative study aimed to increase our knowledge of the ethical problems experienced by nursing home nurses in situations related to the administration of intravenous fluids and/or antibiotics. Research design: An exploratory design was used, and five focus group interviews were conducted with 26 registered nurses. A hermeneutic analytic approach was applied. Ethical considerations: This study was reported to the Norwegian Social Science Data Services in May 2010. The Regional Committee for Medical and Health Research Ethics approved the collaborative research project. Findings: The analysis showed that the nurses experienced difficult decision-making situations, which were interpreted as external pressure and internal pressure. External pressure emerged in interactions with patients and relatives. Organizational factors were also interpreted as external pressure. Internal pressure was interpreted as the nurses’ experience of feeling inadequate in situations where it was difficult to protect the dignity of patients. Discussion: These findings correspond with international studies, which show that ethical problems often arise during decision-making situations. Conclusion: In agreement with the definition of an ethical problem, we found that the nurses experienced uncertainty and disagreements about how situations should be managed. External and internal pressures related to intravenous fluids and/or antibiotics in nursing homes have not been reported in previous studies. Thus, these findings merit further exploration.

scholarly journals Mitigation of a Coronavirus Disease 2019 Outbreak in a Nursing Home Through Serial Testing of Residents and Staff

2020 ◽  
Author(s):  
Daniel J Escobar ◽  
Maria Lanzi ◽  
Pouné Saberi ◽  
Ruby Love ◽  
Darren R Linkin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Disease Outbreaks ◽  
Testing Strategy ◽  
Term Care ◽  
Serial Testing ◽  
Universal Testing ◽  
Care Facilities

Abstract Nursing homes and long-term care facilities represent highly vulnerable environments for respiratory disease outbreaks, such as coronavirus disease 2019 (COVID-19). We describe a COVID-19 outbreak in a nursing home that was rapidly contained by using a universal testing strategy of all residents and nursing home staff.

scholarly journals Re-emergence of diphtheria in Kerala: the need for change in vaccination policy

2019 ◽  
Vol 6 (2) ◽  
pp. 829 ◽  
Author(s):  
Priya Chandran ◽  
M. P. Lilabi ◽  
Thomas Bina ◽  
Jayakrishnan Thavody ◽  
Smiji George
Keyword(s):  
Disease Outbreaks ◽  
Case Fatality ◽  
Immunization Coverage ◽  
Epidemiological Data ◽  
Older Children ◽  
Indian States ◽  
Outbreak Period ◽  
Waning Immunity ◽  
Major Factors ◽  
Age Shift

Background Diphtheria cases continue to occur in India despite a national vaccination program targeting the disease. Outbreaks of diphtheria have been known to occur in areas of low immunization coverage. An age shift has been noted to older children and adults in recent outbreaks from the Indian states of Andhra Pradesh, Karnataka, Delhi and Assam. Kerala witnessed its largest outbreak of Diphtheria in recent times from 2015 to 2017.Methods: Surveillance data from the Regional PEID Cell during the outbreak period was analysed and epidemiological data generated.Results: A total of 734 cases of diphtheria were reported during this period with eight deaths (Case fatality rate=1.08%). The mean age of the cases was 17.4 years (±13.9). More than 72% of the cases occurred in children above 10 year of age and 68% of the cases were either unimmunized or partially immunized. 32% of the cases were immunized for age. Of these, immunized children, 88% were above 10 years of age, indicating waning immunity with age. The existence of a sizeable unimmunized cohort in the adolescent age group and waning immunity among immunized were two major factors contributing to the outbreak.Conclusions: An age shift has been observed in the occurrence of Diphtheria cases during the outbreak in Kerala. Booster doses with Td vaccine during adolescence in addition to maintaining a high immunization coverage in the routine immunization program, with special emphasis on pockets of low coverage is essential for preventing the reemergence of diphtheria.

scholarly journals Mobile Phone-Based Population Flow Data for the COVID-19 Outbreak in Mainland China

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Xin Lu ◽  
Jing Tan ◽  
Ziqiang Cao ◽  
Yiquan Xiong ◽  
Shuo Qin ◽  
...  
Keyword(s):  
At Risk ◽  
Driving Forces ◽  
National Level ◽  
Mainland China ◽  
Disease Outbreaks ◽  
Human Migration ◽  
Virus Spread ◽  
Risk Population ◽  
Population Movements ◽  
Infectious Disease Outbreaks

Background. Human migration is one of the driving forces for amplifying localized infectious disease outbreaks into widespread epidemics. During the outbreak of COVID-19 in China, the travels of the population from Wuhan have furthered the spread of the virus as the period coincided with the world’s largest population movement to celebrate the Chinese New Year. Methods. We have collected and made public an anonymous and aggregated mobility dataset extracted from mobile phones at the national level, describing the outflows of population travel from Wuhan. We evaluated the correlation between population movements and the virus spread by the dates when the number of diagnosed cases was documented. Results. From Jan 1 to Jan 22 of 2020, a total of 20.2 million movements of at-risk population occurred from Wuhan to other regions in China. A large proportion of these movements occurred within Hubei province (84.5%), and a substantial increase of travels was observed even before the beginning of the official Chinese Spring Festival Travel. The outbound flows from Wuhan before the lockdown were found strongly correlated with the number of diagnosed cases in the destination cities (log-transformed). Conclusions. The regions with the highest volume of receiving at-risk populations were identified. The movements of the at-risk population were strongly associated with the virus spread. These results together with province-by-province reports have been provided to governmental authorities to aid policy decisions at both the state and provincial levels. We believe that the effort in making this data available is extremely important for COVID-19 modelling and prediction.

Coding Medicare A and B in Nursing Homes

ASHA Leader ◽  
2012 ◽  
Vol 17 (15) ◽  
pp. 3-31
Author(s):  
Mark Kander
Keyword(s):  
Nursing Homes
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