Comparing multiple infection control measures in a nursing home setting: a simulation study.
Infect Control Hosp Epidemiol
; 45(7): 872-879, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38487822
ABSTRACT
OBJECTIVE:
Compare the effectiveness of multiple mitigation measures designed to protect nursing home residents from infectious disease outbreaks.DESIGN:
Agent-based simulation study.SETTING:
Simulation environment of a small nursing home.METHODS:
We collected temporally detailed and spatially fine-grained location information from nursing home healthcare workers (HCWs) using sensor motes. We used these data to power an agent-based simulation of a COVID-19 outbreak using realistic time-varying estimates of infectivity and diagnostic sensitivity. Under varying community prevalence and transmissibility, we compared the mitigating effects of (i) regular screening and isolation, (ii) inter-resident contact restrictions, (iii) reduced HCW presenteeism, and (iv) modified HCW scheduling.RESULTS:
Across all configurations tested, screening every other day and isolating positive cases decreased the attack rate by an average of 27% to 0.501 on average, while contact restrictions decreased the attack rate by an average of 35%, resulting in an attack rate of only 0.240, approximately half that of screening/isolation. Combining both interventions impressively produced an attack rate of only 0.029. Halving the observed presenteeism rate led to an 18% decrease in the attack rate, but if combined with screening every 6 days, the effect of reducing presenteeism was negligible. Altering work schedules had negligible effects on the attack rate.CONCLUSIONS:
Universal contact restrictions are highly effective for protecting vulnerable nursing home residents, yet adversely affect physical and mental health. In high transmission and/or high community prevalence situations, restricting inter-resident contact to groups of 4 was effective and made highly effective when paired with weekly testing.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Controle de Infecções
/
COVID-19
/
Casas de Saúde
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article