Artist’s computer rendered illustration of a microscopic virus.

Resident COVID-19 infection rates were significantly higher in single-site long-term care facilities with stand-alone buildings than in facilities with smaller, detached buildings, according to a new meta-analysis conducted by a group of researchers in Australia. 

Led by University of New South Wales Sydney Ph.D. student Mohana Kunasekaran, investigators examined 41 articles across 11 countries, which included data from more than 90,000 long-term care residents and 6,500 staff members in 757 facilities.

They found that the overall infection rate among residents was approximately 42%, whereas 21.7% of pooled staff became infected with the virus. Further analyses showed, however, stand-alone single-building facilities were responsible for twice the infection rates. Infections hit approximately 50% of residents in the stand-alones, compared with approximately 26% of residents in facilities with multiple, detached buildings, which allowed residents to remain more physically distant from one another.  

“The design of aged care facilities should have smaller-sized facilities with adequate space for social distancing,” the researchers concluded.

Full findings were published online Friday in Open Forum Infectious Diseases.

The study’s conclusions are similar to those found last year in the United States with regard to the Green House/small nursing home model. That study, limited to nursing homes, showed that facilities that incorporate the Green House/small nursing home model faced significantly lower rates of COVID-19 cases, admissions and mortality than traditional nursing homes. The small-home model had fewer COVID-19 cases when compared with both smaller traditional nursing homes (less than 50 beds), and with larger traditional settings (50 beds or more), the University of North Carolina at Chapel Hill researchers reported.