During the pandemic, U.S. nursing homes have experienced many separate COVID-19 outbreaks lasting an average four weeks, according to a new report by the U.S. Government Accountability Office. The longer the outbreak, the higher the level of transmission in the surrounding community, investigators found.
The report, released Friday, is based on an analysis of federal data from June 2020 through December 2021. In addition to levels of community spread, larger facility size (100 beds or more), government oversight and staff shortages were all associated with longer-lasting outbreaks, the authors reported.
7 days shorter
Before COVID-19 vaccines were available, nursing homes located in counties with low community spread had shorter outbreaks, ending seven days earlier than those in counties experiencing high community spread. In addition, 75% of outbreaks began with a reported staff case.
“These results could indicate that, during times of higher community spread, staff have a greater likelihood of being exposed to the virus in the community and bringing it into the nursing home,” the authors wrote in a summary of their findings.
Facilities describe challenges
The GAO also interviewed officials at six facilities, who described their outbreak experiences, including successes and challenges.
Facilities attributed their infection control successes to a variety of mitigation measures. These included restricting residents to their rooms, wearing personal protective equipment and requiring regular testing. In one case, local authorities restricted road travel near the facility.
But the mitigation measures came with their own challenges, resulting in loneliness and failing health in some residents, some facilities said. Staff were traumatized by early pandemic experiences and had trouble adjusting when visitation resumed, at least one facility reported. The biggest challenges in keeping transmission low included staff shortages and low staff morale, facility administrators agreed.