Friday, Aug. 7Long-term care deaths in COVID-19 are a particular problem. People over age 85 constitute 2 to 3 percent of all cases of COVID-19 and 35 percent of all deaths, and many of them are in nursing homes.The New York Times has an excellent graphics page summarizing the data. Early in the pandemic nearly half of all COVID-19 deaths came in long-term care facilities:https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.htmlThere are also data scientists who track this info from day to day who have a public google sheet on nursing/Long Term Care home COVID-19 data.https://docs.google.com/spreadsheets/d/1ETm51GayRjlnoaRVtUOWfkolEeAQZ-zPhXkCbVe4_ik/edit#gid=435667374As a result of this vulnerability, states have adopted stringent policies protecting long-term care facilities. No visitation is allowed. Staff were trained on infection control. Testing of staff was prioritized. Personal protective equipment was provided. Recently, weekly testing was mandated by the Centers of Disease Control.So, everything is OK now, right?Wrong.One of the principles of epidemiologist that is worth highlighting over and over again is that community transmission scales the risk for every activity. Any procedures you put in place to protect long-term care homes when infection rates were low have a chance of being inadequate when community transmission is higher. In particular, surveillance needs to rise with the community transmission level.Here is a graph from Florida’s long-term care data showing that their recent peak in cases also increased long-term care deaths again. Credit for this graph goes to @Magnets!OH! on Twitter, and the data sources are cited in his Twitter feed.
Link:Magnets!Oh!To highlight this principle again, whatever measures you adopt for mitigation and surveillance to protect your activity during the pandemic need to be relative to the rate of transmission in the community. Community transmission scales the risk of everything else. Contact Dave Blake.