Abstract
BackgroundElderly people in nursing homes are particularly vulnerable to COVID-19 due to their age, the presence of comorbidities, and community living. On March 14, 2020, at the beginning of the first epidemic wave of COVID-19 in France, a cluster was reported in a nursing home in the Nouvelle-Aquitaine region. We monitored the outbreak as well as the infection prevention and control (IPC) measures implemented.MethodsA confirmed case was defined as laboratory-confirmed COVID-19 in a resident or staff member present in the nursing home between March 7 and May 1, 2020; and a probable case as a person presenting an acute respiratory illness after contact with a confirmed case. Symptomatic inpatient residents and symptomatic staff members were systematically tested for SARS-CoV-2. In addition, two screening sessions were held on site.ResultsWe identified 109 cases (98 confirmed, 11 probable). The attack rate was 66% among residents and 45% among staff. Half of all cases were identified during the screening sessions. One-quarter of cases had minor symptoms or were asymptomatic. The case fatality rate among residents was 29%. IPC measures were rapidly implemented such as the quarantine of residents, the reinforcement of staff personal protective equipment, and home quarantine of staff testing positive, which were supplemented in April by systematic controls at the entrance of the nursing home and the creation of additional staff break rooms.ConclusionsThis outbreak confirmed the considerable health impact of SARS-CoV-2 transmission in a nursing home. In addition to the implementation of IPC measures, the early detection of cases through the screening of residents and staff is essential to identify asymptomatic and pre-symptomatic cases and limit the spread of the virus.
Highlights
People in nursing homes are vulnerable to COVID-19 due to their age, the presence of comorbidities, and community living
We monitored the epidemic dynamic in this nursing home and the infection prevention and control (IPC) measures implemented throughout this outbreak
Nursing home description On March 14, 2020, 88 residents were living in the nursing home and 104 professionals worked on site, including health care and non-health care staff, private medical practitioners, and kitchen staff
Summary
People in nursing homes are vulnerable to COVID-19 due to their age, the presence of comorbidities, and community living. On March 14, 2020, at the beginning of the first epidemic wave of COVID-19 in France, a cluster was reported in a nursing home in the Nouvelle-Aquitaine region. In Europe, the first reported case of SARS-CoV-2 was identified in the Nouvelle-Aquitaine region on January 24, 2020 [1]. On March 14, 2020, the University Hospital Centre (CHU) in Poitiers reported a confirmed COVID-19 case in a nursing home resident who was subsequently hospitalized. The coordinating physician of the nursing home promptly identified three other residents with suspected symptoms. They were hospitalized and biologically confirmed as SARS-CoV-2 positive on March 15. We monitored the epidemic dynamic in this nursing home and the infection prevention and control (IPC) measures implemented throughout this outbreak
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