Abstract
Abstract This paper proposes and analyses a stochastic model for the spread of an infectious disease transmitted between clients and care workers in the UK domiciliary (home) care setting. Interactions between clients and care workers are modelled using specially generated networks, with network parameters reflecting realistic patterns of care needs and visit allocation. These networks are then used to simulate a susceptible-exposed-infected-recovered/dead (SEIR/D)-type epidemic dynamics with different numbers of infectious and recovery stages. The results indicate that with the same overall capacity provided by care workers, the minimum peak proportion of infection and the smallest overall size of infection are achieved for the highest proportion of overlap between visit allocation, i.e. when care workers have the highest chances of being allocated a visit to the same client they have visited before. An intuitive explanation of this is that while providing the required care coverage, maximising overlap in visit allocation reduces the possibility of an infectious care worker inadvertently spreading the infection to other clients. The model is generic and can be adapted to any directly transmitted infectious disease, such as, more recently, corona virus disease 2019, provided accurate estimates of disease parameters can be obtained from real data.
Highlights
The catastrophic impact of corona virus disease 2019 (COVID-19) in care homes for older people has been well documented [1, 2], demonstrating the extreme vulnerability of their frail elderly residents receiving personal care to this emerging infection
To model the dynamics of the infectious spread, we have considered networks going from no overlap to high overlap, see Figure 2
In the high overlap network case, we assume that if a client is already receiving a visit from a particular care worker and if they require additional visits, these would most likely be provided by the same care worker
Summary
The catastrophic impact of corona virus disease 2019 (COVID-19) in care homes for older people has been well documented [1, 2], demonstrating the extreme vulnerability of their frail elderly residents receiving personal care to this emerging infection. Vacancy in the domiciliary-care-providing sector is typically 1 in 10, with annual staff turnover of 1 in 5 [3]. Social care, both residential and domiciliary, can contribute to transmission of COVID-19 and other infections such as influenza or norovirus (winter vomiting). Providers may become unable to deliver care if staff are ill or isolating, putting vulnerable people at risk
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