In the United States, the first case of the novel coronavirus 2019 (COVID-19) was detected in January 2020 in the state of Washington. By February 2020, COVID-19 was linked to 167 confirmed cases of staff and residents within a single nursing home in that same state, resulting in 34 deaths. As of March 21, the Kaiser Family Foundation reported that 7732 long-term facilities in 43 state had known COVID-19–positive residents. In the 38 states that reported nursing home mortality data, COVID-19 is responsible for 42% of the deaths. Residents in long-term care facilities are especially vulnerable to the effects of respiratory-borne illness (e.g. influenza), which now includes COVID-19. However, the vulnerability of nursing home residents goes beyond age, physical condition, and frailty and includes their physical environment. Nursing home residents share common caregivers and reside in close, often shared, living arrangements. In addition, pathogenic spread can occur through exposure during transfers to/from the hospital as well as exposure to staff, visitors, and other health care workers who go in and out of the facility.
Popejoy, L., Vogelsmeier, A., Boren, W., Martin, N., Kist, S, Canada, S., Miller, S.J., & Rantz, M. (2020). A coordinated response to the COVID-19 pandemic in Missouri nursing homes. Journal of Nursing Care Quality, published online July 2020.View the PDF