Home-Based Primary Care Led-Outbreak Mitigation in Assisted Living Facilities in the First 100 Days of Coronavirus Disease 2019.
William R Mills, Janet M Buccola, Susan Sender and 7 others
PMID 32674826WHAT IT FOUND
In 101 assisted living facilities, 7 of 1794 residents tested positive for SARS-CoV-2 over 100 days.
The report describes outbreak monitoring, isolation, and staff training, but gives no comparison showing these steps reduced cases.
Key findings
01Seven of 1794 residents in 101 assisted living facilities tested positive for SARS-CoV-2 during the 100-day period.
02Thirty-five residents were classified as persons under investigation, and positive cases occurred in 3 of the facilities.
03Three positive residents were hospitalized, two were discharged by April 30, and one died.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No comparison group was reported, so the low number of confirmed cases cannot be attributed to the outbreak mitigation steps. The report came from one home-based primary care practice and its own assisted living facilities, so it may not apply to other settings. Only 7 confirmed cases were observed, which is too few to estimate how well the mitigation approach worked. The paper describes employees and facilities as part of the response, but the main outcome was resident case counts, not a patient-centered clinical outcome. The authors state that strong evidence does not yet exist regarding efficacy or effectiveness.
The easy way to misread this
Do not read the 0.4% positive rate as proof that the outbreak mitigation program prevented cases. There was no comparison group, and the authors state that strong evidence does not yet exist regarding efficacy or effectiveness.