Stronger Impact of COVID-19 in Nursing Homes of a French Region During the Second Pandemic Wave.
Muriel Rabilloud, Mad-Hélénie Elsensohn, Benjamin Riche and 7 others
PMID 37156472WHAT IT FOUND
Nursing homes in a French region were hit harder by COVID-19 in the second wave than the first.
Outbreaks were more frequent in private for-profit facilities than public ones, and death numbers rose significantly in homes located in densely populated areas.
Key findings
01The proportion of nursing homes reporting at least one outbreak was higher during the second wave (70%) than during the first wave (56%).
02Private for-profit nursing homes had significantly higher outbreak rates than public hospital-associated and private not-for-profit homes during the second wave.
03During the second wave, the cumulative number of COVID-19 deaths in affected homes increased significantly with the population density of the surrounding area.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study relied on imputed dates for symptom onset in about 18% of first-wave and 10% of second-wave outbreaks, which could misattribute cases to the wrong wave. Deaths were used as a proxy for disease spread because testing was inconsistent, especially in the first wave, meaning the true number of infections is unknown. The analysis did not account for differences in resident health status (case-mix) between nursing home types, which could bias the results regarding facility type and outbreak risk.
Declared interests
No specific funding sources or conflicts of interest declarations are provided in the supplied text.
The easy way to misread this
Do not conclude that public nursing homes are safer for residents regarding mortality. While public homes had fewer outbreaks, the number of deaths per outbreak was not significantly different from private for-profit homes. The lower death count in public homes is largely because they had fewer outbreaks, not because they managed severe cases better.