COVID-19: As community rates rose, analysis shows impacts in nursing homes across the U.S.

From the first recognized outbreak of the novel coronavirus in a Seattle-area long-term care facility in February, the tragic impacts that COVID-19 could have on the oldest most vulnerable people and on those who care for them were clear. They also were swiftly replicated in nursing homes across the country as illnesses among staff and residents wrought unprecedented devastation.

Now an analysis of rates of illness and infection among those living and working in nursing homes  across the United States indicates how rising rates community transmission accelerated impacts in those settings.

The analysis, published in a U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report released today, follows the trajectory of coronavirus infections in more than 15,000 nursing homes (99.6% of all such facilities in the U.S.) from May 25 when the Centers for Medicare & Medicaid Services began to require weekly reporting of infections among residents and staff, to late November when rates in facilities peaked at 23.2 confirmed resident infections and 21.3 staff confirmed infections for every thousand occupied nursing home beds.

As rates rose through June and July, dipped in August and September, and then began their steepest climb in October, the analysis shows, they mirrored rates in the surrounding communities, which across the south had climbed by July to 178 infections for every. 100,000 people, and across the mid- and northwest climbed to 615 infections for every 100,000 people.

"Increased COVID-19 incidence in communities with nursing homes increases the risk for introduction of SARS-CoV-2 by staff members," the authors note. Data showing exposures to staff from household and social contacts, they add, may indicate lapses in adherence to safety measures, and underscore needs to use data from community surveillance, maintain routine testing among staff and emphasize in staff training  the need to follow CDC masking and distancing recommendations in social interactions.