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Review
. 2020 Oct;68(10):2153-2162.
doi: 10.1111/jgs.16784. Epub 2020 Sep 2.

COVID-19 in Nursing Homes: Calming the Perfect Storm

Joseph G Ouslander  1 , David C Grabowski  2
Affiliations
Review

COVID-19 in Nursing Homes: Calming the Perfect Storm

Joseph G Ouslander et al. J Am Geriatr Soc. 2020 Oct.

Abstract

The pandemic of viral infection with the severe acute respiratory syndrome coronavirus-2 that causes COVID-19 disease has put the nursing home industry in crisis. The combination of a vulnerable population that manifests nonspecific and atypical presentations of COVID-19, staffing shortages due to viral infection, inadequate resources for and availability of rapid, accurate testing and personal protective equipment, and lack of effective treatments for COVID-19 among nursing home residents have created a "perfect storm" in our country's nursing homes. This perfect storm will continue as society begins to reopen, resulting in more infections among nursing home staff and clinicians who acquire the virus outside of work, remain asymptomatic, and unknowingly perpetuate the spread of the virus in their workplaces. Because of the elements of the perfect storm, nursing homes are like a tinderbox, and it only takes one person to start a fire that could cause many deaths in a single facility. Several public health interventions and health policy strategies, adequate resources, and focused clinical quality improvement initiatives can help calm the storm. The saddest part of this perfect storm is that many years of inaction on the part of policy makers contributed to its impact. We now have an opportunity to improve nursing homes to protect residents and their caregivers ahead of the next storm. It is time to reimagine how we pay for and regulate nursing home care to achieve this goal. J Am Geriatr Soc 68:2153-2162, 2020.

Keywords: COVID-19; SARS-CoV-2; nursing homes.

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References

REFERENCES

    1. Grabowski DC, Mor V. Nursing home care in crisis in the wake of COVID-19. JAMA. 2020;324(1):23-24. https://doi.org/10.1001/jama.2020.8524. Online ahead of print.
    1. Centers for Medicare & Medicaid Services. COVID-19 data. https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg. Accessed July 12, 2020.
    1. Abrams HR, Loomer L, Gandi A, Grabowski DC. Characteristics of U.S. nursing homes with COVID-19 cases. J Am Geriatr Soc. 2020;68(8):1653-1656.
    1. White EM, Kosar CM, Feifer RA, et al. Variation in SARS-CoV-2 prevalence in US skilled nursing facilities. J Am Geriatr Soc. 2020. https://doi.org/10.1111/jgs.16752
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