Control of a COVID-19 outbreak in a nursing home by general screening and cohort isolation in Germany, March to May 2020

Abstract

Elderly care facilities have become a major focus of coronavirus disease (COVID-19) control. Here, we describe an outbreak of COVID-19 in a nursing home in Germany from 8 March to 4 May 2020 (58 days), and the effect of an intervention of general screening and cohort isolation. COVID-19 cases among residents and staff were recorded on a daily basis from the first positive SARS-CoV-2 test from a resident on 8 March 2020, until 4 May 2020 when the last staff member was classified COVID-19 negative. Eighty of 160 residents (50%) and 37 of 135 staff members (27%) tested positive for SARS-CoV-2. Twenty-seven of the 80 residents were asymptomatic but tested positive during the first general screening. Cohort isolation of SARS-CoV-2 positive residents by reorganising the facility proved to be a major effort. After the intervention, four further asymptomatic residents tested positive in follow-up screenings within a period of 6 days, and were possibly infected prior to the intervention. Thereafter, no further infections were recorded among residents. The described outbreak was controlled by implementing general screening and rigorous cohort isolation, providing a blueprint for similar facilities.

Keywords: COVID-19; SARS-CoV-2; infection control; nursing.

Figure 1

Overview of the nursing home’s three buildings A, B and C after separation into COVID-19 negative and COVID-19 positive isolation areas

Figure 2

Number of newly diagnosed COVID-19 cases among nursing home residents and staff by test result date, Wuerzburg, Germany, 8 March–4 May 2020 (n = 160 residents, n = 135 staff)

Figure 3

SARS-CoV-2 testing status and outcome for nursing home residents by date, Wuerzburg, Germany, 8 March–4 May 2020 (n = 160)

Figure 4

SARS-CoV-2 testing status and outcome for nursing home staff by date, Wuerzburg, Germany, 8 March–4 May 2020 (n = 135)