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. 2023 Jan 13;15(1):232.
doi: 10.3390/v15010232.

COVID-19 Clusters in Belgian Nursing Homes: Impact of Facility Characteristics and Vaccination on Cluster Occurrence, Duration and Severity

Sara Dequeker  1 , Milena Callies  1 , Lucy Catteau  1 , Laura Int Panis  1 , Esma Islamaj  1 , Sofieke Klamer  1 , Katrien Latour  1 , Marijke Pauwels  1 , Catharina Vernemmen  1 , Romain Mahieu  2 , Hanna Masson  3 , Muhammet Savsin  4 , Etienne De Clercq  5 , Mireille Thomas  6 , Boudewijn Catry  1   7 , Eline Vandael  1
Affiliations

COVID-19 Clusters in Belgian Nursing Homes: Impact of Facility Characteristics and Vaccination on Cluster Occurrence, Duration and Severity

Sara Dequeker et al. Viruses. .

Abstract

COVID-19 severely affected nursing home residents from March 2020 onwards in Belgium. This study aimed to model the impact of vaccination and facility characteristics on cluster occurrence, duration and severity in this setting. Possible clusters were identified between June 2020 and January 2022, based on the Belgian COVID-19 surveillance in nursing homes. Median attack rates (AR) among residents and staff, case hospitalization rates (CHR) and case fatality rates (CFR) were calculated. A negative binomial model was used to identify the association between nursing home characteristics and the number of cases, hospital admissions and deaths and the duration of the cluster. A total of 2239 clusters were detected in more than 80% of nursing homes. Most of these (62%) occurred before the start of COVID-19 vaccination (end of December 2020). After vaccination, the number of clusters, the AR among residents and staff, the CHR and the CFR dropped. Previous cluster(s) and vaccination decreased the number of cases, hospital admissions and deaths among residents. Previous cluster experience and having started vaccination were protective factors. We recommend continued implementation of targeted interventions such as vaccination, large-scale screening and immediate implementation of additional infection prevention and control measures.

Keywords: SARS-CoV-2; clusters; infection prevention; long-term care facilities; vaccination.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Confirmed cases per 1000 nursing home (NH) residents and per 1000 inhabitants, per week, in Belgium. A two-week moving average is presented from 17 March 2020–2 January 2022. The nursing home residents are included in the confirmed cases among the general population. Grey boxes indicate the COVID-19 (coronavirus disease 2019) waves. Grey brackets indicate the dominant variant. The dotted lines indicate the COVID-19 vaccination campaign (primary course) and the booster administration in nursing homes. Wuhan-Hu-1: Severe acute respiratory syndrome coronavirus 2 (wild type); B.1.1.7: Alpha variant; B.1.617.2: Delta variant; B.1.1.529: Omicron variant; NH: nursing home.
Figure 2
Figure 2
Evolution of the number of confirmed COVID-19 cases among nursing home (NH) residents by week in Belgium, from 22 June 2020 to 2 January 2022. Grey boxes indicate the second, third and fourth COVID-19 wave (from left to right). Dotted lines indicate the starts of the primary course vaccination campaign and of the booster vaccination. Wuhan-Hu-1: Severe acute respiratory syndrome coronavirus 2 (wild type); B.1.1.7: Alpha variant; B.1.617.2: Delta variant; NH: nursing home.
See this image and copyright information in PMC

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