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. 2023 Jun 6:11:1091974.
doi: 10.3389/fpubh.2023.1091974. eCollection 2023.

Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies

Alba Malara  1 , Marianna Noale  2 , Caterina Trevisan  3   4 , Angela Marie Abbatecola  5 , Gilda Borselli  6 , Carmine Cafariello  7 , Pietro Gareri  8 , Stefano Fumagalli  9 , Enrico Mossello  9 , Stefano Volpato  3 , Fabio Monzani  10 , Alessandra Coin  4 , Chukwuma Okoye  10 , Giuseppe Bellelli  11 , Stefania Del Signore  12 , Gianluca Zia  12 , Raffaele Antonelli Incalzi  13 , Annapina Palmieri  14 , Giorgio Fedele  15 , Graziano Onder  16   17 ; GeroCovid Vax Working Group
Affiliations

Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies

Alba Malara et al. Front Public Health. .

Abstract

Background: Numerous individual and organizational factors can influence the spread of SARS-CoV-2 infection in Long Term Care Facilities (LTCFs). A range of outbreak control measures are still implemented in most facilities involving administrations, staff, residents and their families. This study aims to evaluate which measure could influence the transmission of SARS-CoV-2 infection among residents during the period March 2021-June 2022.

Methods: We enrolled 3,272 residents aged ≥60 years. The outbreak control measures adopted to prevent or manage the infection included entry regulations, contact-regulating procedures, and virological surveillance of residents and staff. The association between LTCFs' and participants' characteristics with new cases of COVID-19 infections was analyzed using multilevel logistic regression models.

Results: In 33.8% of the facilities 261 cases of SARS-CoV-2 infection were reported. Among participant characteristics, gender and age were not associated with SARS-CoV-2 infection, while having received the vaccine booster dose was protective against infection [Odds Ratio (OR) = 0.34, 95% Confidence Interval (CI) 0.12-0.99, p = 0.048]. In addition, the implementation of protected areas for family visits was associated with a significant reduction of the probability of infections (OR = 0.18, 95% CI 0.03-0.98, p = 0.047). Overall, about 66% of the variability in the probability of SARS-CoV-2 infection during the observational period may be due to facility structure characteristics and 34% to the participant characteristics.

Conclusions: These data showed that vaccination booster doses and family visit restriction-control are still needed to make the LTCFs safer against SARS-CoV-2 infection.

Keywords: COVID-19 vaccination; Long Term Care Facilities (LTCFS); SARS CoV-2 infection; outbreak control measures; pandemic fatigue.

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Conflict of interest statement

SD was employed by Bluecompanion Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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