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. 2025 Jul 16:S0196-6553(25)00463-8.
doi: 10.1016/j.ajic.2025.07.003. Online ahead of print.

Nursing home visitor policy and COVID-19 infection rates

Huiwen Xu  1 , John R Bowblis  2 , Shuang Li  3 , Yong-Fang Kuo  4 , James S Goodwin  5
Affiliations

Nursing home visitor policy and COVID-19 infection rates

Huiwen Xu et al. Am J Infect Control. .

Abstract

Background: During the Coronavirus disease 2019 (COVID-19) pandemic, Ohio was the only state that collected facility-level visitation data after rescinding its ban on visitors. This study examines the association of allowing outside visitors with COVID-19 infection rates among nursing home residents.

Methods: We assembled a cohort of Ohio nursing homes over 9 weeks (November 1, 2020-January 3, 2021). For each week, we obtained whether a facility allowed visitors, any COVID-19 infections among residents, community infection rates, and other facility characteristics. Marginal structural models examined the association of allowing visitors with resident infections, weighted by the inverse of the probability of allowing visitors.

Results: Of the 677 nursing homes with visitation data, the number of facilities allowing visitors during any week from October 29, 2020 to January 3, 2021 ranged from 226 to 327. Marginal models substantially improved the balance in covariates. In the marginal models, allowing visitors was not associated with the unadjusted rates or adjusted odds of new infection among residents (odds ratio = 0.92, 95% confidence interval: 0.78, 1.08). The result was similar in sensitivity analyses on the lagged effect of allowing visitors.

Conclusions: Allowing visitors in the context of adequate preventive measures was safe, even during a period of high community transmission and before vaccine rollouts.

Keywords: COVID-19 infection; Marginal structural models.

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References

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