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Malara A, Noale M, Trevisan C, Abbatecola AM, Borselli G, Cafariello C, Gareri P, Fumagalli S, Mossello E, Volpato S, Monzani F, Coin A, Okoye C, Bellelli G, Del Signore S, Zia G, Antonelli Incalzi R, Palmieri A, Fedele G, Onder G. Efficacy of COVID-19 control measures on post-vaccination outbreak in Italian Long Term Care Facilities: implications for policies. Front Public Health 2023; 11:1091974. [PMID: 37346108 PMCID: PMC10280634 DOI: 10.3389/fpubh.2023.1091974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
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.
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Affiliation(s)
- Alba Malara
- Associazione Nazionale Strutture Territoriali-Humanitas Foundation, Rome, Italy
| | - Marianna Noale
- Neuroscience Institute, National Research Council, Padua, Italy
| | - Caterina Trevisan
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Department of Medicine, University of Padua, Padua, Italy
| | | | - Gilda Borselli
- Italian Society of Gerontology and Geriatrics, Florence, Italy
| | | | - Pietro Gareri
- Center for Cognitive Disorders and Dementia (CDCD) Catanzaro Lido – ASP Catanzaro, Catanzaro, Italy
| | - Stefano Fumagalli
- Department of Experimental and Clinical Medicine, University of Florence and Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Enrico Mossello
- Department of Experimental and Clinical Medicine, University of Florence and Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Stefano Volpato
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Chukwuma Okoye
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca and Acute Geriatric Unit, San Gerardo Hospital, Monza, Italy
| | | | | | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Annapina Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | - Giorgio Fedele
- Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | - Graziano Onder
- Department of Geriatrics, Universita' Cattolica Sacro Cuore, Rome, Italy
- Fondazione Policlinico Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
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