Infection Control Is Key to Contain Virus in Nursing Homes: Experts

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Of the 351 long-term care facilities currently identified by the Illinois Department of Public Health as having a coronavirus outbreak, 60 percent were cited for infection control violations, the latest federal data shows.

The Centers for Medicare and Medicaid Services updated the Nursing Home Compare tool last week for the first quarter of 2020, which included the list of facilities cited for infection control violations. Routine medical inspections stopped in early March because of the coronavirus pandemic, so the data only extends through February.

An NBC 5 Investigates analysis of the CMS data found 212 of the 351 long-term care facilities listed on IDPH’s website of current outbreaks were cited for infection control problems, which some experts said could call into question preparedness to handle a virus outbreak that has already wreaked havoc on the nursing home community.

“(It’s) perhaps a warning sign of a facility that might be vulnerable to a bad outcome,” said Dr. Ronald Hershow, an epidemiologist at the University of Illinois Chicago School of Public Health. “But some infection control violations might be less relevant than others.”

An infection control violation specifically relevant to stopping the spread of respiratory viruses would be more concerning than a citation for unsanitary conditions in the kitchen, Dr. Hershow explained.

Doctors said COVID-19 outbreaks, however, are random and relentless in nature.

“Even the worst nursing home may get lucky and avoid a COVID-19 introduction because the random event is the introduction event – how the virus gets into the facility,” Dr. Hershow said.

IDPH Director Dr. Ngozi Ezike also said it is difficult to pinpoint the exact reason or cause of an outbreak.

“If (nursing homes) don’t keep up with the things (they’re) supposed to be doing, there could be lapses, and sometimes that is what is causing some of these outbreaks,” said Dr. Ezike. “Some, it’s just that with asymptomatic spread, it is very difficult to even know that someone is potentially spreading the virus. There really isn’t a perfect solution where you could prevent every case.”

According to IDPH’s latest numbers, 1,082 people have died of coronavirus complications in long-term care facilities. The state only updates data once a week on Fridays, so the death toll is likely much higher. As of last Friday, nursing home deaths accounted for 44 percent of all Illinois coronavirus deaths, NBC 5 Investigates found.

The elderly and ill population of nursing homes, combined with congregate settings, make residents especially vulnerable.

“If you wanted to concoct a setting that would have all the ingredients that would make for bad outcomes with this virus, you couldn’t really have invented a better or worse setting than nursing homes,” Dr. Hershow said.

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