ABSTRACT
BACKGROUND/PURPOSE: Long-term care facilities (LTCFs) are high-risk settings for the novel coronavirus disease (COVID-19). The aim of the study was to describe the extent and the impacts of 2021 COVID-19 outbreaks on LTCFs in Taiwan. METHODS: We retrospectively analyzed the data of each COVID-19 outbreak in LTCFs from May 15 to July 31, 2021 in Taiwan. We characterized the features of LTCFs with outbreaks and compared the characteristics of infected staff members and residents of the affected LTCFs. RESULTS: COVID-19 outbreaks were reported in 16 LTCFs (0.9%). The outbreak was significantly associated with LTCFs with ≥50 beds [adjusted odds ratio (aOR), 6.3; 95%confidence interval [CI], 1.9-21.1] and location of Taipei metropolitan area (aOR, 4.6; 95%CI, 1.7-12.8). Resident cases accounted for 75.4% (203/269) of confirmed cases affected by outbreaks. The 30-day all-cause mortality was 24.2% for residents only and was significantly associated with age ≥65 years [adjusted hazard ratio (aHR, 4.3; 95%CI, 1.7-10.5)], presence of symptoms on diagnosis (aHR, 2.2; 95%CI, 1.3-3.7), and LTCF occupancy rate ≥80% (aHR, 3.0, 95%CI, 1.3-7.4). CONCLUSION: COVID-19 outbreaks have a critical impact on residents in LTCFs owing to the advanced age and high prevalence of chronic comorbidities in this population. Multi-pronged infection control measures and mass testing are vital for mitigating COVID-19 transmission in LTCFs.
ABSTRACT
The outbreak of pneumonia caused by novel coronavirus in Wuhan, China began at the end of 2019. World Health Organization named the virus as coronavirus disease 2019 (COVID-19). Afterwards, the pandemic of COVID-19 hit countries worldwide and outbreaks of healthcare-associated infection occurred. The pandemic of COVID-19 is a rigorous challenge to public health and healthcare system in Taiwan. To strengthen the preparedness and response capacity of healthcare system, Taiwan developed 10 contingency strategies for healthcare facilities, long-term care facilities, and laboratories, to reach three major goals: ＂mitigation of the transmission＂, ＂maintenance of the healthcare system operation＂, and ＂reduction of severe and death cases＂. The 10 contingency strategies included: (1) strengthening infection control and biosafety;(2) conducting un-notified on-site inspections and drills on medical responses;(3) tracing and identifying persons at-risk via National Health Insurance database;(4) implementing patient triage and decentralizing in-patients;(5) preparing response hospitals and designated wards;(6) constructing national testing networks;(7) monitoring capacity of healthcare system;(8) expanding capacity of quarantine places;(9) managing visitors to hospitals;and (10) monitoring health status of healthcare workers.