COVID-19 in full inpatient care facillities - a never ending story?

ABSTRACT

Since March 2020, the corona pandemic has consistently exposed the weaknesses of the inpatient care system at the expense of those in need of case. No population group in Germany died more frequently as a result of corona-related infections (outbreaks) than residents of inpatient care facilities. By the end of March 2022. nearly 60% of Munich nursing home residents had become nosocomially infected with COVID-19, of which 18% died COVID-19 associated. Inadequate hygiene measures in the facilities could not and still cannot prevent large outbreaks. Because nursing facilities were not previously required to have hygienic staff, the Munich Health Department conducted standardized inspections and consultations during outbreaks. In almost no facility was a professionally correct outbreak management implemented. In addition, numerous hygiene deficiencies were identified that favored the transmission of SARS-CoV-2 infections to third parties. Furthermore, it became apparent that despite years of professional advice to the nursing facilities, no lasting positive effect on their hygiene management could be achieved. There are several reasons for this a very high staff turnover, a low ratio of skilled workers, and a lack of commitment on the part of the facilities to a structured hygiene management system. Due to the continuing risk to the vulnerable population group in full inpatient care facilities, there is a fundamental need for regulation of binding hygiene management in these facilities - also with regard to risks from outbreaks with other pathogens. This was met by the legislature in September 2022 with an amendment to the Infection Protection Act. However, the theory-practice transfer required for functioning hygiene management can only succeed if sufficient numbers of professionally qualified staff with knowledge of German are available in the facilities to care for those in need of care.