Maximilian Salcher-Konrad and Adelina Comas-Herrera

This note summarizes emerging evidence on COVID-19 outbreak responses in care homes, obtained from a “living” systematic review that focused on COVID-19 mortality and spread of disease in long-term care more broadly (Salcher-Konrad et al, 2020).

The review found that outbreaks in long-term care settings varied widely in terms of the number of people affected, and that evidence on the reasons behind this variation is still emerging. This review will be updated as more evidence becomes available. While this is very early evidence, our review identifies 4 measures may have worked in containing COVID-19 outbreaks in care homes:  

1. Early detection and rapid response after detection of index case
2. Systematic testing of all residents and staff: high prevalence of asymptomatic and presymptomatic cases that would not be detected by a) symptoms screening, and b) one-off testing (if infection has already spread beyond index case).
3. Moving high-risk contacts of cases out of the facility
4. Isolating cases by removing them from the facility or creating separate wards within the facility