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通过应急响应团队的早期干预,在长期护理机构中控制发病率和病死率较低的 COVID-19 疫情。

Containment of COVID-19 outbreaks with lower incidence and case fatality rates in long-term care facilities by early intervention of emergency response teams.

机构信息

Department of Global Health Entrepreneurship Division of Public Health Tokyo Medical and Dental University (TMDU), Bunkyo, Tokyo, Japan.

DMAT Secretariat, National Hospital Organization Headquarters, Tachikawa, Tokyo, Japan.

出版信息

PLoS One. 2023 Jun 27;18(6):e0287675. doi: 10.1371/journal.pone.0287675. eCollection 2023.

Abstract

OBJECTIVE

To examine whether post-outbreak early-phase interventions by emergency response teams (ERTs) in long-term care facilities (LTCFs) contribute to containment with lower incidence and case-fatality rate of COVID-19 and analyse the required assistance.

METHODS

Records from 59 LTCFs (28 hospitals, 15 nursing homes, and 16 homes) assisted by ERTs after the COVID-19 outbreak, between May 2020 and January 2021, were used for the analysis. Incidence and case-fatality rates among 6,432 residents and 8,586 care workers were calculated. The daily reports of ERTs were reviewed, and content analysis was performed.

RESULTS

Incidence rates among residents and care workers with early phase (<7 days from onset) interventions (30·3%, 10·8%) were lower than those with late phase (≥7 days from onset) interventions (36·6%, 12·6%) (p<0·001, p = 0·011, respectively). The case-fatality rate among residents with early-phase and late-phase interventions were 14·8% and 16·9%, respectively. ERT assistance in LTCFs was not limited to infection control but extended to command and coordination assistance in all studied facilities.

CONCLUSION

Assistance in the facility's operational governance from the early phase of an outbreak in LTCFs contributed to a significant decline in incidence rate and case fatality rate among LTCF residents and care workers in facilities.

摘要

目的

探讨疫情爆发后,应急响应团队(ERT)在长期护理机构(LTCF)进行的早期干预措施是否有助于控制疫情,降低 COVID-19 的发病率和病死率,并分析所需的援助。

方法

使用了 2020 年 5 月至 2021 年 1 月期间,ERT 协助的 59 家 LTCF(28 家医院、15 家养老院和 16 家养老院)的记录进行分析。计算了 6432 名居民和 8586 名护理人员的发病率和病死率。对 ERT 的每日报告进行了审查,并进行了内容分析。

结果

早期(发病后<7 天)干预组居民和护理人员的发病率(30.3%,10.8%)低于晚期(发病后≥7 天)干预组(36.6%,12.6%)(p<0.001,p=0.011)。早期和晚期干预组居民的病死率分别为 14.8%和 16.9%。ERT 在 LTCF 的援助不仅限于感染控制,还扩展到所有研究设施的指挥和协调援助。

结论

在 LTCF 疫情爆发的早期阶段,对设施运营治理的援助有助于显著降低 LTCF 居民和护理人员的发病率和病死率。

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