Non-Pharmaceutical Interventions on COVID-19 in Workers and Residents of Nursing Homes in Geneva: A Mixed Qualitative and Quantitative Study.

UNLABELLED

The objective of this study was to examine the impact of varying levels of non-pharmaceutical interventions (NPIs) on COVID-19 transmission in nursing homes during the first wave of the pandemic.

BACKGROUND/OBJECTIVES: The primary aim involved exploring qualitative insights from staff and management regarding the implementation of NPIs. The secondary aim was to determine the cumulative incidence of PCR-confirmed COVID-19 cases among residents. Incident rate ratios (IRRs) were the calculated levels of NPI restrictiveness.

METHODS

We used a mixed methodology to identify factors that might have affected COVID-19 expansion in nursing homes in the canton of Geneva, Switzerland. For the qualitative component, we interviewed the Attending Physicians and/or Director of each nursing home. In the quantitative component, we calculated incident rate ratios (IRRs) for infection between the three levels of COVID-19-related measures taken in these nursing homes, and the cumulative incidence of PCR-confirmed COVID-19 cases in their resident population. This study was conducted in 12 nursing homes located in the canton of Geneva, Switzerland, between 1 March 2020, and 1 June 2020.

RESULTS

Most nursing homes mandated NPIs for their staff and residents during the first wave of COVID-19. We found an equal distribution of maximally ( = 4), moderately ( = 4), and minimally ( = 4) restrictive NPIs for nursing home workers and residents. The extent of NPIs implemented was not shown to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82-45.54, = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75-41.42, = 0.212; minimally restrictive IRR = reference).

CONCLUSIONS

Nursing homes in our study showed high variability in which NPIs, and to what extent, they implemented, with no significant relationship between the restrictiveness of NPIs and COVID-19 incidence among nursing home residents. This suggests that other factors influence the transmission of COVID-19 in these settings. Future research should explore additional determinants and the balance between strict NPIs and the overall well-being of residents.