Evaluating intervention strategies in controlling COVID-19 spread in care homes: an agent-based model

Le Khanh Ngan Nguyen, Susan Howick, Dennis McLafferty, Gillian Hopkins Anderson, Josephine Pravinkumar, Robert Van Der Meer, Itamar Megiddo

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Background:
Care homes are vulnerable to widespread transmission of COVID-19 with poor outcomes for staff and residents. Infection control interventions in care homes need to not only be effective in containing the spread of COVID-19 but also feasible to implement in this special setting which is both a healthcare institution and a home.

Methods:
We developed an agent-based model that simulates the transmission dynamics of COVID-19 via contacts between individuals, including residents, staff members, and visitors in a care home setting. We explored a representative care home in Scotland in our base case and explore other care home setups in an uncertainty analysis. We evaluated the effectiveness of a range of intervention strategies in controlling the spread of COVID-19.

Results:
In the presence of the reference interventions that have been implemented in many care homes, including testing of new admissions, isolation of symptomatic residents, and restricted public visiting, routine testing of staff appears to be the most effective and practical approach. Routine testing of residents is no more effective as a reference strategy while routine testing of both staff and residents only shows a negligible additive effect. Modelling results are very sensitive to transmission probability per contact, but the qualitative finding is robust to varying parameter values in our uncertainty analysis.

Conclusions:
Our model predictions suggest that routine testing should target staff in care homes in conjunction with adherence to strict hand hygiene and using personal protective equipment to reduce risk of transmission per contact.
Original languageEnglish
JournalInfection Control and Hospital Epidemiology
Early online date14 Dec 2020
DOIs
Publication statusE-pub ahead of print - 14 Dec 2020

Keywords

  • SARS-CoV-2
  • healthcare-associated infections
  • agent-based model
  • long term care facilities
  • simulation modelling

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