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A Multifaceted Statewide COVID-19 Infection Control Program in Massachusetts Nursing Homes Reduced Infection Rates in the Most Vulnerable Residents

BOSTON – A new study published today in the Journal of Gerontology: Medical Sciences found that multifaceted interventions, particularly cohorting of residents, in addition to adherence to proper infection control procedures, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents. Earlier studies found that high-risk nursing home residents, especially those who were Black or were suffering from dementia, tended to have higher infection rates for COVID-19.

Alyssa B Dufour, Ph.D., Assistant Scientist II at the Hinda and Arthur Marcus Institute for Aging Research, was the lead author of the study, “The Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes.”

Dr. Dufour’s study sought to look at the potential of a state-wide Massachusetts infection control intervention to reduce COVID-19 infection rates of nursing home residents, especially those who were Black or suffered from dementia – two populations at highest risk of serious coronavirus infections. As of May 2021, 50 percent of COVID-19 infections occurred in people who identified as Black while deaths among people with dementia increased 16 percent. Prior studies have shown that persons with dementia are at higher risk for infection and are more likely to experience severe infection and complications – even if not COVID-19-related – compared to those without dementia.

In order to improve infection control in Massachusetts nursing homes, Hebrew SeniorLife and the Massachusetts Senior Care Association partnered to conduct a COVID-19 infection control intervention in 360 Massachusetts nursing homes over a nine-week period. As part of the intervention, nursing homes were offered weekly webinars, answers to infection control questions, resources to acquire personal protective equipment (PPE), backup staff, and COVID-19 testing. Researchers obtained data from four state audits using infection control checklists, weekly infection rates, and used a federally-mandated assessment instrument (Minimum Data Set) to obtain variables on race and dementia, to determine whether adherence to best infection control practices was associated with a decline in average weekly rates of new COVID-19 infections.

Researchers found the overall effect of the intervention did not differ by nursing homes’ racial composition. However, proper cohorting of residents – such as isolating COVID-19-positive or suspected residents in dedicated wings/units or in separate rooms – was associated with a greater reduction in infection rates among facilities where more than 20 percent of residents were Black or Hispanic. 

Facilities in which more than half of residents had dementia had the largest reduction in infection rates when the nursing homes followed infection control recommendations. Cohorting patients with dementia in those facilities was also associated with greater reductions in infection rates.

“We found that adherence to infection control guidelines, especially proper cohorting of COVID-19 cases and proper PPE use, can effectively reduce COVID-19 infection rates, even in high-risk nursing home residents who are Black or Hispanic or with dementia,” Dr. Dufour said.

Brown University collaborated with Hebrew SeniorLife on the study.

Dr. Dufour’s research was supported by the U.S. Department of Health and Human Services/National Institutes of Health/National Institute on Aging (grant: U54 AG063546-02S3).

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Boston-based Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 3,000 seniors a day across six campuses throughout Greater Boston. Our locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; and Jack Satter House, Revere. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $63 million, making it the largest gerontological research facility in the U.S. in a clinical setting. It also trains more than 1,000 geriatric care providers each year. For more information about Hebrew SeniorLife, visit https://www.hebrewseniorlife.org or follow us on our blogFacebookInstagramTwitter, and LinkedIn.