Almost 24% of the elderly residents of the elderly centers and 15% of their workers were positive for SARS-CoV-2 and, more than half of them, asymptomatic; specifically, 69.7% of residents and 55.8% of workers, according to a study by the Vall d'Hebrón University Hospital in Barcelona. The work, by an interdisciplinary team coordinated by Magda Campins, head of the Preventive Medicine and Epidemiology Service, and by Benito Almirante, head of the Infectious Diseases Service, in close collaboration with primary care centers, was implemented to control the transmission of SARS-CoV-2 in nursing homes in the Hebron Valley area of ​​influence between April 10 and 24, 2020. The results have now been published in Emerging Infectious Diseases..

This study included around 6,000 people, between residents and workers, from a total of 69 nursing homes, both public and private. "This is the first study on the impact of Covid-19 in residences published on such a large sample of people. In addition, the homogeneous action in all residences provides great validity to the results obtained," says Xavier Martínez, doctor of the Service of Preventive Medicine and Epidemiology, researcher of the research group in Epidemiology and Public Health of the Vall d'Hebron Research Institute (VHIR) and one of the authors of the publication.

The services of Clinical Microbiology and Infectious Diseases and Geriatrics of the Gregorio Marañón Hospital in Madrid recently published a study to find out the protection or vulnerability situation of both the elderly and caregivers in the 13 residences in their area of ​​influence. In his case, 2,500 people were evaluated by PCR and antibody tests to determine their degree of immunity. The conclusions were that between 60 and 70% of the older people studied have antibodies, with which they can now lead a normal life such as receiving visits from their relatives or even going for walks. And that 30% of the personnel of the evaluated residences had been in contact with the new coronavirus.

In the Hebron Valley series, the researchers analyzed the presence of symptoms related to Covid-19 and the results of PCR tests on 3,214 residents and 2,655 residential workers. 23.9% of residents and 15.2% of workers were positive for the infection. These data demonstrate a very high transmission of the virus in these centers, especially favored by the characteristics of the residences, such as shared rooms and bathrooms, other common spaces, and the coexistence of dependent people who require a lot of attention.

On the other hand, the presence of symptoms related to Covid-19 in the 14 days prior to the diagnostic test was analyzed. 69.7% of residents and 55.8% of infected workers were asymptomatic; that is, they had not presented fever or respiratory problems in the previous days. These results suggest that the high percentage of asymptomatic cases plays a relevant role in the spread of the virus in this type of center and, therefore, it is essential to detect all both symptomatic and asymptomatic cases to cut the transmission chain. It is considered that the screening based on symptoms in this highly fragile group would be insufficient to detect all incident cases. "When there is a suspicion or case of Covid-19 in nursing homes, infection control actions should be done as quickly as possible. These measures should include testing both asymptomatic and symptomatic people, since if they are infected they can transmit the virus ", explains Blanca Borrás, a physician at the Service of Preventive Medicine and Epidemiology, researcher of the research group in Epidemiology and Public Health of the VHIR and first author of the study.

Based on the results of the initial screening study of the residences, in less than 72 hours from the Hospital del Valle de Hebrón, recommendations were made for infection control and prevention measures adapted to the characteristics of each center. These actions were implemented in coordination with the participation of the Preventive Medicine and Epidemiology, Microbiology and Infectious Diseases services, the hospital management and the primary care services SAP Montaña and CAP Sant Andreu.

Valle de Hebrón organized a team made up of between 8 and 12 nurses, coordinated by María Gutiérrez-San Miguel, a professional from the Process and Quality Directorate of the Valle de Hebrón, who traveled to the residences to take, together with the nursing device Primary Care, about 500 daily samples on average both residents and professionals of the centers. The joint work with Primary Care was essential to carry out the actions in each of the 69 residences, to monitor patients who did not require hospital admission and to sectorize the residences and avoid new infections.

Some of the most important measures taken were isolating infected residents, training workers on prevention measures, and designating specific areas for residents based on the results. The researchers recommend the implementation of a centralized Covid-19 prevention and control strategy that includes screening residents and professionals, regardless of the presence of symptoms, in order to prevent and control Covid-19 outbreaks regardless of the presence of symptoms, to prevent and control outbreaks of Covid-19 in this vulnerable group of people.

Campins explained that it is difficult to detect which resident is infected if they do not test us because fever is not frequent in the elderly, they are not aware of anosmia and headache, asthenia or muscle pain are frequent symptoms in them. The expert has insisted, given the high percentage of registered asymptomatic patients, on the importance of performing PCR on all residents and new workers in a residence; daily monitoring of all and PCR for all if a positive case is detected. In this case, periodic PCR should be continued until no positive case occurs.

Campins has said that he values ​​"well" the plan to return to normality in residences released by the Generalitat of Catalonia because "we cannot have the elderly confined forever." And he recalled that there is more risk in residences than in families, as long as they are aware that they live with a vulnerable person and must act accordingly. He recommends that upon return to the residence, after spending the holidays with the family, the resident undergo PCR.

Regarding what happened during the acute phase of the pandemic, Campins explained that the Hebron Valley, in the absence of a strategy by the Public Health of the Generalitat, acted on its own, in collaboration with the primary care of the area, and He moved doctors and nurses and brought personal protective equipment to the residences and informed their managers and workers about what they should do (how to order common rooms, what to do with positive cases, etc.). Every day, he says, the toilets traveled to the residences and the patients who could be cared for in the residence were treated there and those who needed admission to the hospital were referred. In this way, the hospital did not collapse and, says Campins, there were no Dantesque situations in the elderly centers either.

According to the criteria of The Trust Project

Know more

  • Barcelona
  • Catalonia

De-escalation Costa Brava ready to face the Barcelona exodus after the end of the state of alarm in Catalonia

EventsA gang falls that trafficked more than a thousand people from Africa to Europe

They find fragments of the meteorite that was used as "divine signal" in the War of Succession

See links of interest

  • Last News
  • English translator
  • Programming
  • Catalonia Calendar
  • Work calendar
  • Daily horoscope
  • Santander League Ranking
  • League calendar
  • TV Movies
  • Themes
  • West Ham United - Chelsea
  • Extremadura UD - Racing de Santander
  • Ponferradina - Fuenlabrada
  • Real Betis - Villarreal
  • Real Madrid - Getafe, live