The following is a summary of “How to protect long-term care facilities from pandemic-like events? – A systematic review on the effectiveness of non-pharmacological measures to prevent viral respiratory infections,” published in the June 2024 issue of Infectious Disease by Arnold et al.

The COVID-19 pandemic exposed gaps in preparedness for highly contagious respiratory viruses, particularly in vulnerable settings like long-term care facilities where outbreaks can be devastating.

Researchers conducted a retrospective study evaluating the effectiveness of non-pharmacological interventions (NPIs) implemented in long-term care facilities (LTCFs) to mitigate the spread of COVID-19 and improve patient outcomes.

They conducted a review to assess the effectiveness of NPIs used in LTCFs for protecting residents and staff against viral respiratory pathogens with pandemic potential. Different 4 databases Medline, Embase, CINAHL and 2 COVID-19 specific registries were searched (September 20220). Two experienced researchers independently screened and extracted the data. The study incorporated RCTs and non-randomized observational studies which evaluated the effects of interventions. The primary outcomes of interest were the number of outbreaks, infections, hospitalizations, and deaths. A narrative synthesis was conducted to summarize the findings, focusing on the direction and strength of the observed effects. Finally, the certainty of the evidence was evaluated using the GRADE approach.

The result showed 13 observational studies and 3 (cluster) RCTs conducted in high-income countries. Most studies focused on SARS-CoV-2, with a few addressing influenza or upper respiratory tract infections. Findings suggest that diverse measures and hand hygiene interventions can reduce infection-related outcomes among residents and staff . Measures such as staff self-confinement with residents, staff compartmentalization in LTCFs, and routine testing of residents and staff may also offer some effectiveness. Additionally, strategies like restricting shared spaces, serving meals in rooms, and separating infected and non-infected residents were deemed potentially effective but with very low certainty of evidence. The evidence gap map underscores limited research on crucial interventions like visiting restrictions, pre-entry testing, and air filtration systems.

Investigators concluded that LTCFs should prioritize the potentially helpful NPIs despite low evidence certainty, highlighting the need for more research before future pandemics.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09271-7