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Nursing Homes And The Spread Of COVID-19: The How, Why, And What Can Be Done

We’ve been hearing it all over the news and many of us have been exposed to it in our personal and daily lives: the threat of COVID-19 in nursing homes. According to experts, these facilities are “breeding grounds” for the virus, leaving many of us frightened for ourselves or loved ones who reside in or are employed by a nursing home.

At first thought, it might seem counterintuitive that of all locations, nursing homes would be a hotspot for the virus. After all, wouldn’t the level of prevention and sanitation be greatest in these environments, given the fact that many nursing home residents are particularly susceptible to the virus? This begs a closer look at just how COVID-19 spreads in nursing homes.


COVID-19 is transmitted from person to person mainly through respiratory droplets produced when an infected individual coughs or sneezes. However, COVID-19 virus particles can also remain alive on surfaces, and can thereby be transmitted through the touching of contaminated objects in the environment.


There are many reasons COVID-19 seems to be particularly prevalent in nursing home facilities, including the following:

  • The population density is high, meaning there are a lot of people in a relatively small amount of space
  • Staff and residents must routinely contact shared dining, activity, and therapy spaces
  • Residents in nursing homes are there for a reason—namely, they have underlying medical conditions which increase their vulnerability to the virus
  • Due to the nature of the work in nursing homes, staff members could be exposed to the bodily fluids of infected patients
  • If a staff member has unknowingly contracted the illness and therefore continues to work in close proximity with residents and other staff members, the virus could easily be transmitted

These are all of the ingredients necessary for a “breeding ground” of COVID-19, and the problem is worsened by the fact that many nursing homes fail to adhere strictly to infection control guidelines designed to prevent the transmission of the virus.

What Can Be Done?

If you have a loved one living in a nursing home and are concerned about whether or not they have already contracted COVID-19, you have the option of requesting that their primary doctor order a test. Unfortunately, the CDC guidelines are such that not everyone is deemed in need of testing. For this reason, there is no guarantee that your loved one will be able to receive a test.

In the effort to prevent the transmission of COVID-19 in nursing homes, the CDC has established strategies for adoption within these facilities. Each strategy falls into one of five categories designed to tackle a specific aspect of the problem. These are as follows:

1) Prevent The Virus From Entering The Facility

  • Restrict all visitors with the exception of those for residents under end-of-life care
  • Only allow essential service and healthcare providers into the facility
  • Every person who enters the facility must have their temperature checked and must be asked screening questions regarding symptoms of COVID-19 infection
  • Residents are barred from field trips outside of the facility

2) Early Detection Of Infected Individuals

  • All residents must have their temperature checked, as well as be screened for symptoms of COVID-19
  • Isolation precautions need to be initiated for any resident who develops a fever or symptoms that could indicate COVID-19 infection
  • Facilities are required to alert local or state health departments within 24 hours of identifying any of the following:
    • a resident who must be hospitalized for a severe upper respiratory infection
    • a resident who passes away as the result of a severe upper respiratory infection
    • three or more residents who have developed a respiratory infection
    • a suspected or confirmed case of the virusEnsure Sufficient Levels Of PPE And Other Supplies

3) Prevent Transmission Of The Virus 

  • Social distancing measures must be taken to separate residents, which should include a suspension of group gatherings
  • Residents must wear a face mask whenever they exit their room or plan to be near other residents
  • Staff must wear face masks at all times while in the facility
  • In response to a positive case of COVID-19 in a particular unit of the facility, all residents in that unit must be confined to that unit
  • An N95 respirator mask, gown, eye protection, and gloves must be worn by all staff while working with an infected resident

4) Ensure Sufficient Levels Of PPE And Other Supplies

  • Inventory should be taken of all PPE and other supplies
  • Local or state health departments should be alerted when there are low levels or impending low levels of PPE or other necessary supplies
  • When appropriate, PPE should be reused

5) Identify And Manage Severe Illness

  • All confirmed and suspected cases of COVID-19 should remain in a designated area within the facility
  • All residents who show signs of the virus should have their oxygen saturation level, temperature, and blood pressure recorded a minimum of three times per day

Do You Suspect That A Particular Nursing Home Is Not Following The CDC Guidelines?

If anyone has reason to believe that a nursing home is not following the CDC guidelines, they should contact the local health department. In addition, they can contact a nursing home abuse attorney who can review and/or investigate the situation, explain their rights, and ultimately do everything possible to protect nursing home residents. Valid negligence or wrongful death claims could be brought against any nursing home facility that fails to protect its residents by failing to adhere to the CDC guidelines.

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