[Skip to Content]

Claim CME

Research, Methods, Statistics

The Importance of Long-term Care Populations in Models of COVID-19

Educational Objective
To understand that long-term care populations need their own models when measuring COVID-19 infection rates

1 Credit CME

JAMA

Published Online: June 5, 2020

Viewpoint

Article Information and Disclosures

Karl Pillemer, PhD¹;

Lakshminarayanan Subramanian, PhD²;

Nathaniel Hupert, MD, MPH³

Author Affiliations

¹Weill Cornell Medicine, Division of Geriatrics and Palliative Medicine, Department of Human Development, Cornell University, New York, New York
²Courant Institute of Mathematical Sciences, New York University, New York, New York
³Cornell Institute for Disease and Disaster Preparedness, Departments of Medicine and Population Health Sciences, Weill Cornell Medicine, New York, New York

Read article on JAMA Network

Read Article Claim CME

In February 2020, the US outbreak of novel coronavirus disease 2019 (COVID-19) began with a cluster of cases at a long-term care (LTC) facility in Washington State. Since then, 34 of the 40 states with available data report that at least 40% of COVID-19-related deaths in those states have occurred in LTC facilities,¹ which provide ideal conditions for rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the populations in these facilities bear a significant burden of the pandemic, mathematical models that contribute to US national or state policy do not account for residents of LTC facilities separately from surrounding populations in their calculations.² This Viewpoint explores why it is important to separate projections for residents of LTC facilities and the general population.

Claim CME

Sign in to take quiz and track your certificates

Buy This Activity

Article Information

Corresponding Author: Karl Pillemer, PhD, Weill Cornell Medicine, Division of Geriatrics and Palliative Medicine, Cornell University, 1300 York Ave, New York, NY 10065 (kap6@cornell.edu).

Published Online: June 5, 2020. doi:10.1001/jama.2020.9540

Conflict of Interest Disclosures: Dr Pillemer reports receipt of grants from the National Institutes of Health and personal fees (speaking honoraria) and grants from the American Seniors Housing Association outside the submitted work. Dr Hupert reports providing unpaid consultation services (related to novel coronavirus 2019 modeling) to the Greater New York Hospital Association outside the submitted work. Dr Subramanian reports being a consultant for the World Bank and being the cofounder of Entrupy Inc, Gaius Networks Inc, and Velai LLC. No other disclosures were reported.

Additional Contributions: We acknowledge the contributions of Srikanth Jagabathula, PhD, Mark S. Lachs, MD, MPH, Beth Simone Noveck, PhD, Anthony E. Rosen, MD, MPH, and Monika M. Safford, MD, to this article. None of these individuals received compensation for their contributions to this article.

References

Kaiser Family Foundation. State reports of long-term care facility cases and deaths related to COVID-19 (as of May 28, 2020). Accessed June 3, 2020. https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/

Institute for Health Metrics and Evaluation (IHME). COVID-19: What’s new for May 29, 2020. Accessed June 3, 2020. http://www.healthdata.org/covid/updates

Ferguson NM , Laydon D , Nedjati-Gilani G , et al, Imperial College COVID-19 Response Team. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Published March 16, 2020. Accessed May 20, 2020. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

Institute for Health Metrics and Evaluation (IHME). COVID-19 Projections. Updated May 29, 2020. Accessed June 3, 2020. https://covid19.healthdata.org/projections

Shen M , Xiao Y , Rong L . Modeling the effect of comprehensive interventions on Ebola virus transmission. Sci Rep. 2015;5:15818. doi:10.1038/srep15818 PubMed Google Scholar Crossref

CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343-346. doi:10.15585/mmwr.mm6912e2 PubMed Google Scholar Crossref

State of New Jersey. What is the state doing to protect residents and staff at nursing homes or long-term care facilities? Updated May 21, 2020. Accessed May 20, 2020. https://covid19.nj.gov/faqs/nj-information/general-public/what-is-the-state-doing-to-protect-residents-and-staff-at-nursing-homes-or-long-term-care-facilities

State of New Jersey. How is the state using data to make decisions and slow the spread of COVID-19? Updated April 28, 2020. Accessed May 20, 2020. https://covid19.nj.gov/faqs/nj-information/the-latest-data/how-is-the-state-using-data-to-make-decisions-and-slow-the-spread-of-covid-19

Barnett ML , Grabowski DC . Nursing homes are ground zero for COVID-19 pandemic. JAMA Health Forum. Published March 24, 2020. Accessed May 20, 2020. https://jamanetwork.com/channels/health-forum/fullarticle/2763666

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.