Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK

Julii Brainard, Steven Rushton, Tim Winters, Paul R. Hunter

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)
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BACKGROUND: Residential care homes for the elderly are important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease. METHODS: We undertook secondary analysis of 248 care homes in Norfolk, UK. The dataset counted nurses, care workers and non-care workers, their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) and residents (if any) with suspected COVID-19 in the period 6 April to 6 May 2020. Concurrent descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and sanitizer) were in the data. PPE access was categorized as (most to least) green, amber or red. We undertook two-stage modelling, first for suspected COVID-19 cases amongst residents and second relating any increases in case counts after introduction to staffing or PPE levels. RESULTS: Counts of non-care workers had strongest relationships (P < 0.05) to introduction of suspected SARS-CoV-2 to the homes. Higher staff levels and more severe PPE shortages were linked to higher case counts (P < 0.05) during the monitoring period. CONCLUSION: Managing aspects of staff interaction with residents and some working practices might reduce ingression to and spread of COVID-19-like illness within care homes.

Original languageEnglish
Pages (from-to)228–235
Number of pages8
JournalJournal of Public Health
Issue number2
Early online date28 Dec 2020
Publication statusPublished - Jun 2021


  • Older people
  • Management and policy
  • Infectious disease
  • COVID-19
  • personal protection equipment
  • mixed effect models
  • care homes
  • Cox proportional hazards model

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