COVID-19 - Coronavirus disease 2019

Simulation platform for assessment and improvement of control measures against diffusion of SARS-CoV-2 in nursing homes and long-term care facilities – COVEHPAD

Submission summary

Background: The current COVID-19 outbreak could be devastating among dependent elderly people housed in nursing homes and long-term care facilities (NHLTFs) given the intensity of contacts (between residents and between residents and staff) and the difficulty to identify infection in this elderly population due to the disease misleading symptomatology. The recommendations given to the general population might not be adequate in this specific context. Describing the diffusion of the outbreak within this frail population and quantifying the impact of the implemented measures of control and prevention are important to provide information that may help adapting recommended managements of the current and future outbreaks in NHLTFs.
Objective: The main objective is to build a simulation platform for assessment and improvement of control measures against the diffusion of COVID-19 in NHLTFs. To fulfill this objective, we will describe the dynamics of diffusion of the outbreak among elderly people housed in NHLTFs and quantify the impacts of the measures currently taken or that could be proposed later to prevent and control the outbreak using a simulation model with estimation of transition parameters.
Study population: The study population will be the residents of a sample of 20 NHLTFs in Rhône-Alpes-Auvergne Region selected in four strata of facilities: hospital public, non-hospital public, lucrative private, non-lucrative private.
Data collection: The data will be collected retrospectively from the 1st of February 2020 and prospectively to the end of the outbreak. They will include, in particular, the daily number of possible, probable and confirmed cases, their characteristics and evolution, the number and characteristics of the residents, the staff members and the visitors, the implemented measures of prevention and control, the number of contacts between staff and residents and between residents as measured with electronic sensors in one facility.
Modelling: The modelling will include a step of parameter estimation based on collected data and another step of simulation to quantify the impacts of different scenarios on the outbreak. COVID-19 outbreak will be studied using a compartment model that will consider 4 interacting populations (residents, nursing staff, physicians, and visitors) and the following compartments: susceptible to infection, infected and incubating, contagious without symptoms, contagious with symptoms, hospitalized, cured and dead. The residents will be split into 3 groups according to the level of dependency as measured by GIR score. The estimation of the transition rates and the effects of methods of prevention and control (by likelihood decomposition) will be based on the numbers of observed transitions between compartments, modeled as realizations of Poisson processes. At the step of simulation, the model will allow quantifying the impacts on infection incidence of changes in the transition rates due to various measures of prevention and control, changes in the observed contact matrix, and prevalence of infection in visitors and staff.
Deliverables:
• A simulation platform with the developed model and the parameters for various situations.
• Results of the modelling.
• Recommendations for improvement resident management.

Project coordination

Philippe VANHEMS (Direction à la Recherche Clinique et à l'Innovation - Hospices Civils de Lyon)

The author of this summary is the project coordinator, who is responsible for the content of this summary. The ANR declines any responsibility as for its contents.

Partner

EPIMOD EPIMOD
EpiGreen EpiGreen
HCL - CHU LYON Direction à la Recherche Clinique et à l'Innovation - Hospices Civils de Lyon

Help of the ANR 94,370 euros
Beginning and duration of the scientific project: March 2020 - 18 Months

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