ECDC Rapid Risk Assessment: Several recent COVID-19 outbreaks in long-term care facilities in the EU/EEA
On 26 July ECDC published the Rapid Risk Assessment COVID-19 outbreaks in long-term care facilities in the EU/EEA in the context of current vaccine coverage, following several outbreaks that occurred in these settings during the past six months in several EU/EEA countries, resulting in some cases of severe disease and deaths.
While high vaccination coverage among long-term care facilities (LTCF) residents was confirmed in all reported outbreaks, based on the available reported data, vaccination coverage among LTCF health care workers (HCW) and other staff was often sub-optimal.
Andrea Ammon, ECDC Director, said:
“Protecting the elderly and the frail must continue to be a priority. COVID-19 vaccine uptake needs to be further promoted among long-term care facilities residents and all persons who come in contact with them such as healthcare workers, auxiliary staff, caretakers and visitors. In the current epidemiological context, meticulous compliance with non-pharmaceutical interventions like the use of face masks, appropriate hand hygiene and physical distancing should be maintained”.
Variants of concern (VOCs) associated with higher transmissibility have been implicated in most of the outbreaks of breakthrough infections in LTCFs. It is expected that similar outbreaks will occur as the circulation of the B.1.617.2 (Delta) VOC and/or of other VOCs increase in the community.
Although the effectiveness of COVID-19 vaccines authorised in the EU/EEA is high, no vaccine is 100% effective. SARS-CoV-2 infections amongst fully vaccinated persons (i.e. ‘breakthrough infections’) are expected, particularly in the elderly, or persons with underlying conditions. Vaccines prevent severe disease to a large extent, however, we can still see hospitalisations and even deaths in these populations.
Specific measures to reduce the impact of COVID-19 on individuals residing in LTCF include:
- Full vaccination coverage of residents and all people in contact with LTCF residents needs to be rapidly ensured. This includes in addition to residents, healthcare personnel and other staff working in LTCF, as well as visitors.
- Countermeasures to reduce the risk of virus introduction into these LTCF communities need to be in place.
- Early identification of COVID-19 cases is essential for the introduction of control measures and the prevention of any further spread of outbreaks. Therefore, testing, contact tracing and investigation of LTCF COVID-19 cases and outbreaks should remain a priority for public health authorities.
- Meticulous compliance with non-pharmaceutical interventions (NPIs).
Efforts should be undertaken to promote further COVID-19 vaccination to unvaccinated LTCF staff through specific activities targeting vaccine acceptance and barriers to uptake. Regarding mandatory vaccination for HCW and auxiliary staff, even though mandatory requirements can be highly effective depending on the reasons for under-vaccination, other strategies may be sufficient or more advisable and negative effects need to be considered ahead of time.
