An Experience of the Early Stage of COVID-19 Outbreak in Nursing Homes in Gyeonggi Province, Korea

Background: We aimed to identify the problems in response and to present the importance of infection control in nursing homes (NHs) through an epidemiological analysis of the first and second COVID-19 outbreaks in Gyeonggi province. Methods: We reviewed the NH’s structural and operational data and in-depth epidemiologic reports for confirmed cases that were obtained as part of an emergency public health response. Results: Two COVID-19 outbreaks in NHs stemmed from infected nursing home workers (NHWs), and cohorting measures were implemented as a method of infection control. However, the outcome of cohorting was unfavorable due to the unexpected spread to NHWs wearing personal protective equipment (PPE) during work. As a result, the majority of confirmed cases was nursing home residents with a median age of 86, and they accounted for 72% and 60% of confirmed cases in NH A and NH B, respectively. Moreover, all cases of mortality were nursing home residents, and the case-fatality rates were 44.44% and 33.33%, respectively. Conclusion: We confirmed that NHs and NHWs were closely involved in the process and outcomes of outbreaks. Enhanced infection control techniques for NHs and NHWs should be mandatory to prevent further transmission in addition to external factors such as social measures and medical supplies.