A preliminary study has found evidence of a link between COVID-19 cases at colleges and eventual outbreaks at nearby nursing homes, adding to mounting research showing the direct impact that community spread can have on vulnerable populations.
Researchers tracked two specific strains of the novel coronavirus as they spread through the town of La Crosse, Wisc., the home of a University of Wisconsin campus among other institutions.
“Although the majority of cases were among college-age individuals, from a total of 111 genomes sequenced we identified rapid transmission of the virus into more vulnerable populations,” the researchers concluded in the study, which is still awaiting formal peer review. “Eight sampled genomes represented two independent transmission events into two skilled nursing facilities, resulting in two fatalities.”
The paper, written by University of Wisconsin professor Paraic Kenny among others, included a warning for university officials across the country as they weigh the risks and benefits of holding classes on campus this fall.
“Our study highlights the very significant risks imposed by college administrator reopening decisions, not just on college-associated populations, but on vulnerable individuals in surrounding communities,” the researchers wrote.
Other scientists cautioned that more research would be necessary to fully prove the connection between college and nursing home outbreaks, the Washington Post reported in a wider story about the COVID-19 situation in La Crosse, a city located roughly between Madison, Wisc. and Minneapolis on the Wisconsin-Minnesota border.
But Thomas Friedrich, a University of Wisconsin-Madison professor who has researched the COVID-19 genome, told the Post that high rates of coronavirus infection among students is like a major fire that can throw off sparks and create new, separate fires.
“High levels of transmission among students in La Crosse absolutely increased the risk of outbreaks in skilled nursing facilities,” Friedirch told the paper. “[Kenny’s] data are totally consistent with this scenario, but they do not prove beyond a shadow of a doubt that specific viruses traveled from students to nursing home residents.”
Nursing homes in La Crosse had been spared by COVID-19 until recent weeks, the Post reported, with most of the 19 recorded deaths this fall occurring at long-term care facilities — and all of them representing people over the age of 60.
Kenny was blunt in his assessment of the situation in his comments to the Post.
“Completely, completely, completely predictable,” he told the publication. “Everything we’ve known about this virus since January, everything we’ve known about 20-year-olds for the last 3,000 years — it’s predictable.”
Multiple studies have determined that high rates of overall COVID-19 infections increase the risk for outbreaks at long-term care facilities. Between March and May, for instance, coronavirus death spikes at nursing homes in New York City and Detroit almost exactly mirrored the toll among the general population, while Cleveland — which had significantly less community spread — saw significantly fewer COVID-19 deaths in nursing homes.
The two charts below, originally published in the Journal of the American Medical Association, illustrate the effect clearly. The top row shows overall deaths on a weekly basis, while the bottom displays skilled nursing facility mortality. The yellow lines are data for 2020, while the blue shows 2019 death rates for comparison.
Community spread is not the only factor, as researchers have also determined that facilities with more robust staffing hours are better at preventing and containing outbreaks than those with spottier coverage.
As with the general population, COVID-19 has also disproportionately affected nursing homes in communities of color, with high percentages of Black residents a reliable indicator of outbreak risk.