Factors associated with transmission of SARS-CoV-2 in aged care settings

Globally, aged care facilities (ACFs) have been recognised as high-risk settings for severe outcomes from coronavirus disease 2019 (COVID-19). Once severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been introduced into a facility, it has the potential to have high transmission rates, which have been associated with a range of factors including crowding, sharing of bathroom facilities, and gathering in common areas, which result in prolonged close physical contact between aged care staff and other residents. Since the early days of the pandemic, COVID-19 preventive measures have focused on practices such as social distancing, the use of protective equipment, maintaining hygiene, quarantine requirements and contact-tracing . Such infection prevention and control methods continue to be a mainstay of COVID-19 management alongside the rollout of COVID-19 vaccines around the world.

Physical layout-related factors
Evidence of the role of built environment on spread of SARS-CoV-2 is limited in aged care. However, it is widely accepted that contacts in closer proximity are at higher risk of infection. There is a gap in infection control in aged care around the built environment, especially in relation to using the existing space to allow social distancing and isolation

Non-pharmaceutical interventions: Use of face masks
Studies have reported face masks to be a simple yet effective and widely accepted protective measure for reducing risk of COVID-19 transmission via droplet and aerosol transmission. Many of these studies have assessed the use of face masks in the general population, or their effectiveness in conjunction with other preventive measures such as physical distancing. However, these studies are not representative of individuals living in ACFs, where health characteristics of residents typically differ from that of the general population and certain preventive measures, such as physical distancing, are difficult to implement. There are currently few studies assessing the effectiveness of face masks in reducing COVID-19 risk in ACFs.