CPSTF Recommends Non-Pharmaceutical Interventions to Reduce Transmission of Viral Respiratory Infections in Long-Term Care Communities

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The Community Preventive Services Task Force (CPSTF) recommends non-pharmaceutical interventions (NPIs) in long-term care (LTC) communities to decrease viral respiratory infection incidence among LTC community residents and staff.

Evidence shows that during a viral respiratory infection outbreak or pandemic, combinations of NPIs can reduce the risk of infection among LTC community residents and staff.

What are Non-Pharmaceutical Interventions?

LTC communities for adults with disabilities and older adults can adopt NPIs as strategies to prevent, slow, or stop the spread of viral respiratory infections. NPIs may be directed to residents, staff, and visitors and applied at individual, community, and environmental levels.

  • Individual level NPIs may include using personal protective equipment such as gloves and masks, proper hand hygiene, and staff not coming to work when sick.
  • Community level NPIs may include testing and screening, physical distancing, visitor restriction, and resident admission or transfer restriction.
  • Environmental level NPIs may include cleaning and disinfecting and improving ventilation.

Why is this important?

LTC communities provide a broad range of health, personal care, and supportive services to residents who may have limited selfcare capabilities due to physical, cognitive, or mental disability. Individuals may receive long-term care services in a variety of settings, including residential care communities or group homes, continuing care retirement or life care communities, assisted living, nursing homes or skilled nursing facilities. Services offered may include nursing care, 24-hour supervision, three meals a day, and assistance with activities of daily living (Harris-Kojetin 2019, NIH National Institute on Aging 2019).

The COVID-19 pandemic highlighted the vulnerability of residents in LTC communities to viral respiratory infections. LTC community residents make up less than 1% of the U.S. population but accounted for more than 23% of all COVID-19 deaths as of January 2022 (Kaiser Family Foundation 2022).

CDC’s guidance to prevent and slow the spread of viral respiratory infections includes vaccination, treatment, and nonpharmaceutical interventions (CDC 2024a). NPIs are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of infections (CDC 2024b, Qualls 2017). A combination of individual, community, and environmental NPIs can be used to prevent or respond to respiratory infection outbreaks or pandemics in LTC settings (Qualls 2017).

References

Centers for Disease Control and Prevention. (2024a) Respiratory viruses and older adults. Retrieved from Respiratory Viruses and Older Adults | Respiratory Illnesses | CDC. Accessed 5/16/2024.

Centers for Disease Control and Prevention. (2024b) Preventing respiratory viruses. Retrieved from Preventing Respiratory Viruses | Respiratory Illnesses | CDC. Accessed 5/20/2024.

Harris-Kojetin L, Sengupta M, Lendon JP, et al. Long-term care providers and services users in the United States, 2015–2016. National Center for Health Statistics. Vital and Health Statistics 2019;3(43).

Kaiser Family Foundation. (2022) Over 200,000 residents and staff in long-term care facilities have died from COVID-19. Retrieved from Over 200,000 Residents and Staff in Long-Term Care Facilities Have Died From COVID-19 | KFF. Accessed 5/16/2024.

NIH National Institute on Aging. (2023) Long-term care facilities: assisted living, nursing homes, and other residential care. Retrieved from https://www.nia.nih.gov/health/assisted-living-and-nursing-homes/long-term-care-facilities-assisted-living-nursing-homes. Accessed 5/16/2024.

Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic Influenza — United States, 2017. MMWR Recommendations and Reports 2017;66(No. RR-1):1–34. DOI: http://dx.doi.org/10.15585/mmwr.rr6601a1.