The Benefits of Nursing Home Air Purification on COVID-19 Outcomes: A Natural Experiment |
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| Affiliation: | 1. Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA;2. Evidence Synthesis Program Center, Providence VA Medical Center, Providence, RI, USA;3. Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center, Providence, RI, USA;4. Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA;5. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA |
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| Abstract: | ObjectivesImproving indoor air quality is one potential strategy to reduce the transmission of SARS-CoV-2 in any setting, including nursing homes, where staff and residents have been disproportionately and negatively affected by the COVID-19 pandemic.DesignSingle group interrupted time series.Setting and ParticipantsA total of 81 nursing homes in a multifacility corporation in Florida, Georgia, North Carolina, and South Carolina that installed ultraviolet air purification in their existing heating, ventilation, and air conditioning systems between July 27, 2020,k and September 10, 2020.MethodsWe linked data on the date ultraviolet air purification systems were installed with the Nursing Home COVID-19 Public Health File (weekly data reported by nursing homes on the number of residents with COVID-19 and COVID-19 deaths), public data on data on nursing home characteristics, county-level COVID-19 cases/deaths, and outside air temperature. We used an interrupted time series design and ordinary least squares regression to compare trends in weekly COVID-19 cases and deaths before and after installation of ultraviolet air purification systems. We controlled for county-level COVID-19 cases, death, and heat index.ResultsCompared with pre-installation, weekly COVID-19 cases per 1000 residents (−1.69; 95% CI, −4.32 to 0.95) and the weekly probability of reporting any COVID-19 case (−0.02; 95% CI, −0.04 to 0.00) declined in the post-installation period. We did not find any difference pre- and post-installation in COVID-19–related mortality (0.00; 95% CI, −0.01 to 0.02).Conclusions and ImplicationsOur findings from this small number of nursing homes in the southern United States demonstrate the potential benefits of air purification in nursing homes on COVID-19 outcomes. Intervening on air quality may have a wide impact without placing significant burden on individuals to modify their behavior. We recommend a stronger, experimental design to estimate the causal effect of installing air purification devices on improving COVID-19 outcomes in nursing homes. |
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| Keywords: | Nursing homes SARS-CoV-2 COVID-19 indoor air air purification ultraviolet |
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