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      Nursing Homes and COVID-19: A Crisis on Top of a Crisis

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          Abstract

          The COVID-19 pandemic has caused a staggering number of deaths and a great deal of suffering in U.S. nursing homes. The spread of the virus across the country introduced a new emergency to a long-term care sector that had already been in a state of crisis for multiple decades. Nursing homes have been underfunded and understaffed for years, often delivering inadequate care to their vulnerable residents, and they are financed and regulated separately from the rest of the U.S. health care system. During the pandemic, policy responses at both the federal and state levels were often slow and inadequate, partly due to a frayed infrastructure that is the result of years of inattention from policy-makers. We review the state of nursing home care in the United States and the impacts of the pandemic, and we argue that a package of broader policy and delivery reforms should be implemented to improve the care of older adults that could help to prevent future tragedy.

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          Is Open Access

          OpenSAFELY: factors associated with COVID-19 death in 17 million patients

          COVID-19 has rapidly impacted on mortality worldwide. 1 There is unprecedented urgency to understand who is most at risk of severe outcomes, requiring new approaches for timely analysis of large datasets. Working on behalf of NHS England we created OpenSAFELY: a secure health analytics platform covering 40% of all patients in England, holding patient data within the existing data centre of a major primary care electronic health records vendor. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19 related deaths. COVID-19 related death was associated with: being male (hazard ratio 1.59, 95%CI 1.53-1.65); older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared to people with white ethnicity, black and South Asian people were at higher risk even after adjustment for other factors (HR 1.48, 1.29-1.69 and 1.45, 1.32-1.58 respectively). We have quantified a range of clinical risk factors for COVID-19 related death in the largest cohort study conducted by any country to date. OpenSAFELY is rapidly adding further patients’ records; we will update and extend results regularly.
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            COVID-19 and Racial/Ethnic Disparities

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              Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening

              Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening.
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                Author and article information

                Journal
                The ANNALS of the American Academy of Political and Social Science
                The ANNALS of the American Academy of Political and Social Science
                SAGE Publications
                0002-7162
                1552-3349
                November 2021
                February 02 2022
                November 2021
                : 698
                : 1
                : 137-162
                Article
                10.1177/00027162211061509
                f4e29190-44ae-4f3b-a0b8-83b0ba9f7416
                © 2021

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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