HealthDay News — Federal National Healthcare Safety Network (NHSN) data appear to understate total COVID-19 cases and deaths in nursing homes in the United States, according to a study published online Sept. 9 in JAMA Network Open.

Karen Shen, Ph.D., from Harvard University in Cambridge, Massachusetts, and colleagues conducted a cross-sectional study comparing COVID-19 cases and deaths reported by U.S. nursing homes to the NHSN with those reported to state departments of health in late May 2020. Nursing homes from 20 states were included, with 4,598 facilities in 12 states and 7,401 facilities in 19 states that required facilities to report cases and deaths, respectively. To infer the national (15,397 facilities) unreported cases and deaths in May and December 2020, estimates of nonreporting were extrapolated.

The researchers found that in the first NHSN submission in sample states, a mean of 43.7 percent of COVID-19 cases and 40.0 percent of COVID-19 deaths prior to May 24 were not reported among 15,415 U.S. nursing homes, including 4,599 with state case data and 7,405 with state death data. This suggested that, nationwide, 68,613 cases and 16,623 deaths were omitted, representing 11.6 and 14.0 percent of COVID-19 cases and deaths, respectively, among nursing home residents in 2020.


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“Although current measures of COVID-19 prevalence and mortality reflect a devastating public health crisis for the nursing home population, it is likely that even more lives were impacted that will never be fully captured in existing data,” writes the author of an accompanying editorial.

Abstract/Full Text

Editorial