<scp>Long‐Term</scp> Care Facilities and the <scp>COVID</scp> ‐19 Pandemic: Lessons Learned in Madrid
Francisco Javier Martínez-Peromingo, José Antonio Serra Rexach
Abstract
We have read with interest the excellent article by DʼAdamo et al on the ABCDs of managing the coronavirus disease 2019 (COVID-19) pandemic in long-term care,1 and we want to report our experience in Madrid, the hardest hit city by the pandemic in Spain.1 The Autonomous Community of Madrid is a Spanish region with a population of 6,662,000 people. It has one of the highest longevity rates in Europe, with 17.5% and 5.5% of its total population aged 65 years and older and 85 years and older, respectively. This region was first hit by the COVID-19 pandemic at the beginning of March 2020, with a rapid dissemination and an exponential increase in the number of contagions and deaths, particularly in older adults living in long-term care facilities (LTCFs). At the time the pandemic started, Madrid had approximately 480 LTCFs, housing approximately 44,000 older adults. Older patients living in LTCFs in Madrid were clearly the most vulnerable population during the pandemic. From March 8 to April 19, 2020, 19% of older patients (n ~ 8,300 cases) living in these facilities died, with a six-fold increase compared with the same period in the last years. In conclusion, the high fatality rate among older adults living in LTCFs in Madrid during the COVID-19 pandemic showed us our strengths, such as being aware of the geographical distribution of all LTCFs and keeping in close contact between hospitals and LTCFs in a consolidated continuing healthcare program led by a hospital-based geriatrician. What we failed to do was not to reallocate resources earlier, as we focused first in acute care in tertiary hospitals, and not to test as many patients as possible to implement better successful isolation measures. We learned the importance of minimizing contacts, applying stringent hygiene measures, and providing protective equipment to staff members. We want to give thanks to all healthcare workers at long-term care facilities in the Autonomous Community of Madrid for their great effort amid the coronavirus disease 2019 pandemic. Authors do not declare any conflict of interest regarding this article. Both authors contributed equally to the design, writing, and reviewing of the article. This article has not been funded by any grant or sponsor.