Abstract
More than half of the coronavirus disease 19 (COVID-19) related mortality rates in the United States and Europe are associated with long-term-care facilities (LTCFs) such as old-age organizations, nursing homes, and disability centers. These facilities are considered most vulnerable to spread of an pandemic like COVID-19 because of multiple reasons including high density of elderly population with a diverse range of medical requirements, limited resources, nursing activities/medications, and the role of external visitors. In this study, we aim to understand the role of visitor’s family members and specific interventions (such as use of face masks and restriction of visiting hours) on the dynamics of infection in a community using a mathematical model. The model considers two types of social contexts (community and LTCFs) with three different groups of interacting populations (non-mobile community individuals, mobile community individuals, and long-term facility residents). The goal of this work is to compare the outbreak burden between different centre of disease control (CDC) planning scenarios, which capture distinct types of intensity of diseases spread in LTCF observed during COVID-19 outbreak. The movement of community mobile members is captured via their average relative times in and out of the long-term facilities to understand the strategies that would work well in these facilities the CDC planning scenarios. Our results suggest that heterogeneous mixing worsens epidemic scenario as compared to homogeneous mixing and the epidemic burden is hundreds times greater for community spread than within the facility population.