<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Eline Vandael</style></author><author><style face="normal" font="default" size="100%">Katrien Latour</style></author><author><style face="normal" font="default" size="100%">Esma Islamaj</style></author><author><style face="normal" font="default" size="100%">Laura Int Panis</style></author><author><style face="normal" font="default" size="100%">Milena Callies</style></author><author><style face="normal" font="default" size="100%">Freek Haarhuis</style></author><author><style face="normal" font="default" size="100%">Kristiaan Proesmans</style></author><author><style face="normal" font="default" size="100%">Brecht Devleesschauwer</style></author><author><style face="normal" font="default" size="100%">Javiera Rebolledo</style></author><author><style face="normal" font="default" size="100%">Alice Hannecart</style></author><author><style face="normal" font="default" size="100%">Romain Mahieu</style></author><author><style face="normal" font="default" size="100%">Louise De Viron</style></author><author><style face="normal" font="default" size="100%">Etienne De Clercq</style></author><author><style face="normal" font="default" size="100%">Anne Kongs</style></author><author><style face="normal" font="default" size="100%">Naïma Hammami</style></author><author><style face="normal" font="default" size="100%">Jean-Marc François</style></author><author><style face="normal" font="default" size="100%">Dominique Dubourg</style></author><author><style face="normal" font="default" size="100%">Sarah Henz</style></author><author><style face="normal" font="default" size="100%">Boudewijn Catry</style></author><author><style face="normal" font="default" size="100%">Sara Dequeker</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">COVID-19 cases, hospitalizations and deaths in Belgian nursing homes: results of a surveillance conducted between April and December 2020</style></title><secondary-title><style face="normal" font="default" size="100%">Archives of Public Health</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">Jan-12-2022</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">80</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;BACKGROUND:&amp;nbsp;In Belgium, the first COVID-19 death was reported on 10 March 2020. Nursing home (NH) residents are particularly vulnerable for COVID-19, making it essential to follow-up the spread of COVID-19 in this setting. This manuscript describes the methodology of surveillance and epidemiology of COVID-19 cases, hospitalizations and deaths in Belgian NHs.&lt;/p&gt;

&lt;p&gt;METHODS:&amp;nbsp;A COVID-19 surveillance in all Belgian NHs (n = 1542) was set up by the regional health authorities and Sciensano. Aggregated data on possible/confirmed COVID-19 cases and hospitalizations and case-based data on deaths were reported by NHs at least once a week. The study period covered April-December 2020. Weekly incidence/prevalence data were calculated per 1000 residents or staff members.&lt;/p&gt;

&lt;p&gt;RESULTS:&amp;nbsp;This surveillance has been launched within 14 days after the first COVID-19 death in Belgium. Automatic data cleaning was installed using different validation rules. More than 99% of NHs participated at least once, with a median weekly participation rate of 95%. The cumulative incidence of possible/confirmed COVID-19 cases among residents was 206/1000 in the first wave and 367/1000 in the second wave. Most NHs (82%) reported cases in both waves and 74% registered ≥10 possible/confirmed cases among residents at one point in time. In 51% of NHs, at least 10% of staff was absent due to COVID-19 at one point. Between 11 March 2020 and 3 January 2021, 11,329 COVID-19 deaths among NH residents were reported, comprising 57% of all COVID-19 deaths in Belgium in that period.&lt;/p&gt;

&lt;p&gt;CONCLUSIONS:&amp;nbsp;This surveillance was crucial in mapping COVID-19 in this vulnerable setting and guiding public health interventions, despite limitations of aggregated data and necessary changes in protocol over time. Belgian NHs were severely hit by COVID-19 with many fatal cases. The measure of not allowing visitors, implemented in the beginning of the pandemic, could not avoid the spread of SARS-CoV-2 in the NHs during the first wave. The virus was probably often introduced by staff. Once the virus was introduced, it was difficult to prevent healthcare-associated outbreaks. Although, in contrast to the first wave, personal protective equipment was available in the second wave, again a high number of cases were reported.&lt;/p&gt;
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