Background: Efforts to protect residents in nursing homes involve non-pharmaceutical interventions, testing, and vaccine . We sought to quantify the effect of testing and vaccine strategies on the attack rate, length of the epidemic, and hospitalization .
Methods: We developed an agent-based model to simulate the dynamics of SARS-CoV-2 transmission in a nursing home with resident and staff agents . Interactions between 172 residents and 170 staff were assumed based on data from a nursing home in Los Angeles, CA . We simulated scenarios assuming different levels of non-pharmaceutical interventions, testing frequencies, and vaccine efficacy to block transmission .
Results: Under the hypothetical scenario of widespread SARS-CoV-2 in the community , 3-day testing frequency minimized the attack rate and the time to eradicate an outbreak . Prioritization of vaccine among staff or staff and residents minimized the cumulative number of infections and hospitalization, particularly in the scenario of high probability of an introduction . Reducing the probability of a virus introduction reduced the demand on testing and vaccine to reduce infections and hospitalizations .
Conclusions: Improving frequency of testing from 7-days to 3-days minimized the number of infections and hospitalizations, despite widespread community transmission . Vaccine prioritization of staff provides the best protection strategy, despite high risk of a virus introduction.