| Pandemic Preparation and Response in Long-Term Care Hospitals: Lessons from COVID-19 Outbreaks and Preparedness for Future Infectious Diseases |
Jin Ju Park1, Kiju Kim2,3, Hyuk Ga3,4, Heekyung Chun5, Pyung Suk Ki3,6, Seung Gyu Ji3,7, Joong-Sik Eom8, Tark Kim9 
, Jacob Lee1
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1Division of Infectious Disease, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
2Goodlight Hospital, Gwangju, Republic of Korea
3Korean Convalescent Hospital association, Republic of Korea
4Incheon Eun-Hye Convalescent Hospital, Incheon, Republic of Korea
5Infection Control Network, Republic of Korea
6Gaeun Hospital, Bucheon, Republic of Korea
7Jeonnam Jeil Hospital, Hwasun, Republic of Korea
8Division of Infectious Disease, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
9Division of Infectious Disease, Department of Internal Medicine, Soonchunhyan University Bucheon Hospital, Bucheon, Republic of Korea |
Correspondence:
Tark Kim,
Email: ktocc@schmc.ac.kr
Jacob Lee,
Email: litjacob@chol.com
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Received: 21 February 2025 • Revised: 14 May 2025 • Accepted: 29 May 2025 |
| Abstract |
Background
This study aimed to analyze the coronavirus disease-19 (COVID-19) response in long-term care hospitals (LTCHs) and establish a preparedness and management framework for addressing novel infectious diseases.
Methods
A national survey was conducted in Korea between June 19 and June 30, 2023. Using an anonymous online questionnaire, the survey gathered information on the general characteristics of participating hospitals, preparedness for infectious diseases in LTCHs prior to the COVID-19 pandemic, preparedness for in-house outbreaks during the COVID-19 pandemic, experiences of in-house COVID-19 outbreaks, and a section related to vaccines and treatments.
Results
Of the 1,425 domestic LTCHs, 201 (14.1%) completed the survey. Of the 201, before the COVID-19 pandemic, 24.9% of LTCHs had a disaster preparedness team and 27.9% had conducted training for infectious disease disaster preparedness. During the COVID-19 pandemic, 99.0% of the institutions established response teams for preparedness against COVID-19, and 89.1% of the 201 institutions experienced in-house outbreaks. Most institutions had experienced shortages of materials (78.8%), staff (96.1%), and caregivers (88.3%). The COVID-19 treatments prescribed at the LTCFs were: nirmatrelvir/ritonavir (86.6%), molnupiravir (36.8%), and remdesivir (22.4%). Independent vaccination was administered in 99% of the institutions.
Conclusions
Despite the establishment of response systems, most LTCHs experienced in-house outbreaks during the COVID-19 pandemic. These institutions commonly faced challenges such as staffing shortages and supply constraints. To ensure better preparedness for future outbreaks, infection control systems should be regularly evaluated and maintained through ongoing training, even during non-outbreak periods. |
| Key Words:
Long-term care, hospital, emerging infectious disease, pandemic preparedness |
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