PUTTING CORONAVIRUS TO THE TEST: 'We have to get to an order-of-magnitude understanding of how many people have actually been infected. We really don't know if we've been 10 times off or 100 times off in terms of the cases.'.

• Author: POWELL, AL

THROUGH NO FAULT of their own, nursing homes no longer may be the best place to house vulnerable elderly patients. Epidemiologist Michael Mina, assistant professor of epidemiology at the Harvard University School of Public Health and its Center for Communicable Disease Dynamics, says that he believes the coronavirus that causes COVID-19 is more transmissible than previously thought.

It has been difficult to keep it from spreading in a number of settings, including hospitals, cruise ships, and nursing homes--in Massachusetts alone, some 102 nursing homes had reported 551 cases by the first week in April, according to the Massachusetts Department of Public Health. Even with current restrictions on visitors, employees regularly moving in and out of the facilities means it is inevitable that additional cases will occur.

"I do think as many people as we can get out of these homes, it is probably better," says Mina, also an associate professor of immunology and infectious diseases and associate medical director in clinical microbiology at Boston's Brigham and Women's Hospital's Pathology Department. "I think that this is an extraordinarily transmissible virus. 1 think it's more transmissible than we recognize and actually preventing it from spreading within nursing homes [would be] an extraordinary feat."

The focus on nursing homes has heightened recently, in part due to revelations of 21 deaths at the Holyoke Soldiers Home since late March, of which at least 15 were due to the coronavirus. A cluster of deaths at a nursing home in Washington that began in February highlighted senior citizens' vulnerability to developing severe illness from the virus and, since early March, nursing homes across the country have restricted visitors in an effort to reduce risk to residents.

In response to the growing threat, Harvard-affiliated Hebrew SeniorLife (HSL) has instituted a self-shelter-at-home directive for 1,700 residents at five senior living campuses across greater Boston. The organization has seen 36 COVID-19 cases and nine deaths among residents, as well as eight cases among employees.

"COVID-19 is already taking a heavy toll in Massachusetts, and despite vigilant efforts that started in late February to prevent the occurrence of the virus on our campuses, it has been felt deeply," HSL CEO and Pres. Lou Woolf said in a statement. "Time is of the essence to self-shelter at home to protect our residents and staff from this threat."

The Massachusetts...