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In Reply: We agree with Dr Koh and colleagues that admitting patients with influenza to nursing homes during a pandemic would pose a risk to the vulnerable residents of the facility. The morbidity and mortality of influenza in that setting are significant.¹ We were not endorsing admission of influenza patients to nursing homes in a pandemic but assessing the attitude of nursing homes toward that practice. This in turn may help with overall public health planning.

Health care is delivered in multiple settings, including hospitals, subacute care settings, long-term care facilities/nursing homes, rehabilitation facilities, assisted living facilities, outpatient facilities, and home care with visiting nurses. All of these settings may be asked to step up during an emergency to the best of their abilities. In addition, ad hoc alternate care facilities may be activated in a pandemic. Care transitions provide an easy opportunity for pathogens to be transferred from one . . . [Full Text of this Article]

Philip W. Smith, MD
pwsmith@unmc.edu
University of Nebraska Medical Center
Omaha

Lona Mody, MD, MSc
University of Michigan Medical School
Ann Arbor

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RELATED LETTER

Nursing Homes During an Influenza Pandemic
Gerald Choon-Huat Koh, Judy Sng, and David Koh
JAMA. 2008;300(20):2366-2367.
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