Managing the COVID-19 pandemic in nursing homes


COVID-19 targets older individuals, whether they are at home or staying in assisted living facilities or nursing homes, resulting in high mortality rates. Sadly, as everyone knows, nursing facilities deal with many challenges in managing a virus outbreak because they have unique social and clinical factors to consider. 

The medical professionals paying close attention to how the virus impacts nursing homes are appalled by the situation but not exactly shocked as they expected this situation to happen. All medical experts knew what was coming together with the pandemic that affects the world. The number of elders catching the virus and dying because of it is horrifying, but the underlying factors that led to this situation are no surprise to anyone in the sector. There've been issues of concern for a while now. 

New York Times released the results of a study showing that over 34,000 deaths (37% of the nation's fatalities from COVID-19) occurred in nursing homes. But because each state reports the cases differently, the number of elders dying in long-term care facilities can be higher. At present, there is a reporting system designed to track the number of COVID-19 cases in nursing homes and funnel data to the CDC. 

A high number of articles and studies that provide recommendations on how nursing homes can manage virus outbreaks appeared. The following paragraphs describe the most common challenges and issues managers experience when running this kind of facility. 

Reduce asymptomatic staff transmission

As already known, many COVID-19 patients are asymptomatic, and they can easily transmit the virus to the people they come in contact with. Asymptomatic staff transmission is the most common factor that triggers coronavirus cases in nursing home facilities. Healthcare workers are essential in assisted living and nursing homes. Still, they're also the main source of disease for patients and residents because they can catch the virus outside the facility. Managers can use screening procedures like questionaries for common symptoms and signs of the virus and temperature checks to identify infected but presymptomatic or asymptomatic workers. 


In addition to these measures, limiting staff contact with residents is also helpful, as long as it doesn't deter the service quality. Assigning specialists to a small number of patients can prevent a large outbreak if an asymptomatic staff member is spreading COVID-19. Also, limiting workers interactions in group settings like meetings and break rooms can reduce the possibility of the spread between staff.

Loss of key experts boosts the risk of large outbreaks

From what's been seen, the loss of a manager or director, infection prevention agent, director in environmental services, or medical professional early in the outbreak can increase the risk of a larger outbreak. It's vital to maintain strong leadership and management in the facility as long as possible to ensure the right decisions are made. 

In case the doctors are diagnosed with the virus and can no longer work in the facility, the manager should consider collaborating with an organisation specialised in telemedicine for nursing homes because it can provide them with the essential medical services while their specialists are recovering. A specialist in primary care is assigned to the facility, and they provide 24/7 assistance to support the healthcare workers care for the patients. Telemedicine organisations have multiple specialist practices available, and they can easily cover for the on-site doctors that are no longer able to come to work. For the facilities that don't have an in-house specialist, telemedicine is also helpful because they can hire an expert to care for the patients during the pandemic. 

In case of the loss of a key expert, nursing homes should find an alternative specialist who can fill the role. 

The managers should always assume the outbreak is coming

The quicker a nursing home can act, the better. The biggest risk for a long-term care facility is to think a virus outbreak can never happen in this building. Managers should instead be ready to face this situation at any time. They should develop procedures and policies for any kind of scenario, ensure they have appropriate protective equipment for workers, dedicated equipment to care for the patients, and staff plans and protocols on where to place the patients and when to discharge them to a hospital. When a virus outbreak occurs in a nursing home, the managers and personnel need to move quickly and efficiently to limit the patients' spread and care properly. 

Test often

Tests are widely available nowadays, and nursing homes can test the staff and residents when they show infection signs. Because workers seem to be the main source of spread in a facility outbreak, it's crucial to identify the ones carrying the virus as soon as possible to ensure the residents are at low risk of catching it. Testing is proved to limit the spread by focusing on affected staff and tracing their contacts so that all patients are properly monitored and treated. Early testing of patients can also limit the exposure to coronavirus of negative residents. Only because someone was in contact with a positive patient it doesn't mean they also caught the virus. By testing them, the facility managers can identify the positive ones and isolate the negative ones. 

Nursing homes should develop relationships with local laboratories and the local health departments before they experience an outbreak to ensure they have procedures in place that allow them to test and treat their residents quickly. And they should always remember that a negative test today doesn't imply a negative test in the future, and they should repeat the tests when appropriate in case a resident or worker is at a high level of exposure. 

Nursing homes must collaborate with local community partners

As coronavirus has found its way into nursing homes, they have to take the time to communicate and collaborate with their partners to navigate the challenges together. Community partnership is crucial in the present situation because it provides long-term care facilities with resources, education, training, and help to deal with the pandemic. 

The above solutions are intended to help medical facilities address elders and provide them with solutions if they experience an outbreak. 

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