August 2020 Interim EuGMS guidance to prepare European Long-Term Care Facilities for COVID-19

Abstract

Purpose The European Geriatric Medicine Society (EuGMS) is launching a second interim guidance whose aim is to prevent the entrance and spread of COVID-19 into long-term care facilities (LTCFs). Methods The EuGMS gathered experts to propose a guide of measures to prevent COVID-19 outbreaks in LTCFs. It is based on the specific features of SARS-CoV-2 transmission in LTCFs, residents’ needs, and on experiences conducted in the field. Results Asymptomatic COVID-19 residents and staff members contribute substantially to the dissemination of COVID-19 infection in LTCFs. An infection prevention and control focal point should be set up in every LTCF for (1) supervising infection prevention and control measures aimed at keeping COVID-19 out of LTCFs, (2) RT-PCR testing of residents, staff members, and visitors with COVID-19 symptoms, even atypical, and (3) isolating subjects either infected or in contact with infected subjects. When a first LCTF resident or staff member is infected, a facility-wide RT-PCR test–retest strategy should be implemented for detecting all SARS-CoV-2 carriers. Testing should continue until no new COVID-19 cases are identified. The isolation of residents should be limited as much as possible and associated with measures aiming at limiting its negative effects on their mental and somatic health status. Conclusions An early recognition of symptoms compatible with COVID-19 may help to diagnose COVID-19 residents and staff more promptly. Subsequently, an earlier testing for SARS-CoV-2 symptomatic and asymptomatic LTCF staff and residents will enable the implementation of appropriate infection prevention and control. The negative effects of social isolation in residents should be limited as much as possible.

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

“…Nursing home residents very often require care and support that is of intimate nature, which makes them vulnerable to contracting easily spreadable infections such as COVID-19 [ 2 , 3 ]. Understanding the unique characteristics of the nursing home population is important because in some European countries, the population of nursing home residents is projected to increase by up to 127% by 2050 [ 4 ].…”

Global Population Aging, National Development Level, and Vulnerability to the Pandemic

“…Asymptomatic COVID-19 residents and staff members contribute substantially to the dissemination of COVID-19 infection in long-term care facilities. 55 Some approaches advocated by other researchers to protect older adults in long-term care facilities should be adopted by both developed and developing countries. Specifically, widespread testing of residents and staff members is needed, regardless of symptom status, for close symptom monitoring.…”

“…Specifically, widespread testing of residents and staff members is needed, regardless of symptom status, for close symptom monitoring. 55 , 56 Frequent training in the use of personal protective equipment and ensuring a stockpile of appropriate personal protective equipment available on site are also recommended to prevent the spread of the current virus through contact and droplet transmission among residents and staff. 56 , 57 Staff compartmentalization in patients and health care–professional areas also need to be implemented in nursing homes to cut off potential infection sources.…”

Wearing masks and establishing COVID-19 areas reduces secondary attack risk in nursing homes

“…COVID-19 is spreading rapidly to nursing homes (NH) [1-3] and recommendations have been issued to reduce new cases in NH where a COVID-19 outbreak has been identified [4]. Guidelines from the European Geriatric Medicine Society (EuGMS) mention a variety of interventions based on testing, mask-wearing, or isolation of people with established or suspected infection and their contacts [5]. The relative impact of the different interventions on the magnitude of potential COVID-19 outbreaks in NH remains unclear and requires testing.…”