mask on the affected resident. Isolation is likely most important and should be done promptly, as the stakes are high. We know that there are atypical presentations to this infection in older people, and a cough even without fever should raise suspicion. 8 Every attempt should be made to accommodate these residents in a different area of your facility. If your facility is unable to physically isolate, it may be appropriate, whenever possible, to request that residents and patients wear masks or facial coverings. 9 If testing is limited, consider coordinating with your laboratory to safely arrange pooling samples by using one assay for multiple people to identify that your facility has COVID-19 circulating. 10 For example, use one assay to test four people. If the test returns negative, you can be reassured. If it returns positive, likely further testing and aggressive isolation would be necessary.If testing is more readily available than PPE, testing of residents and staff should be done as frequently as possible, ideally every week. If you can establish through testing and isolation a COVID-19 free facility, staff testing may be more important that resident testing. Recommendations for isolating should also include, wherever possible, partnering with neighboring LTCFs to cohort confirmed patients. COVID-19-specific units can be set up, which would minimize rotating staff, reduce training time and allow for limited reuse of face shields, gowns, and other equipment.In summary, in these fast-changing circumstances, the authors would like to stress that in the absence of treatment, isolation should be the fundamental guiding principal and that whatever tools are available to a LTCF to achieve that may be variable and should be optimized to that end.