Long-term care facilities taking every COVID-19 precaution possible

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Since March 2020, 14 long-term care institutions in the Southwestern Public Health region have reported one or more cases of COVID-19.

Four of the Oxford-Elgin institutions have had more than one outbreak.

The public health unit continues to work with all of the region’s institutions, testing and providing measures they can take to prevent the spread of the virus.

“Always, in any long-term care home, we know that there are vulnerable people there, and that infections of any sort are dangerous to them,” said Dr. Joyce Lock, Medical Officer of Health at Southwestern Public Health. “So there are standards of procedures that are always in place to prevent infections from spreading.

“When there is an outbreak, we up the ante – a lot – to ensure that absolutely every last measure to prevent the spread of infection is put into place. So it’s actually building on routine precautions, then we add extra ones.”

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One precaution is ensuring staff do not inadvertently spread the infection to themselves or other residents by making sure they know how to properly use and wear personal protective equipment, said Lock.

“In this case (COVID-19), we use personal protective equipment for a respiratory virus. So that does involve using a mask and eye shield, and a gown, and gloves. Then there are protocols that staff are trained on how to take these off and how to put them on.”

Many other measures are put into place to ensure things are as safe as possible, she said, including extra cleaning.

“They are more careful about which staff works with which patient so that, again, by making sure that we cohort the staff to the patients properly they don’t actually end up accidentally infecting healthy people.”

Any staff that test positive for COVID-19 are excluded from work, said Lock, and testing continues regularly at long-term care institutions during an outbreak.

“When there is a case in a long-term care home then everybody is tested,” said Lock. “Then, after that, we re-test again anybody who has developed symptoms.”

At a long-term care home with an outbreak, everyone has undergone multiple tests – some more than others depending on how concerned they are that although the individual may not have been positive before, perhaps the situation changed a bit.

“So then we re-test them.”

Some long-term care facilities only have 1-2 cases before they are safely resolved. Others experience a much wider spreading of COVID-19.

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“It depends on several factors,” Lock explained. “One, it depends on the index case, who inadvertently introduced the COVID virus into the home. As much as everybody gets rounds of tests every week, you can start shedding virus before you even get symptoms. Sometimes that might just be a stroke of bad luck… that somebody did everything properly, but still some virus was shed.”

Another issue is viral load – the amount of virus that is shed.

“Some people are more what we call ‘super spreaders,’” said Lock. “Somehow, for some reason, they (spread) higher levels of virus than the next person.

“The other issue is that COVID is a respiratory virus, and small respiratory viruses are very hard to control at the best of times. Even with the best of infection prevention and control activities by the home, it can happen.

“So sometimes it’s just the criss-crossing of a few of these different things all at the same time, and then you’ll have the cases start to spread.

“I think that even though some homes have been fortunate so far, all of them – no matter what – are at risk for this, and that’s why we are so keen and so delighted that we can start vaccinating staffs, and hopefully before long, residents, because that’s actually the best protection.”

A limited number of vaccinations have already been given within the Southwestern Public Health unit, said Lock.

“A week ago, all of our long-term care homes were offered the option of sending some staff to London to receive some doses of vaccine. And further options for more staff are being offered today (Dec. 29).

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“We are a part of the London project, which is offering vaccines to long-term care homes in the Middlesex-London Health Unit, the Huron Perth Health Unit and in the Southwestern Public Health Unit geography.

“So, yes, some of our (Oxford-Elgin region) staff have already been immunized with their first (vaccine) shot.

“The highest priority right now is our staff in our long-term care homes because that’s where our most vulnerable citizens live. So that’s our No. 1 priority. Thereafter, we hope that we will be able to start to vaccinate the residents in the homes.”

Hospitals that are in outbreak have also been eligible, said Lock, noting London Health Sciences as an example.

Although vaccine manufacturers are working ‘full-out’ to make doses, and the federal government is working ‘full-out’ to acquire doses, Lock said she thinks it will be “some months” before there will be sufficient vaccine for the general population.

“It is coming, which is really exciting,” said Lock.

cabbott@postmedia.com