COVID-19 outbreaks in long-term care: what happens and the work being done to prevent them

If you have a loved one in long-term care, you may be worried about the potential for a COVID-19 outbreak. While the Saskatchewan Health Authority has undertaken a number of measures to prevent COVID-19 from entering care facilities, high community transmission means an elevated risk to all residents. What exactly happens during an outbreak in a long-term care home and how it will impact your loved one and you?

What happens when an outbreak is declared?

When a COVID-19 outbreak is declared in a long-term care home, nurses employed with the Saskatchewan Health Authority in Public Health, Infection Prevention and Control, and Occupational Health and Safety begin to investigate the cases and carry out contact tracing (the process of contacting individuals who have come in close contact with someone who has tested positive). In addition, the following measures are put in place to rapidly identify new cases and halt the spread:

• Monitoring residents frequently throughout the day for any signs of illness 
• Onsite testing for residents and staff
• Outbreak control measures, including temporarily keeping residents in their room, limiting visitors for compassionate reasons only (e.g., family or support persons during end-of-life care), cancelling group activities, restricting  individuals moving into the home, and enhanced cleaning.

How your loved one is affected

Some residents who contract COVID-19 will have very serious symptoms requiring medical intervention, but the biggest impact on those in care settings can still be isolation. Residents who are COVID-19 positive, have symptoms, are presumed positive or are close contacts to a positive case, are required to isolate in their rooms, even for meals. When residents are isolated, they are placed on droplet/contact plus precautions, which means that staff put on personal protective equipment (e.g., masks, gowns, gloves) before entering their rooms.

It can be a particularly difficult time for residents who are required to remain in their rooms with limited visitation from family and friends. Long-term care home staff is committed to both meeting residents’ care needs and engaging them in activities, like painting and knitting, that can be done in their rooms. Staff members are also committed to helping residents maintain contact with their loved ones, and family members are encouraged to continue visiting with their loved ones virtually.

What’s being done to support residents

Long-term care homes are coming up with creative ways to provide support and socialization to residents during an outbreak; for example, events like music and reminiscing that allow for six feet of space between residents are supported. Homes have also been using technology such as Facetime to help residents connect with their loved ones. In addition, therapy and recreation staff may offer independent activities to residents who wish to participate.

How outbreaks are being prevented

Measures to prevent outbreaks include:

• COVID-19 screening: All staff, approved contractors and approved visitors are screened on arrival at the home. Screening includes a temperature check and a series of questions. Residents are also screened twice daily. As soon as a resident shows any symptoms of COVID-19, they are immediately put on isolation and droplet/contact plus precautions, even before they are tested for COVID-19. Family members will be contacted if this happens.
• Masking and hand hygiene: All staff, approved contractors and approved visitors are required to mask at all times and practice regular hand hygiene. Residents are required to mask in public areas and practice regular hand hygiene.
• Physical distancing: Break spaces and resident dining rooms are set up to ensure distancing for residents and staff. Group activities follow the Public Health Order for group sizes, unless an outbreak has been declared, at which point all group activities are cancelled.
• Enhanced cleaning: Environmental Services is providing enhanced cleaning, with a focus on high touch surfaces.

What you can do to help prevent outbreaks in long-term care homes

There are many things you can do to help protect your loved ones in long-term care:

• Even if you are providing compassionate care to a loved one, do not visit if you are experiencing even the mildest symptoms. Stay home. 
• Contact the home prior to coming to ensure it is safe to visit, and follow the guidelines around visitation when present. Wear a mask and practice good hand hygiene. 
• All of the resident’s family and friends should follow the public health recommendations: wear a mask, wash your hands, maintain physical distancing, stay home if sick and get tested. Contact the home to set up virtual visits with your loved ones (e.g., Facetime).

The home can address any questions or concerns you may have and assist you with the process if you are unsure how it works. You can also keep connected with your loved ones via phone and by sending cards and letters.

What else you can do during an outbreak

As a family member you are an integral part of the community of the home where your loved one resides. This is why it is so important for you to:

• Follow communication (e.g., emails, website, Facebook) provided to you from the home.
• Share your thoughts and suggestions for effective communication with leadership at the home. 
• Understand that staff may not be as available to immediately answer calls during an outbreak. Please be patient and know that their energy and attention is on providing the best possible care to your loved one and the other residents in the home, and they will connect with you as soon as they are able.

As a family member, you are vitally important to the health and well-being of your loved one and to the community environment within the home. All long-term care homes are committed to returning to family presence when it is safe to do so following an outbreak. Your understanding, patience and cooperation to keep residents, families and staff safe during the pandemic are greatly appreciated.