COVID-19 resources on Infection control

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Medicine is a social science: COVID-19 and the tragedy of residential care facilities in high-income countries

Commentary published in BMJ Global Health, 5(8) 2020. Comments on the pandemic spread of COVID-19 in high-income countries that have witnessed an extraordinary high death toll of people living in residential care facilities. Provides insights from a social sciences and public health perspective about infections. Citation: Krones, T., Meyer, G., & Monteverde, S. (2020). Medicine is a social science: COVID-19 and the tragedy of residential care facilities in high-income countries. BMJ Global Health, 5(8), e003172.

Last updated on hub: 13 November 2020

Mitigating the impact of the COVID-19 outbreak: a review of international measures to support community-based care

International Long-term Care Policy Network

This report provides a brief overview of the policy responses and practice measures used internationally to respond to the impact of COVID-19 on the provision of community-based care. The data provided is largely collected from the country reports on the COVID-19 long-term care situation, including Australia, Austria, Brazil, China, England, Germany, Hong Kong, Ireland, Israel, Italy, Netherlands, Slovenia, South Korea, and the United States. Key findings include: community-based care faces unique challenges during the COVID-19 pandemic compared to other parts of the long-term care continuum; several countries have taken steps to prevent the spread of COVID-19 infections in community-based care including the closure of adult day centres and other service providers; continuity of care is of upmost importance – a disruption of care and support could have serious negative impacts on individual health and well-being due to increased risk of loneliness and social isolation; the dispersed nature of community based care suggests that direct governmental action and oversight may be more difficult to provide than for residential care settings such as care homes or nursing facilities; efforts to maintain continuity of care in community-based care include government financial support to home care workers; recruitment of volunteers and family members to act as paid carers; and the provision of remote psychological supports to home care workers; some countries have taken steps to move patients and home care workers to residential care settings; few countries are specifically reporting data on infections and deaths among users of home care – an exception to this is Australia; overall evidence of national measures to support community-based care is still lacking for most countries.

Last updated on hub: 04 November 2020

Mitigation of risks of COVID-19 in occupational settings with a focus on ethnic minority groups – consensus statement from PHE, HSE and FOM

Public Health England

Consensus statement from Public Health England (PHE), Health and Safety Executive (HSE ) and the Faculty of Occupational Medicine (FOM) on the mitigation of risks of COVID-19 in occupational settings with a focus on ethnic minority groups.

Last updated on hub: 24 November 2020

More than just a visitor: a guide to essential family carers

Methodist Homes for the Aged

This guidance sets how Methodist Homes (MHA) can start to re-introduce family visits indoors in its care homes, as lockdown restrictions ease, especially for those who have been unable to have any outdoor visits. During lockdown, MHA enabled families to have regular video calls with residents, as well as telephone calls and opened up for outdoor visits in gardens when it was safe to do so. Sadly, not all residents have been able to take part in these so MHA has developed its guidance, in conjunction with that from the Government, for families to once again be able to come into care homes and see their loved one, albeit on a limited basis initially. An essential family carer (EFC) is a resident’s family member or friend whose care for a resident is an essential element of maintaining their mental or physical health. The guidance sets out what being an EFC involves, including following infection control measures including sharing evidence of having been free from COVID-19 for at least 28 days and wearing Personal Protective Equipment (PPE).

Last updated on hub: 15 March 2021

Mortality associated with COVID-19 in care homes: international evidence

International Long-term Care Policy Network

This document focuses on mortality associated with COVID-19 in care homes, summarising information from three types of sources: epidemiological studies, official estimates and news reports; and relies on national experts for confirmation of sources and definitions. Key findings include: official publicly available data on the numbers of deaths among care home residents linked to COVID-19 is not available in many countries; international comparisons are difficult due to differences in testing capabilities and policies, different approaches to recording deaths, and differing definitions of what constitutes a “care home”; there are three main approaches to quantifying deaths in relation to COVID-19: deaths of people who test positive (before or after their death), deaths of people suspected to have COVID-19 (based on symptoms or epidemiologically linked), and excess deaths (comparing total number of deaths with those in the same weeks in previous years); another important distinction is whether the data covers deaths of care home residents or only deaths in the care home; based on the data gathered for this report, the current average of the share of all COVID-19 deaths that were care home residents is 46% (based on 21 countries); the share of all care home residents who have died (linked to COVID-19) ranges from 0.01% in South Korea to over 4% (which would mean that over one in 25 care home residents have died linked to COVID-19) in Belgium, Ireland, Spain, the UK and the US; currently, there is limited evidence from anywhere in the world on how individuals who receive care in the community have been directly or indirectly affected by COVID-19.

Last updated on hub: 04 November 2020

Moving practice online: knowledge exchange for social service practitioners adapting to the covid -19 context

A summary of responses to a knowledge exchange held with social service practitioners in New Zealand on how they were adapting their practice to ensure physical distancing during the coronavirus (Covid-19) pandemic. Practitioners described many ways that their processes, practices and technologies were changing in order to continue their work. The document provides a brief overview paragraph summarising each area of practice adaptation and a list of ideas from practitioners. Four areas of practice adaptation are covered: engaging in direct practice - including managing potential risks related to heightened family stresses and the possibilities of family violence; managing service user pathways, including managing new referrals; ethical and cultural issue, such as balancing user needs with the need to reduce the spread of the virus; and staff issues relating to staff protections, work practices that reduce spread of the virus.

Last updated on hub: 07 May 2020

National Care Forum COVID-19 guidance and resources

National Care Forum

The COVID-19 section of the National Care Forum (NCF) website is a good source for government guidance and information relevant to the care sector. The resource includes links to information about: infection control, CPA Visitors’ Protocol, clinical guidance, regulation, information governance, workforce, supported housing and homeless, volunteering wellbeing and other practical resources.

Last updated on hub: 20 August 2020

National Care Forum infection, prevention and control (IPC) compliance assessment tool

National Care Forum

This compliance assessment is a simple tool which has been developed using the most recent information on infection prevention and control (IPC) from the CQC and others. It will help care providers know how well they are doing, identify areas in which they need to improve and bring the guidance together into one place. This completion of an assessment using this tool will also provide the evidence that they need to satisfy the CQC requirements and will help ensure services are prepared and in a strong position to manage any ‘second wave’ of COVID-19, or indeed, other yet unknown pressures. There are 8 sections to the tool covering the management of visitors, social distancing, admissions, PPE, testing, premises, staffing and policy. Each section contains a description of what is important to consider and examples of evidence that could be seen as good practice.

Last updated on hub: 28 September 2020

NICE guidance: preventing infection and promoting wellbeing

Skills for Care

This webinar – delivered by NICE – focuses on two areas of NICE guidance: helping to prevent infection and promoting positive mental wellbeing, considering the particular challenges for social care during the COVID-19 pandemic. The webinar also covers NICE COVID-19 rapid guidelines and NICE social care quick guides.

Last updated on hub: 29 June 2020

Nontraditional small house nursing homes have fewer COVID-19 cases and deaths

Journal of the American Medical Directors Association

Objectives: Green House and other small nursing home (NH) models are considered “nontraditional” due to their size (10–12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer people living, working, visiting, and being admitted to Green House/small NHs, and private rooms and bathrooms, but this assumption has not been tested. If they prove advantageous compared with other NHs, they may constitute an especially promising model as policy makers and providers reinvent NHs post-COVID. Design: This cohort study compared rates of COVID-19 infections, COVID-19 admissions/readmissions, and COVID-19 mortality, among Green House/small NHs with rates in other NHs between January 20, 2020 and July 31, 2020. Setting and Participants: All Green House homes that held a skilled nursing license and received Medicaid or Medicare payment were invited to participate; other small NHs that replicate Green House physical design and operational practices were eligible if they had the same licensure and payer sources. Of 57 organizations, 43 (75%) provided complete data, which included 219 NHs. Comparison NHs (referred to as “traditional NHs”) were up to 5 most geographically proximate NHs within 100 miles that had <50 beds and ≥50 beds for which data were available from the Centers for Medicare and Medicaid Services (CMS). Because Department of Veterans Affairs organizations are not required to report to CMS, they were not included. Methods: Rates per 1000 resident days were derived for COVID-19 cases and admissions, and per 100 COVID-19 positive cases for mortality. A log-rank test compared rates between Green House/small NHs and traditional NHs with <50 beds and ≥50 beds. Results: Rates of all outcomes were significantly lower in Green House/small NHs than in traditional NHs that had <50 beds and ≥50 beds (log-rank test P < .025 for all comparisons). The median (middle value) rates of COVID-19 cases per 1000 resident days were 0 in both Green House/small NHs and NHs <50 beds, while they were 0.06 in NHs ≥50 beds; in terms of COVID-19 mortality, the median rates per 100 positive residents were 0 (Green House/small NHs), 10 (<50 beds), and 12.5 (≥50 beds). Differences were most marked in the highest quartile: 25% of Green House/small NHs had COVID-19 case rates per 1000 resident days higher than 0.08, with the corresponding figures for other NHs being 0.15 (<50 beds) and 0.74 (≥50 beds). Conclusions and Implications: COVID-19 incidence and mortality rates are less in Green House/small NHs than rates in traditional NHs with <50 and ≥50 beds, especially among the higher and extreme values. Green House/small NHs are a promising model of care as NHs are reinvented post-COVID.

Last updated on hub: 03 March 2021

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