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SHORT COMMUNICATION
Year : 2020  |  Volume : 6  |  Issue : 2  |  Page : 123-124

Strengthening infection prevention and control services in the long-term care facilities amidst fighting against Corona Virus Disease 2019 pandemic


1 Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission30-Mar-2020
Date of Decision31-Mar-2020
Date of Acceptance03-Apr-2020
Date of Web Publication29-Aug-2020

Correspondence Address:
Professor Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu - 603108
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mamcjms.mamcjms_23_20

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  Abstract 


The ongoing Corona Virus Disease-2019 (COVID-19) pandemic has influenced the lives of everyone, regardless of the fact that whether they are part of the general community or a vulnerable population groups and are living in campsites or in conflict areas or even in long-term care facilities (LTCF). In general, LTCFs are usually overcrowded and thus the possibility of rapid transmission of infection cannot be ruled out. Infection prevention and control has been acknowledged as the key strategy to prevent the causative virus from entering or spreading within the facilities and also to prevent its transmission outside these facilities. In conclusion, in the fight against the COVID-19 pandemic, it is extremely important to safeguard the health of vulnerable population groups in long-term care facilities through strengthening of the infection prevention and control strategies.

Keywords: COVID-19 pandemic, infection prevention and control, long-term care facilities, World Health Organization


How to cite this article:
Shrivastava SR, Shrivastava PS. Strengthening infection prevention and control services in the long-term care facilities amidst fighting against Corona Virus Disease 2019 pandemic. MAMC J Med Sci 2020;6:123-4

How to cite this URL:
Shrivastava SR, Shrivastava PS. Strengthening infection prevention and control services in the long-term care facilities amidst fighting against Corona Virus Disease 2019 pandemic. MAMC J Med Sci [serial online] 2020 [cited 2020 Sep 21];6:123-4. Available from: http://www.mamcjms.in/text.asp?2020/6/2/123/293884




  Introduction Top


The ongoing Corona Virus Disease-2019 (COVID-19) pandemic has influenced the lives of everyone, regardless of the fact that whether they are part of the general community or a vulnerable population groups and are living in campsites or in conflict areas or even in long-term care facilities (LTCF).[1] The global count has increased to 1,133,758 cases and 62,784 deaths, with the European region leading both in terms of the number of reported cases (54.8% of the global caseload) and deaths (73.9% of the global deaths).[2] It is an alarming fact that the disease which initiated in the form of a cluster of pneumonia cases in a single city of China has now been reported in 208 nations and territories in less than 3 months and keeping the trends of the disease in mind, the scenario is expected to become even worse.[2]

Long-Term Care Facilities and the factors favoring disease transmission

LTCFs refers to those facilities, which are meant for extending care to people suffering from some form of physical or mental disabilities, like nursing homes or centers for rehabilitation.[1] The presence of elderly people in such facilities cannot be ruled out. From COVID-19 perspective, two facts have been confirmed, namely the disease is transmitted between persons through close contact or fomites and that the risk of an adverse outcome is more for elderly and those who are living with pre-existing illnesses. In general, LTCFs are usually overcrowded and thus the possibility of rapid transmission cannot be ruled out. At the same time, owing to the presence of at-risk population groups, it becomes extremely challenging to ensure that the residents, employees and visitors are safeguarded from COVID-19.[1],[3]

Scope of infection prevention and control in LTCFs

Infection prevention and control (IPC) has been acknowledged as the key strategy to prevent the causative virus from entering or spreading within the facilities and also to prevent its transmission outside these facilities. The first and foremost thing is to work in collaboration and as per the guidelines released by the national authorities to ensure infection prevention. In each of these facilities, one specific nodal point needs to be identified, which is responsible for training of all the employees about IPC, sensitize residents, give emphasis on the compliance to hand hygiene through ensuring availability of soap-clean water-alcohol-based hand rubs or via display awareness materials to improve IPC or other supplies, and finally sustain high standards of hygiene and sanitation. This should be carried out by a team of employees in the facility and it is their responsibility to coordinate the entire process.[1]

Social distancing and other interventions

The practice of physical distancing should be encouraged in these settings by restricting the number of visitors, cancellation of group activities, redistributing people during meal timings, advising residents to maintain a distance of 1 meter and discourage the practice of touching like shaking hands. Ideally, no visitor should be allowed in such facilities, but under special circumstances, if permitted, should be screened for signs and symptoms suggestive of disease and also instructed to practice respiratory and hand hygiene and social distancing. In general, the quality of response to a potential outbreak in LTCFs depends on the early detection, isolation, provision of appropriate care and containment of the source of infection. Early recognition can be established by periodically checking for the development of symptoms of the disease and reporting to the nodal point or health personnel, if any such case is detected. Even the employees and visitors should be monitored for the same, and if the symptoms develop, they should be asked not to come for their regular symptoms till the symptoms subside.[1],[3],[4]

Inmate becomes symptomatic - What to do?

Once a resident is suspected or confirmed of the disease, the public health authorities should be notified and positive cases are instructed to continuously wear face mask and they should be encouraged to strictly adhere to standard IPC. Other residents in the same room should be reallocated to other rooms (if possible), and all the contaminated surfaces should be cleaned regularly. In case, the diagnosed patient is an elderly and has underlying medical illnesses, they should be treated in hospital he/she. All the diagnosed cases or the persons who are involved in the care should strictly adhere to the standard protocol for the use, removal and safe disposal of personal protective equipment. In addition, the water-sanitation and hygiene services in such facilities also need to be strengthened to ensure better hand hygiene and safe disposal of excreta.[4] The residents with infection should not be allowed to move freely and they should be isolated in their rooms only. These cases should be isolated till two negative laboratory tests for COVID-19 are obtained at least 24 hours apart after the resolution of the symptoms.[1] However, it is important to ensure that the mental health needs of the residents are addressed on a timely basis.[5]


  Conclusion Top


In conclusion, in the fight against the COVID-19 pandemic, it is extremely important to safeguard the health of vulnerable population groups in LTCFs through strengthening of the infection prevention and control strategies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Infection prevention and control guidance for long-term care facilities in the context of COVID-19-Interim guidance. Geneva: WHO Press 2020. p: 1-4.  Back to cited text no. 1
    
2.
World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report − 79; 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200405-sitrep-76-covid-19.pdf?sfvrsn=6ecf0977_4. [Accessed on April 6, 2020].  Back to cited text no. 2
    
3.
World Health Organization. 2019 Novel Coronavirus (2019‑nCoV): strategic preparedness and response plan. Geneva: WHO Press 2020. p: 1-20.  Back to cited text no. 3
    
4.
World Health Organization, UNICEF. Water, sanitation, hygiene, and waste management for the COVID-19 virus. Geneva: WHO Press 2020. p: 1-4.  Back to cited text no. 4
    
5.
Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian J Psychiatr 2020;51:101990.  Back to cited text no. 5
    




 

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