Guidance for the Prevention of the COVID-19 Epidemic in Long-Term Care Facilities: A Short-Term Prospective Study
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GUIDANCE FOR THE PREVENTION OF THE COVID-19 EPIDEMIC IN LONG-TERM CARE FACILITIES: A SHORT-TERM PROSPECTIVE STUDY Y. ROLLAND1, M.-H. LACOSTE1, A. DE MAULEON1, A. GHISOLFI1, P. DE SOUTO BARRETO1, H. BLAIN2, H. VILLARS1 1. Gérontopôle de Toulouse, INSERM 1027; 31059 Toulouse, France; 2. Pole Gérontologie, Montpellier University Hospital, Montpellier University, MUSE, Montpellier, France. Corresponding author: Professeur Yves Rolland, Gerontople de Toulouse, 20 rue du Pont Saint Pierre, 31 059 Toulouse, France, Tel: 05 61 77 64 45, E-Mail : [email protected]
Abstract: Background: Guidance aiming at limiting the entry and spread of the COVID-19 have been widely communicated to Long-term Care Facilities (LTCFs). However, no clinical research has investigated their relevance. Objective: Our objective was to compare the guidance applied for the prevention of the COVID19 epidemic between the LTCFs having been contaminated by COVID-19 and LTCFs having not been contaminated. Methods: A questionnaire was sent and systematically accompanied by phone call to the 132 LTCFs of Haute-Garonne (Occitania region, South-West of France). The questionnaire focused on the preventive measures implemented before March 23, 2020 (first LTCFs contaminated in this area). The questionnaire focused on physician support, implementation of usual guidance (eg, masks, hydro-alcoholic solute used), training on hygiene, containment in residents’ rooms and other distancing measures, use of temporary workers, compartmentalization within zones of residents and staff and a self-assessment analogic scale on the quality of the application of the preventive measures. We compared implementation of the guidance between the LTCFs with at least one case of COVID-19 among residents and/or health care professionals and LTCFs without COVID-19 case (between March 23rd and May 6th). Results: 124 LTCFs participated (93.9%). 30 LTCFs (24.19%) were contaminated with COVID-19. Large heterogeneity of the application of the guidance was observed. Public LTCFs (OR= 0.39 (0.20-0.73), LTCFs which organized staff compartmentalization within zones (OR= 0.19 (0.07-0.48)), and LTCF with a staff who self-assessed a higher quality implementation of the preventive measures (OR= 0.65 (0.43-0.98)) were significantly more likely to avoid contamination by the COVID-19 outbreak. Conclusion: Our study supports the relevance of guidance to prevent the entry of COVID19, in particular the staff compartmentalization within zones, as well as the perception of the staff regarding the quality of implementation of those measures in LTCFs. Key words: COVID-19, long-term care facility, guidance, prevention.
Introduction
was questioned (5). Indeed, these guidance were irregularly applied during the first weeks of the epidemic for several reasons: inadequate or lack of personal’s protective equipment (such as masks or hydro-alcoholic gel), a shortage of rt-PCR testing kits, insufficient space to organize compartmentalization within zones, a shortage in personnel, the lack of a proper unders
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