March 17th CDC Call Recap: Coronavirus Disease (COVID-19) Update and Information for LTC Facilities

Sharing a few key points presented on March 17th’s CDC Clinician Outreach and Communication Activity (COCA) Webinar:



Presenters:

Dr Brendan Jackson

Medical Epidemiologist

CDC COVID-19 Response Clinical Team (CDC)


LCDR Kara M Jacobs Slifka, MD

Medical Officer

CDC COVI -19 Infection Prevention and Control Response Team


Recognizing COVID-19:

Incubation period on average is 4-5 days but can be as little as 2 and as long as 14 days


Signs and Symptoms:

  • Fever, cough, fatigue, diarrhea, nausea, respiratory symptoms

  • 80% experience mild symptoms

  • Most do not experience a runny nose

  • Often conditions take a quick decline after a week or so when the lungs begin to fill with fluid – may not have had shortness of breath prior to the downturn

  • 20-30% require ICU for respiratory support

  • Often combined with influenza and may present with a normal chest x-ray early on

  • Mortality Rate: (worsened by underlying chronic health conditions and obesity)

- 30 y.o. – 1/500

- 60 y.o. – 1/12

- 80 y.o. – 1/7


Long Term Care Special Considerations:

  • Higher mortality rate

  • Not all present with fever – may experience confusion and malaise

  • Educate all team members on signs and symptoms, Vital Signs and Pulse Oximetry

  • Check all residents upon admission and at least twice daily for signs and symptoms – check temp, Pulse Oximetry and signs/symptoms

  • Infection control KEY

  • If COVID-19 is found in the building – increase frequency of checks for all residents


Management and Treatment:

  • There are no treatments specific to COVID-19

  • Use caution with IV fluids – do not want to overload system and end up with increased fluid on the lungs

  • Watch for secondary infections which may be present


Strategies to Decrease Risk (utilize CDC Preparedness checklist on the CDC webpage):

  • Restrict visitation of all Non-Essential personnel

  • Immediate restriction of all visitation

  • Screening at the door – no one ill allowed in. Temp Check and Questionnaire Required.

  • Template letter available from CDC explaining actions to be taken for family and visitors

  • Post notification outside of the building

  • Group Distancing – 6’ apart - communal dining and activities cancelled

  • Staff health a priority – stay home if ill. Regularly monitor for fever and symptoms.

  • Staff health - avoid groupings of 10 or more people, eliminate unnecessary travel

  • If symptoms arise for staff members: mask, notify facility and go home

  • PPE Shortage is real: Assess inventory now, Know health department and coalition contact #’s

  • Clean between patients: blood pressure cuffs, hoyer lifts, pulse oximeters… any multi pt devices used

  • Preserve supply of PPE – check the CDC website for tips – mentioned, utilizing same face mask and eye wear per caregiver -do not touch – sanitize hands before and after putting on and taking off


If symptoms arise in patients:

  • Isolate in single room with private bath if possible – close the door

  • All staff mask, gown and glove, eye protection & sanitize

  • Decision to Hospitalize determined based on clinical assessment - if needs can be met - care for in place

  • Airborne Infection Isolation rooms are not required to care for COVID-19 cases


Let's Get to the Point:

Thank you for caring for our highest risk population!
Information is continually being updated. Please keep your questions and helpful ideas coming!