Guidance for the Prevention of the COVID-19 Epidemic in Long-Term Care Facilities: A Short-Term Prospective Study

• Published in: The Journal of nutrition, health & aging Vol. 24; no. 8; pp. 812 - 816
• Main Authors: Rolland, Yves, Lacoste, M.-H., De Mauleon, A., Ghisolfi, A., De Souto Barreto, P., Blain, H., Villars, H.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-08-2020; Springer Verlag (Germany)
• Subjects: Aging; Betacoronavirus; Coronavirus Infections; Coronavirus Infections - prevention & control; COVID-19; Food and Nutrition; France; Geriatrics/Gerontology; Geriatry and gerontology; Health Facilities; Health Facility Administration; Health Facility Administration - methods; Human health and pathology; Humans; Life Sciences; Long-Term Care; Long-Term Care - methods; Male; Medicine; Medicine & Public Health; Neurosciences; Nutrition; Pandemics; Pandemics - prevention & control; Pneumonia, Viral; Pneumonia, Viral - prevention & control; Primary Care Medicine; Primary Prevention; Primary Prevention - methods; Prospective Studies; Quality of Life Research; SARS-CoV-2; Surveys and Questionnaires; France; COVID-19; long-term care facility; guidance; prevention
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-020-1440-2

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 COVID-19 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 COVID-19, 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.