COVID-19 Infection Control in Nursing Homes
Testing Strategy
- Conduct weekly testing of all residents and staff in facilities without active outbreaks using rapid antigen tests or PCR testing 2, 4, 5
- Increase testing frequency to every 3 days once a single COVID-19 case is identified in the facility 2, 4
- Use nasopharyngeal swabs for SARS-CoV-2 testing via RT-PCR or rapid antigen tests 6
- Rapid antigen tests are preferred when available due to immediate results enabling faster cohorting 2, 4
Isolation and Cohorting Protocols
- Isolate COVID-19 positive residents in well-ventilated single rooms when possible, or maintain at least 1 meter bed distance if single rooms are unavailable 7, 8, 9
- Physically separate COVID-19-positive residents from others in a separate area of the facility 1, 2, 4
- Assign dedicated staff to work exclusively in the COVID-19 cohort to prevent cross-contamination 1, 2, 4
Personal Protective Equipment (PPE) Requirements
- All staff must wear masks, gowns, gloves, and eye protection when caring for COVID-19 positive residents 1, 2, 4
- Staff should wear N95 masks (preferred) or surgical masks when in the same room as infected residents 7, 8, 10
Environmental Infection Control
- Clean and disinfect all high-touch surfaces using 500 mg/L chlorine-containing disinfectant frequently every day 7, 8, 10
- Open windows for ventilation in shared areas such as toilets and kitchens 7, 10
Treatment Protocols
- Administer Paxlovid or other available antivirals to eligible residents as soon as possible after positive test and within 10 days of symptom onset to reduce probability of death 2, 3
- Monitor vital signs regularly including temperature, heart rate, respiratory rate, and oxygen saturation 8, 9, 10
Vaccination Strategy
- Ensure all residents receive COVID-19 vaccination as the primary prevention strategy - vaccination dramatically reduced case fatality rates even with highly transmissible variants like Omicron 2, 3