Skilled Nursing and Assisted Living
Member Alert
February 28, 2020

Coronavirus Update: Preparing Your Facility for What May Lie Ahead
Words like "pandemic" can strike fear among communities. You have no doubt heard this word over the course of the last week regarding the coronavirus, also termed COVID-19.

You will likely hear more about the coronavirus in the days ahead. Currently, there is no need to panic. There has been only one confirmed case of coronavirus reported in Washington and that person has fully recovered and been discharged from the hospital. There are ways you can protect yourself at work and at home - and help prevent the spread of the virus in your area. We are providing you this update only to help you prepare your facility in the (hopefully) unlikely event we experience an outbreak in Washington State.

The coronavirus is spread from person-to-person through droplets suspended in the air, very similar to how influenza spreads. It is also possible for an individual to become infected by touching a surface or object that has the virus and then touching one’s mouth, nose or eyes. During this time, centers should review their infection prevention and control policies and procedures for droplet precautions among residents and staff. The CDC is currently recommending Standard, Contact, and Airborne Precautions, including the use of eye protection when providing care for patients with confirmed or suspected COVID-19. 

Currently, the CDC believes that the incubation period of this coronavirus can range from 2-14 days. Commonly reported symptoms include fever, cough, and shortness of breath. Seniors and individuals with preexisting medical conditions such as diabetes are at a heightened risk of developing severe complications. The average mortality rate is currently believed to be 2.3% but rises to 8% for patients between the ages of 70 and 79 years. In contrast, the mortality rate for the common flu is 0.1 – 0.2%.  
The CDC does not currently recommend that the general public use face masks. Instead, they recommend following everyday preventive actions , such as washing your hands, using alcohol-based hand sanitizers, covering your cough, and staying home when you are sick. In addition, centers should educate families and visitors on signs and symptoms of respiratory illness and encourage them to visit with loved ones through alternative means when they are ill, such as telephone or Skype, or wearing a mask during visits. 
Due to decreases in exports from select countries, including China, India, and Taiwan, and increases in demand, manufacturers of select types of personal protective equipment (PPE) are reporting an increase in volume of orders and challenges meeting order demands. Plans are already underway to surge manufacturing globally. You can learn more about the CDC's strategies for optimizing the supply of PPE here. If members are experiencing challenges in meeting their PPE requests, please contact your local and state health departments.  

ALTSA-Residential Care Services (RCS) has issued a Dear Provider/Administrator letter for both assisted living and skilled nursing facilities with expectations, guidance and resources.

Please view the following information and resources to help you stay prepared.

Protect yourself at work:

  • Good respiratory hygiene / cough sneeze etiquette.
  • Advise all staff to wear their PPE diligently when appropriate. At this time, the CDC is not recommending use of PPE for workers who are not providing direct patient care. 
  • When it is appropriate, use social distancing from anyone displaying symptoms.
  • Wash or sanitize your hands after every interaction with a resident or visitor.
  • Observe waste disposal best practices (e.g., touchless, lined wastebaskets). 
  • More stringent standards are called for if you have reason to suspect a possible cause, such as droplet precautions for the resident; full PPE for all staff within a six-foot radius; N95 masks; isolation gowns; and face/eye protection.
  • If you suspect a possible coronavirus case, please report it to the Department of Health.

Protect your building: 

  • Consider adding more robust language to your entrance signs, such as warning signs in bold letters asking visitors having flu and/or respiratory symptoms to temporarily refrain from visiting the facility even if they don't have travel history.
  • Reminder training of staff and volunteers on sources of exposure, prevention, recognition of symptoms, response when an outbreak has been identified, and communication protocols. 
  • Encourage all staff to self-isolate at home if they display symptoms of the flu, especially if they have received the flu vaccine.
  • Take precautionary removal of care staff who identify as suspected cases. Have them self-isolate at home as well.
  • Prohibit staff from reporting to work if they are sick until cleared to return. 
  • Consider restricting admissions or heightened screening.
  • Environmental cleaning: At this time, retrain to and follow these guidelines from CDC about infection control and cleaning. 
  • Post visual alerts that remind everyone to wash their hands and cover their coughs.
  • Assess status of the community’s preparedness (stockpiling supplies such as sanitizers, masks, gloves, cleaning products, water, food and linens). 

Protect yourself at home and in the community: 

  • Practice social distancing when possible. Stay away from anyone coughing or sneezing, particularly if you do not know the person. 
  • Practice good hand washing hygiene.
  • If you are sick: Stay home and self-isolate if you have flu symptoms or a fever.
  • Prepare for schools or businesses to close.
  • If you are sick, call the physician, clinic or hospital before you visit them. Do not go to a clinic or hospital with symptoms without calling first - they will instruct you on the proper procedures.

While we are still taking a "wait and see" approach, the above-mentioned information can be used to minimize what potential impact may be coming. 

Thank you to California Association of Health Facilities for their assistance with this alert.

WHCA's staff is here to assist you in any way that we can should you have any questions or concerns. Please feel free to contact Elena Madrid by email or by dialing (800) 562-6170, ext. 105, or Vicki McNealley by email or by dialing (800) 562-6170, ext. 107.