How will a residential aged care facility outbreak look when the majority of staff and residents are vaccinated?
During the Victorian residential aged care facility (RACF) outbreaks in 2020, the transmission statistics revealed that 13% of cases were residents and 15% were staff. The mortality rate was in the hundreds.
Currently in NSW, there are 48 outbreaks, with 10 in rural areas. Of these outbreaks, 0.5% are residents and 0.4% are staff. Last week, there were 14 deaths; 10 of these were on palliative pathways and 5 were not vaccinated.
The main outbreak management issues in the vaccinated environment include:
- furloughing of staff for the first few weeks, hence the significance of RACFs cohorting staff now to minimise impact and shore up surge workforces
- getting through the first 24 hours. Most RACFs are self-managing the outbreaks after the first 24 hours, with the support of the state-level outbreak management team only
- evidence-based infection prevention and control practices in relation to planning outbreak zones, working in PPE and donning and fit checking of P2 or N95 respirators.
- Continuity of care for residents:
- Healthy North Coast’s RACF GP Outbreak Response Framework.
- An Australian Government fact sheet on continuity of care for GPs is being developed.
- Advance care directives and plans incorporating COVID-19 statements that uphold residents’ wishes.
- Deconditioning continues to be seen in residents. The use of allied health staff where possible during the outbreaks and afterwards is a priority.
Locally, meetings between the RACFs, Healthy North Coast, local health districts and the Public Health Unit (PHU) continue, ensuring preparedness and information sharing from the Ministry of Health, the Australian Government COVID-19 teams and the aged care peak bodies. The group are grateful to the ongoing efforts of the PHU staff who continue to attend despite excessive workloads. Minutes from these meetings are available to interested GPs and practice staff – please contact:
Bron McCrae
Deputy Director Healthy Living and Ageing, Healthy North Coast
[email protected]
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