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Health Protocols for The Prevention of Covid-19 in the Elderly Care Centers of Social Care Centers

Professionals & Health Workers

Environmental Protection for the Elderly and Employees

  • Ensure the availability of personal protection equipment.
  • Distribute hand sanitizers in visible places, and fix them on the walls (they must contain 60-80% of alcohol, and be in accordance with the requirements of the Food and Drug Authority).
  • Ensure that hand soap is available in toilets, and that hand sanitizers are available at the sinks and at entrances to toilets.
  • Dirt should be removed with soap and water before disinfection.
  • Health practitioners must commit to washing hands with soap and water for 40 seconds or using hand sanitizer (60-80% of alcohol) for 20 seconds, especially before and after dealing with the elderly or touching what belongs to them.
  • Commit to periodically disinfect surfaces and toilets after each use with disinfectants approved by the Food and Drug Authority or the Ministry of Health and follow the instructions for sanitizing health facilities.
  • A schedule should be kept of times of disinfection for surfaces and toilets, and a special schedule should be devoted to disinfection periods.
  • It is preferable to provide self-operating taps in the toilets, and if they are not available, a cleaner must be allocated to disinfect the toilets, especially taps, sinks and door handles periodically.
  • Ensure good ventilation in all places, especially gathering places and toilets, with the use of natural ventilation.
  • Regularly change or clean air filters for ventilation devices, especially air conditioners.
  • Single-use tools must be provided in social care centers, such as spoons and plates, and special tools for the elderly must be allocated such as towels and clothes.
  • Continuously disinfect interactive screens or touch-based guidance screens, if any, or place disinfectant wipes next to them.
  • Provide no-touch waste bins, and the waste must be disposed of continuously.
  • Health employees and practitioners must wear surgical masks throughout their work hours, and follow instructions for infection control in health facilities.
  • Visitors must wear surgical masks during their stay in the social care centers.
  • The elderly must not be forced to wear masks because they may cause difficulty in breathing, an evaluation must be done by a doctor to check the elderly’s ability to wear masks from a health point of view, and they must be urged to cover the mouth and nose with any cloth cover.
  • Prohibit shaking hands and hugging between the elderly and visitors.
  • Crowding in rooms inside the social care centers should be reduced, and emphasis should be placed on the application of social distancing (of one and a half meters) between the elderly in common rooms.
  • Apply social distancing on necessary group activities and group dining.
  • Cancel outdoor activities such as trips, outside tours, etc.

Reporting and Monitoring

Visiting Relatives and Friends

  • Legalize visits to social care centers for the elderly, and each center must develop an appropriate plan to legalize visitation periods, for example:
    • Facilitate and encourage alternative methods of communication, such as using virtual communication applications.
    • Restrict visits to specific hours and locations within the social care centers for all visitors, and schedule them with a prior appointment to reduce crowding.
    • Prevent people who are not related to the elderly from entering the social care center, such as volunteers and non-medical service providers (barbers, counselors).
  • Visitors must wear surgical masks and surgical gowns throughout the time of the visit, and disinfect their hands well with an alcohol-based disinfectant before entering.
  • Request visitors to inform personnel in social housing for the elderly if they develop symptoms of respiratory infection within 14 days of visiting the social care center.
  • An inspection point must be established at the entrance to social housing for the elderly, and it should include taking the temperature with a device approved by the Food and Drug Authority and asking about respiratory symptoms (cough or shortness of breath).
  • Keep a record of outside visitors.
  • Prevent entry for those with a high temperature (38 ° C or more), or those with symptoms of respiratory infection.
  • Visitors must be notified to head directly to the resident’s room and then leave the center as soon as the visit ends.

When a Case Previously Infected with Covid-19 Enters the Social Care Center for The Elderly as a New Arriving Case or is Transferred to the Centers After Receiving Treatment

  • The elderly’s return after treatment must be appropriate. Physician evaluation must be done before transfer to the center as follows:
  • If a case was confirmed to be infected with COVID-19 and did not fully recover from the disease, then she/he must not be transferred to the center until she/he has fully recovered.
  • If a case has recovered from COVID-19, she/he can be received in the regular departments after being evaluated by the hospital’s infection control department and the health staff at the center.
  • If a case tested negative for COVID-19, but there are still symptoms, the case can be admitted to the regular wards, but only if she/he is isolated in a room that meets the isolation requirements.
  • A laboratory examination for COVID-19 is not required for all new arrivals or those transferred to the elderly social care centers.
  • Confirmed cases of COVID-19 must be isolated for at least 14 days before being transferred to the common rooms.
  • New elderly residents whose condition is unknown, and who do not have symptoms of Covid-19, must be isolated in a single room for 14 days or, if possible, laboratory examined to ensure that they are free of infection.

If there is a confirmed or suspected case among the elderly, a laboratory examination for covid-19 must be performed. Depending on the availability of capabilities, the following must be done:

  • Perform an examination on all the elderly and all employees in the center.
  • If it is not possible to examine all employees and all the elderly, examination should be limited to employees and the elderly in the same department.
  • If it is not possible to examine everyone in the department, examination should be limited to companions in the same room and the health practitioners who were in contact with the confirmed or suspected case.
  • If there is more than one suspected case, and there are not enough isolation rooms, the cases can stay in the same room, taking precautions spacing them out so that the infection is not transmitted to people who are not infected.
  • Patients must be isolated inside a single, well-ventilated room, and contact and spray isolation precautions must be applied. If a spray-emitting procedure is performed, air isolation precautions must be applied, and if there is no single room, the isolation may be carried out in a group room, only if the room is dedicated for positive cases.
  • Caution residents not to leave their rooms in the event of a suspected or confirmed case, and in case of necessity, adhere to wearing a medical mask.
  • All employees and the elderly must be followed up daily by asking about temperature, respiratory symptoms and other symptoms for a period of 14 days starting from the registration date of the confirmed case.

For the Elderly Suffering from Memory Problems or Alzheimer’s Disease

  • Asking them about respiratory symptoms may not help, so in case of suspicion, a laboratory examination must be done to ensure that they are free of disease.
  • Allocate a section for them, provided that each elderly is in a private room due to the difficulty of their application of social distancing and the difficulty of their understanding instructions.
  • Note mood changes and memory deterioration that may be associated with COVID-19, and perform laboratory examination when they present.
  • If they are infected with COVID-19, avoid changing their daily life routine, in order not to lead to deterioration of their mental state and the difficulty of treating them.

Communication and Awareness

  • Visitors, employees and the elderly must be educated about COVID-19 and the precautionary measures that must be taken. By making them aware of the following:
    • Definition of the disease, its methods of transmission, its symptoms, and the need to disclose symptoms.
    • Protection from COVID-19, including awareness of the importance of hand washing and disinfection, how to use a mask and other means of protection.
    • Following the etiquette of sneezing and coughing (use a paper tissue and use the elbow by bending the arm).
  • Educational posters must be distributed at various places in social care centers.
  • Health and personal care providers must be educated and trained.
  • Encourage the elderly to wear masks if they do not have any health problems, and educate them about importance of masks.

Implementation

  • Infection control departments in the elderly social care centers must develop a plan to receive new arrivals and how to deal with them regarding COVID-19.
  • An infection control officer must be present to supervise elderly social care centers.
  • Promote residents’ physical, psychological and social health in elderly social care centers and provide appropriate healthy diets according to their health status.
  • The application of preventive and rehabilitative health programs for the elderly must be organized.
  • Continue organizing the health follow-up for chronic diseases in hospitals, and coordinate with specialized clinics in rescheduling appointments and dispensing medicines.
  • Provide and support health services in social care centers.
  • Health requirements must be followed in the workers’ accommodation.
  • A trained employee must be assigned to follow infection control tasks in every elderly social care center, to monitor infection and follow up on the implementation of precautionary measures.
  • Develop alternative plans in case of shortage of employees and health practitioners due to absence or sickness, to ensure the continuity of work with high efficiency.
Appendix (1): Groups at higher risk of infection