Novel Coronavirus (COVID-19) Information for MSCA Members
In an effort to keep MSCA members updated on the latest guidance regarding the Novel Coronavirus (COVID-19), below are infection control recommendations we encourage you to implement in order to protect your residents, staff and visitors. The Massachusetts Department of Public Health (DPH) and the Centers for Disease Control and Prevention (CDC) continue to closely monitor the emergence of respiratory illness caused by a novel coronavirus (COVID-19). The risk to Massachusetts residents currently remains low.
AHCA/NCAL hosted a COVID-19 webinar for all long term care providers on Tuesday, March 3rd. In the interest of public health, this webinar is open to all long term care providers, including members and non-members of AHCA/NCAL.
The webinar will include an update from Centers for Disease Control and Prevention (CDC) officials and AHCA/NCAL staff. Please click here to access a recording of the webinar.
Over the weekend, the Centers for Disease Control released Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities (LTCF). In addition, all nursing facilities should carefully review the current CDC interim infection control recommendations regarding patients/residents who require or may require evaluation for COVID-19.
The infection control recommendations include the following:
- Assess residents’ symptoms of respiratory infection upon admission to the facility and implement appropriate infection prevention practices for incoming symptomatic residents.
- Monitor residents for fever or respiratory symptoms.
- Minimize the chance for exposure through communication with patients/residents/families, other healthcare facilities, and emergency medical services (EMS) personnel before patient/resident arrival.
- Ensure triage procedures (e.g. signage, travel questions) are in place at the facility point of entry to detect and isolate patients/residents who might require further evaluation for COVID-19. Immediately provide a facemask to these patients/residents, if tolerated.
- Review plans for cohorting residents in the same room or wing who become sick to prevent the spread to other residents and staff, should the outbreak continue to grow.
- Consider restricting admissions or heightened screening.
- Healthcare personnel at risk of exposure to an individual presenting with signs and symptoms (fever, cough, runny nose, sore throat) and exposure criteria consistent with COVID-19 should also adhere to Standard, Contact, and Airborne Precautions including eye protection (e.g., goggles, face shield, NOTE: glasses are not sufficient for protection).
- Ensure that healthcare personnel are educated, trained, and have practiced the appropriate use of Personal Protective Equipment (PPE) prior to caring for a patient/resident, including attention to correct use of PPE.
- Perform hand hygiene with alcohol-based hand rub (ABHR) before and after all patient/resident contact, contact with potentially infectious material, and before putting on and upon removal of PPE, including gloves. Use soap and water if hands are visibly soiled.
- Monitor staff adherence to hand washing or use of alcohol hand gels as well as ensuring they are consistently following contact isolation precautions.
- Remind staff, contractors, volunteers to stay home if they are sick (see detailed guidance Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)
- Encourage all staff to self-isolate at home if they display symptoms of the flu or respiratory symptoms, 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.
- Facilities may consider screening employees for travel to countries with confirmed outbreaks and requiring those employees to self-isolate for 14 days and require a physician’s note to return to work.
- Environmental cleaning: Follow the CDC guidance on infection control and cleaning.
- Post visual alerts that remind everyone to wash their hands and cover their coughs.
- Monitor visitors for adherence to hand washing or use of alcohol hand gels as well as ensuring they are consistently following contact isolation precautions when indicated.
- Add more robust language to 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. Provide alternate ways for family members to stay in touch with residents, like Skype, phone calls and email.
- Provide information to families on what they can do to protect themselves. Per the CDC this includes:
- Following preventive actions known to prevent the spread of viruses including:
- washing your hands, using alcohol-based hand sanitizers,
- covering your cough, and
- staying home when you are sick (which includes any of the following: fever, cough, runny nose, sore throat)
- The CDC does NOT currently recommend the use of facemasks by the general public.
- Hand Hygiene:
- Hand hygiene is essential for preventing the spread of infectious organisms in healthcare settings. The DPH fact sheet summarizes the recommended use of Alcohol Based Hand Rub (ABHR) in long term care facilities and provides answers to frequently asked questions.
It is important to ensure healthcare facility policies and practices are in place to reduce exposure to respiratory pathogens including 2019-nCoV. While the risk of COVID-19 to Massachusetts residents remains low, the risk for contracting influenza remains high and DPH reminds you there is still time to offer influenza vaccine to residents and staff.
Personal Protective Equipment (PPE):
Given the increased demand for PPE supplies due to the 2019-nCoV outbreak combined with seasonal flu activity, DPH asks health care facilities to continue to prepare to care for patients with suspected or confirmed 2019-nCoV by implementing the following measures:
- Assess availability of personal protective equipment (PPE) and other infection prevention and control supplies (e.g., hand hygiene supplies) that would be used for both healthcare personnel (HCP) protection and source control for infected patients (e.g., facemask on the patient).
- Establish contingency plans if the demand for PPE or other supplies exceeds supply.
- Review plans for implementation of surge capacity procedures and crisis standards of care.
- Prioritize the use of N95 respirators for those healthcare personnel (HCP) at the highest risk of acquiring infection or experiencing complications of infection.
- Exclude health care personnel not directly involved in patient care for patients on isolation precautions (Contact, Droplet, or Airborne) from contact with these patients.
If a potential shortage of PPE is identified within a facility after taking these measures, health care facilities should utilize resources across their organization (including established supply chain processes), check with mutual aid partners, and if needed contact the appropriate regional Health and Medical Coordinating Coalition (HMCC) for resource support. You can also learn more about the CDC's strategies for optimizing the supply of personal protective equipment here.
If you need additional assistance, please contact the Mass Senior Care office at 617-558-0202.
For questions related to COVID-19 contact the Massachusetts Department of Public Health Bureau Infectious Disease and Laboratory Sciences at
Dedicated DPH website for information on COVID-19
Dedicated Centers for Disease Control website for COVID-19
Sources: DPH, CDC, AHCA