Impact of Coronavirus and Risks to Healthcare Providers Including Nursing Homes and Other Elderly Care

WASHINGTON, DC – As the novel coronavirus, also known as COVID-19, continues to infect people in the United States, nursing homes, assisted living, and other elderly healthcare facilities face an increased risk of fatalities compared to the American population as a whole. The virus has infected over 90 locations worldwide and there have been 35 states (including Washington DC) that have reported cases. Of all the coronavirus related deaths in the US, 16 of them have been in a Seattle-based nursing home. The mortality rate of infected people over 80 could be as high as 15%; those with preexisting health conditions such as heart or lung diseases or diabetes are even more susceptible. Healthcare providers from Honolulu to Houston are preparing for the worst by stocking up on essential supplies, including personal protective gear (face masks, gowns, gloves, eye protection), soaps, alcohol-based hand sanitizer, and especially vital medication. 

*As of 03/10/2020

Not much is known about this new virus sweeping the world, but the Centers for Disease Control advises that elderly healthcare facilities take special precautions to ensure the safety of their residents. It is especially important for these kinds of facilities to ensure their staff is healthy and does not have the virus. As we have seen in the Washington nursing home as well as the cruise ships in Yokohama, Japan, and Oakland, California, facility staff have much more interaction with individuals so they are at an increased risk of receiving and transmitting the disease to others. The CDC  invites healthcare staff to take their free online course, the Nursing Home Infection Preventionist Training course. The organization emphasizes the necessity to keep facility staff virus-free and gives recommendations on how to contain the virus and gives special guidance to elderly healthcare facilities.  

Healthcare providers of the elderly should take the extra precaution to ensure all entities that work with them comply with CDC recommendations.
This includes:

  • Notify vendors and contractors that have access to facilities to practice proper hygiene, to train their staff on coronavirus prevention, and how to prevent the spread of the virus in facilities. 
  • Request relevant entities to confirm they are complying with CDC guidelines.
  • Require vendors and contractors to inform their employees to not come to any facilities if they are experiencing coronavirus-like symptoms or have traveled to affected areas within the last 14 days.

Healthcare providers to the elderly still have legal responsibilities and it is important to ensure compliance.
They are enforced by the Occupational Safety and Health Administration (OSHA) and include:

  • Ensuring a workplace, “free from recognized hazards that are causing or are likely to cause death or serious physical harm.”
    • This may include OSHA’s personal protective gear standards. OSHA’s guidance on personal protective gear may be found here
    • OSHA has also given guidance in the past on best practices with the flu. Although a different disease, this is the most relevant guidance available.
  • Keeping records of any employee’s that contract the coronavirus and abide by OSHA’s recordkeeping requirements. 
    • However, DO NOT announce and specify which employee is sick. Even when there is a pandemic, medical privacy laws are still in place. 
  • If employees take sick leave, abide by the Family and Medical Leave Act and applicable local laws surrounding sick leave.
    • The Centers for Disease Control recommends elderly healthcare facilities to have a sick leave policy that is, “flexible and consistent with public health guidance and that employees are aware of these policies.”
    • If an employee contracts coronavirus and is disabled from the disease, the American Disability Act may also be relevant.
  • DO NOT make statements requiring certain protected classes to not show up to work (i.e. Workers over 70 or pregnant must work from home, Workers of Chinese descent from Wuhan must work from home).
    • It is ok to say: Workers who have traveled to affected areas must work from home, Workers who have coronavirus-like symptoms must work from home.
Elderly healthcare providers should take all steps to prevent the spread into your facilities, including (but not limited to): 
  • Require sick employees or visitors to stay home, and separate the sick from the healthy.
  • Waive a doctor’s note for sick leave, ensure staff knows of sick leave policies.
  • Ensure the workplace is cleaned regularly, and personal hygiene items such as alcohol-based hand sanitizer and disposable wipes are available.
  • Provide travel guidance and stop all non-essential work-related travel.
  • Create policies for employees to work from home.
  • Encourage e-communication, phones and emails don’t spread viruses but in-person visits do.
  • Identify staff that will care for sick patients, to especially train them, have them only care for sick patients, and monitor their health.
  • Allow residents and visitors to wash hands frequently.
  • Place hands-free trash bins near doors to easily dispose of personal protective gear.
  • Minimize or consider eliminating all group activities. 
  • Monitor the health of individuals in facilities frequently for signs of the coronavirus
One of the highest risks of coronavirus infection for elderly care facilities come from outside visitors, this includes family and friends. It is important to inform visitors of the dangers of the virus and how to prevent the spread of it. Consider educating all visitors on proper hygiene, as well as coughing and sneezing etiquette; also to limit visits until the situation is more under control. 

The CDC’s recommendations for elderly healthcare providers can be found by clicking here. 

Printable CDC posters about the coronavirus can be found here. 

We at Exclusion Screening want to thank those who are on the front lines of this virus, and especially those looking after the elderly. We understand the difficulty of the job with this disease spreading through the population.




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