key: cord-325953-yvtyh27k
authors: Shea, Yat-Fung; Lam, Ho Yeung; Yuen, Jacqueline Kwan Yuk; Adrian Cheng, Ka Chun; Chan, Tuen Ching; Mok, Wing Yee Winnie; Chiu, Ka Chun Patrick; Luk, Ka Hay James; Chan, Hon Wai Felix
title: Maintaining zero COVID-19 infection among long term care facility residents in Hong Kong
date: 2020-05-29
journal: J Am Med Dir Assoc
DOI: 10.1016/j.jamda.2020.05.042
sha: 
doc_id: 325953
cord_uid: yvtyh27k

nan

Letter to the Editor 1 2

Maintaining zero COVID-19 infections among long term care facility residents in Hong Kong 3 4

Introduction: During the novel coronavirus disease 2019 (COVID-19) pandemic, older adults are a 5 particularly vulnerable group with higher mortality. 1 In long-term care facilities (LTCFs), the risk of 6 serious outbreaks is great given a higher prevalence of dementia and potential poor resident 7 compliance with infection control measures such as hand hygiene and wearing of surgical masks. 2, 3 8

Transmission from infected health care workers in LCTFs have led to disastrous outbreaks. 2 Hong 9

Kong recorded its first confirmed case of COVID-19 on January 23, 2010. Up to the point of writing 10 (16 th May 2020), there has been no LTCF resident (~74000 in 940 LTCF) infected with COVID-19 in 11

Hong Kong. We believe that the following measures have contributed to this favorable outcome. reported to the CHP and CGAT link nurses. All staff (n=60) and most residents (n=102) in the involved 55 facilities were instructed to save deep throat secretions or throat swab for SARS-CoV-2 by real-time 56 reverse transcriptase polymerase chain reaction (rRT-PCR) and the tests were repeated 8-9 days apart 57 during the quarantine period. They all turned out negative. Four residents under surveillance were 58 admitted with fever and respiratory symptoms but respiratory specimens for SARS-CoV-2 rRT-PCR 59 were again negative. Workflow to alert the appropriate personnel including the hospital infection

team and staff in Emergency Department were set-up so as to ensure smooth transfer of 61 residents to the acute hospital

Conclusions and Implication: We achieved a zero COVID-19 infection rate among LTCF residents 64 because of strict hand hygiene, near 100% compliance among staff in wearing of surgical masks, 65 prohibition of visitors and reducing the frequency of on-site physician visits. However, it remains our 66 concern how the restriction of visitors may affect the general wellbeing of residents

Clinical course and risk factors for mortality of adult inpatients 74 with COVID-19 in Wuhan, China: a retrospective cohort study

Asymptomatic and Presymptomatic SARS-CoV-2 77 Infections in Residents of a Long-Term Care Skilled Nursing Facility -King County

Institution type-dependent high prevalence of dementia in 80 long-term care units

Efficacy of trivalent seasonal influenza 82 vaccination in reducing mortality and hospitalization in Chinese nursing home older adults

Guidelines for Residential Care Homes for the Elderly or Persons 85 with Disabilities for the Prevention of Coronavirus disease (COVID-19) (interim)

Temporal profiles of viral load in posterior 89 oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: 90 an observational cohort study

Authors declared there are no conflict of interest. 70 71 72