key: cord-1037814-qy1xusas
authors: Weng, Cheng-Chie; Lin, Yueh-Er; Lin, Yu-Chin; Chen, Wei
title: New preventative measures against coronavirus disease 2019 for home care aides in Taiwan
date: 2020-04-16
journal: J Gerontol A Biol Sci Med Sci
DOI: 10.1093/gerona/glaa092
sha: 5eddd6f0f426cf9e2470e88860cedeee886575f4
doc_id: 1037814
cord_uid: qy1xusas

nan

A c c e p t e d M a n u s c r i p t Emerging data indicate that COVID-19 is of a particular risk in older people requiring home-based long-term care (LTC), specifically in those with co-morbidities 4 . Owing to the rapidly aging population, our government established a plan (LTC version 2.0) in 2017 to better integrate the community-based LTC system, incorporating both health care and disability prevention 5 . As part of this LTC system, home care aides (HCAs) deliver support services, such as cooking, feeding, bathing, and toileting to people in their homes. They are like the "ears and eyes" of the LTC system. HCAs can obtain information on the changing health status of care recipients by following up on their health outcomes 6 . HCAs could then contact the care recipients home-based physician regarding their medical needs, which may help ease the pressure on hospitals and emergency services and prevent the spread of infection.

As HCAs are essential in helping society's most vulnerable get through the COVID-19 crisis, the government has implemented new measures to protect them from acquiring A c c e p t e d M a n u s c r i p t COVID-19. At the beginning of the epidemic, regular education and training seminars were held on dealing with COVID-19. Before shifts start, the HCAs undergo fever and respiratory symptoms screening. A new sick leave policy has been implemented that allows ill HCAs to stay at home. If an HCA travels internationally, they are not allowed at work for 14 days. Personal protective equipment including surgical masks, gloves, gowns, and eye protection were also supplied. Additionally, the government has provided surgical masks every week since March 2020 (5 pieces per person per week).

All care recipients are required to have their body temperature recorded and reported daily. This to protect the HCAs from being infected by them and ensure that the care recipients are well. The travel history, occupation, contact history, and cluster of the people or families who live with the care recipients has also been investigated. We have requested our care recipients to avoid contact with any person in quarantine, including those that they may live with. We have also reorganized the grouping and schedule of our HCAs to avoid COVID-19 spreading between different HCAs.

Although the government has implemented a number of measures to fight against COVID-19, the following aspects still need to be considered. First, the government should provide a list of people under home quarantine so that the HCAs can take extra precaution at these homes. Second, the government must prioritize services provided by care recipients so that some services can be canceled if HCAs are unavailable. Third, A c c e p t e d M a n u s c r i p t a telehealth system must be implemented so that we can monitor the body temperature of our care recipients and avoid contact with those that have a fever.

It is unknown whether large-scale community transmission of COVID-19 will occur in Taiwan. Most home-based care agencies will cooperate with government measures, devise a plan, and attempt to mitigate the risk of transmission as much as possible. If

HCAs are well protected, they may play an essential role in the battle against COVID-19 in Taiwan.

World Health Organization

Response to COVID-19 in Taiwan: big data analytics, new technology, and proactive testing

Cumulative total of 373 COVID-19 cases confirmed in Taiwan; 57 patients released from isolation. Taiwan Centers for Disease Control

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

From fragmentation toward integration: a preliminary study of a new long-term care policy in a fast-aging country

The effectiveness of home services in Taiwan: a people-centered approach

M a n u s c r i p t