Nursing home doctors recommend ways to reduce COVID-19 deaths as prospect of ‘second wave’ looms

In response to the estimate that more than one-third of COVID-19 deaths have occurred in long-term care facilities, the American Medical Directors Association has published recommendations to decrease the spread of the pandemic virus among nursing home residents and staff. 

Recommended protocols for facility staff also include COVID-19 testing on a serial basis — three tests one-week apart — to enable identification of newly infected staff. Also recommended is to have staff assigned to specific units to permit easier contact tracing in the event of COVID cases, and to have staff who are assigned to COVID-19 units not work elsewhere in the facility.

Among other recommendations: the creation of COVID-specific units, screenings of residents twice daily, discontinuation of drug-delivery modes (e.g., nebulizers) that might spread the virus, and reviews with patients and families of do-not-intubate and do-not-hospitalize advance directives.

“The scope and speed of the COVID-19 pandemic brought continual changes in healthcare protocols as providers learned more about the disease’s transmission,” said Paula Lester, M.D., FACP, CMD, a geriatrician at NYU Winthrop Hospital and the corresponding author of the consensus recommendations, which were recently published online in Journal of American Medical Directors Association (JAMDA).

“The time has come to consolidate our learnings as a field in terms of caring for at-risky elderly and implement uniform, best practices, especially as we prepare for a potential second wave of infections in the coming months, as well as for future pandemics,” adds Lester, who along with her co-authors serves as a skilled nursing facility (SNF) certified medical director.