COVID-19 Outbreak in Nursing Home.

Recently, there was a COVID-19 Outbreak in my Nursing Home. Nearly 50% of our residents were infected. Which largely increased our workload. I would like to share how we deal with COVID-19 in the Nursing Home setting.

Isolation

If we note some residents are infected, we usually just isolate the infected individuals in the isolation room. But this time, nearly 50% of our residents got infected, and we won't have enough isolation room. Therefore we would implement reverse isolation.

Isolation means to isolate the infected one. Then reverse isolation means to isolate the non-infected one.

We put those non-infected residents into the same room, and the weakest resident into the isolation room independently. Hoping that they won't get infected. Turns out this strategy is quite effective. The infection number stopped increasing. We have successfully broken the transmission chain.

Monitoring

Monitoring can be mainly separated into 2 parts: Monitoring of the infected and Monitoring of the non-infected.

Monitoring of the infected

When you get infected, several symptoms can be commonly seen. For example fever, sputum, coughing, and so on. Therefore, we will carry out Q4H Vital signs observation. Vital signs include 1)Blood Pressure 2)Pulse 3)SpO2 4)Respirator Rate 5)Temperature. Which means we will measure the data above every 4 hours. Of course, we will observe for other possible symptoms at the same time.

Monitoring of the non-infected

For those non-infected, we will carry out Daily RAT for them, to monitor their status.

Medication

There are medications for treating COVID-19. They are Paxlovid and Molnupirvair, they are antiviral medications specially designed for COVID-19.

Besides, we also give other medications for treating symptoms:

• Paracetamol

  • For treating fever, headache, and sore throat.

  • We usually give paracetamol 1000mg QID PRN when body temperature>40°C.

• Chlorpheniramine (Piriton)

  • For treating Dry Cough, Irritated Airway, Stiffy Nose, and other allergy-like symptoms

  • Usually Chlorpheniramine 4mg TDS PRN

• Lysozyme

  • For sore throat.

  • Usually Lysozyme 30mg TDS PRN

• Bromhexine

  • For treating sputum. To help break down sputum and easier to cough up.

  • Usually Bromhexine 8mg TDS PRN

Prevention

We have carried out a series of policies. The main purpose is to stop the transmission and to reduce the number of infected people.

1. Daily RAT testing for staff

2. Suspend all social activities

3. Nursing care from non-infected to infected.

4. Upgrade Protective Equipments of staff

By the time I am writing this blog. The COVID-19 outbreak is over already. Everything back to normal. But unluckly, I was infected by COVID-19 after the outbreak.......

I am enjoying my Sick Leave Vacation! HAHA!