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Covid-19: Organization of prevention in nursing homes (NHs) and in long term care facilities (LTCFs)

In the context of the increase in vaccination in NHs and LTCFs: to date, more than 80% of residents have received at least one dose of vaccine and approximately 50% have received a complete vaccination (2 doses), the French High Council for Public Health (HCSP) updates its guidelines   to prevent the transmission and spread of SARS-CoV-2, with a focus on specific measures such as the way to organize the visits of the residents in their rooms,  the collective activities, the collective meals or outings.

These guidelines are of a transitory nature and may be changed rapidly depending on the national situation and the occurrence of clusters. Their continuation depends on the impact of vaccination on transmission in the event of SARS-CoV-2 carriage, the suitability of the circulating SARS-CoV-2 variants of interest and the available vaccines, and the level of vaccination coverage of residents and professionals.

The HCSP recommends, in particular, to:

  • maintain a high level of compliance with physical distancing and space management measures (cleaning, ventilation, person density);
  • allow individual or family visits by vaccinated residents according to a complete and validated vaccination plan, in their rooms and on walks in the surrounding area;
  • allow the resumption of certain collective activities in small groups between residents and supervisors, provided that the residents have been vaccinated according to a complete and validated vaccination protocol;
  • allow the continuation of visits in the event of a single case of Covid-19 in a resident, provided that a broad screening for other cases in the establishment is carried out and that this cross-sectional screening is negative. In the event of a positive case, and depending on the number of secondary cases, the maintenance of collective activities will be discussed again locally to avoid the start of a cluster;
  • allow outings to families or groups of vaccinated residents according to a complete and validated protocol;
  • increase the protection of residents who have not been vaccinated according to a complete vaccination protocol or who have not been immunized against SARS-CoV-2 within the last six months, if they participate in collective activities or outings;
  • allow visits from residents who have not been vaccinated or immunized against SARS-CoV-2 infection according to a specific and organized circuit and outside the room;
  • use saliva samples as a priority for screening campaigns for professionals and residents (see HCSP opinion on the prioritization of saliva RT-PCR tests, in progress) around a case and during iterative sampling to monitor a cluster.

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