United States: On-site support urgently needed to curb COVID-19 outbreaks in long-term care facilities | Doctors Without Borders

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Detroit, Michigan, August 4, 2020– The COVID-19 pandemic has taken a disproportionate toll on one of society’s most vulnerable communities: the elderly living in long-term care facilities. In Michigan, where the international medical humanitarian organization Médecins Sans Frontières / Médecins Sans Frontières (MSF) has been working for two months, more than 7,500 residents have tested positive for COVID-19 and more than 2,000 have died, or nearly ‘one-third of all deaths in the state. This reflects reports of a high number of nursing home deaths from COVID-19 nationwide.

Drawing on decades of experience responding to epidemics and more recent experience in nursing homes in Europe and South America, MSF has supported more than 50 long-term care facilities, including 31 nursing homes and 24 adult foster homes in Michigan between late May and July 31.

“We have seen COVID-19 trigger an acute crisis in addition to chronic neglect and lack of support at long-term care facilities,” said Heather Pagano, MSF’s emergency coordinator in Michigan. “At the onset of the pandemic, long-term care facilities were left to fend for themselves without protective equipment or proper infection prevention and control (IPC) training. Staff told us they are overwhelmed and confused, drowned in guidelines and regulations on safety measures from many sources, but without the support on the ground that can make all the difference.

MSF mobile teams in Michigan provided direct in-person support to improve IPAC measures. The most common topics addressed by MSF were the proper separation of confirmed, potentially exposed or newly arrived residents, hand hygiene and the appropriate use of personal protective equipment. These measures help reduce the transmission of COVID-19 in shared spaces. Hands-on training is essential for non-clinical staff as well as clinical staff. This is especially true for environmental service personnel who play a central role in infection control, but who often do not receive dedicated training.

Helping understaffed and overworked teams cope with a period of heightened emotional stress in the face of the constant risk of COVID-19 for staff and residents was another key priority for MSF. MSF’s welfare officer engaged in active listening using a trauma-informed approach and provided stress reduction techniques to staff and residents. Tools and short activities staff could use to help each other or to boost residents’ morale were also suggested.

Staff in long-term care facilities face a double burden: anxiety and grief in their day-to-day reality, having lost colleagues and residents to COVID-19, while simultaneously experiencing stigma in their area .

“We were terrified, but we had 100 souls relying on us and we couldn’t just lock ourselves in our house like everyone else had been told to do,” said Connie Flanigan, director of nursing at Advantage Wayne in Detroit. . “We had to find a way out of here and take care of these souls.”

“When I hear something someone says about nursing homes, I take it to heart because I work so hard,” Flanigan said. “My heart is there. I would like the public to know that when you can’t be here to be their family, we are. And we choose to be. We spend 12 and 14 hours a day here because that’s where we want to be.


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