Dalidowicz, M; Miller, L. Do neck or back coverings provide additional protection to gown and N95 mask when conducting an aerosol generating procedure? 2020 May 13; Document no.: EOC051201-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 18 p. (CEST evidence search report)
· Small simulation studies have demonstrated potential contamination of neck and back area
· Many associations recommend neck coverage, or if unavailable to ensure sanitation/washing of exposed skin after doffing PPE
· Several warnings that increasing amount of PPE increases chances of contamination and may decrease level of compliance
Badea, A; Groot, G; Dalidowicz, M; Miller, L. Do neck or back coverings provide additional protection to gown and N95 mask when conducting an aerosol generating procedure? 2020 May 15; Document no.: EOC051201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 9 p. (CEST rapid review report)
Howell-Spooner, B; Miller, L. How are Hutterite colonies responding to and coping with COVID-19 prevention and outbreaks? 2020 Jun 12; Document no.: PH061201-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 10 p. (CEST evidence search report)
The Hutterian Safety Council has established a COVID-19 taskforce to provide guidance for communities to best prevent and cope with COVID-19
Only one published study has investigated the prevalence of coronaviruses in relation to influenza vaccination/infection in Hutterite populations. This study found that coronaviruses are much less prevalent than influenza, entero/rhinoviruses and pediatric RSV and that it occurred in all age groups.
This study also found a high degree of co-circulation of other respiratory viruses along with influenza, which invites the questioning of signs/symptoms falsely attributed to influenza and therefore influencing empiric use of antivirals
Most studies available focus on influenza, polio and other common vaccine-preventable childhood communicable disease
One study assessing influenza in Hutterite populations found that the immunization of children and adolescents led to a protective effect among the community over multiple years of seasonal influenza and provided ~60% herd protection
Okpalauwaekwe, U; Reeder, B; Howell-Spooner, B; Miller, L. How are Hutterite colonies responding to and coping with COVID-19 prevention and outbreaks? 2020 Jun 12; Document no.: PH061201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 16 p. (CEST rapid review report)
Mueller, M; Howell-Spooner, B. How are other jurisdictions distributing COVID-19 vaccines in non-healthcare worker environments and what is the rationale for those distribution models? 2021 Jan 15; Document no.: PH011401-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 15 p. (CEST evidence search report).
· Recommended to use existing vaccination structures and delivery services as much as possible for distribution of the COVID-19 vaccines
· Important to consider cold-chain requirements when developing distribution plans
· Should consider alternate locations for hard-to-reach populations that are easily accessible and familiar
· Consider branching out to mobile vaccination (e.g. home visits, door-to-door), pharmacies, workplaces, congregate living facilities, walk-up/drive-through mechanisms for vaccine delivery
Badea, A; Groot, G; Mueller, M; Howell-Spooner, B. How are other jurisdictions distributing COVID-19 vaccines in non-healthcare worker environments and what is the rationale for those distribution models? 2021 Jan 19; Document no.: PH011401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 17 p. (CEST rapid review report)
Young, C; Dalidowicz, M. How are rapid antigen tests being used in different settings? What is the evidence on the impact of the use of rapid antigen tests on COVID-19 outbreak parameters?? 2021 Dec 30, Document no.: EOC211203 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2021. 115 p. (CEST rapid review report).
· Overall, there is a lack of high quality evidence to support recommended pandemic preparedness strategies (checklist items) to prevent or mitigate respiratory infection outbreaks in LTC.
· In the absence of high-quality or mixed evidence to support strategies for pandemic preparedness, it is advisable to follow clinical practice guideline recommendations that have been based on expert opinion (key sources are identified in red). This is particularly the case for infection control interventions that are likely to have no negative impacts on LTC residents (e.g. hand hygiene, cough etiquette). Strategies that have a potential negative impact on LTC residents (e.g. visitor restrictions) must be handled with more flexibility and individual assessment to determine how infection control can be preserved while minimizing negative consequences for residents and families.
· Internationally recognized pandemic/outbreak preparedness checklists for LTC (e.g. CDC 2020, Buynder et al. 2017) share many similarities to the current SHA Annex R checklists.
· Consideration should be given to converting the checklist into a planner with accountabilities to demonstrate how each item is being addressed (similar to CDC 2020). Links can be embedded in the planner/checklist to more detailed information, such as the PPE burn calculator (CDC 2020), education/training materials (WHO 2020), and communication materials for families (CDC 2020, WHO 2020, Buynder et al. 2017).
· Consider the addition of specific detail to the SHA pandemic preparedness checklists on the date of the next pandemic plan/checklist review, contact names for local resource acquisition or assistance with staffing, tracking forms for dates of education/training with staff and residents, tracking of audits/observation of infection control practices, surge capacity planning items, and expanded items for communication (see attached recommendations from family caregivers of the Saskatchewan LTC Network).
· Discrepancies exist between reported (77-100%) and observed (25-63%) adherence to infection control practices, indicating a need for independent audits. Adherence rates improve with direct observation, frequent education reminders and prompts.
· Even when there is not an outbreak in a home, the pandemic response results in increased workload demands on staff due to infection control practices (e.g. PPE and hand hygiene), loss of family caregiver assistance with resident care, enhanced care needs of residents due to anxiety, increased communication with family caregivers and other members of the care team, monitoring and restricting resident movement in the home, enhanced cleaning, staff absenteeism, and education/training. Consideration is needed for a provincial process for evaluation of needs within individual homes, and allocation of additional human resources, disposable supplies, equipment, or funding to ensure that both infection control and usual care needs of residents are consistently met.
· Maintaining public confidence through communication is a defined infection control strategy. Communication strategies include individual communication between family members and staff, public communication strategies by individual facilities and provincially through dedicated pandemic information pertaining to LTC (e.g. dedicated LTC section on provincial websites).
