There is limited information on transferring infected LTC residents to an off-site cohort location such as a purpose-built field hospital. Lessons learned from SARS suggest that transfers to dedicated facilities for cohorting may increase spread.
A greater number of recommendations support on-site cohorting of residents infected with droplet/contact transmitted illnesses. Health Canada’s COVID-19 Interim Guidance for LTC Homes report states that transfers within and between facilities should be avoided except for medically indicated procedures that cannot be provided by the long-term care home e.g. respiratory failure requiring ventilation or hemodynamic compromise.
Family members encourage cohorting a resident in the LTC home if possible. They also recommend following residents’ advanced care directives to determine whether life-sustaining measures are preferred, robust healthcare and psychosocial support for residents who are cohorted, and clear communication with residents and family members.
Cohorting on site includes isolation of residents to their rooms (preferably single occupancy) or dedicated units in the home. Staff and equipment cohorting should also be implemented if possible (i.e.dedicated staff that do not provide care to residents in non-infected units, and resident specific equipment).
Consider cohorting in day program spaces, recreation rooms, palliative care rooms, chapels, or dining rooms in the home that are no longer being used as common spacesas long as call bells or other appropriate communication measures are in place.
Tupper, S; Ward, H; Ellsworth, C; Dalidowicz, M; Boden, C. What are the best practices for cohorting long-term care residents to reduce transmission of COVID-19? 2020 Apr 16; Document no.: LTC041501 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 10 p. (CEST rapid review report)