COVID-19 has made its NZ debut in recent weeks, with 5 confirmed imported cases. It has also now been officially declared a pandemic by the WHO. With these developments, we’ve seen the general public, hospitals and particularly our long term care facilities (LTCF) become more concerned than ever of an outbreak occurring on our soil.
But before we batten down the hatches, put spikes on my VW Polo’s tyres or hoard the newest currency, toilet paper, we need to take a DEEP BREATH and review expected responsibilities.
We knew, we prepared, and now we monitor.
We knew in January, from the NZ MOH, that the risk of importing COVID-19 to NZ was high, but that the risk of a sustained outbreak was still low.
As leaders, your staff rely on you to have common-sense guidelines, direct them to the correct sources, be prepared for staff illnesses and set the example of what best practice looks like. This also means that the manager must also be aware of what is expected of the facility from a legal standpoint. We must remind our ourselves and our colleagues that we already have established outbreak plans and policies available. It may be more of a matter of breaking these out to re-familiarise ourselves with the steps. We run fire drills, why not run outbreak drills?
What we already know:
- There are self-quarantined cases in NZ and a few cases within LTCFs in AUS.
- COVID-19 is a DROPLET/CONTACT PRECAUTION virus, just like other influenza-like illnesses (ILI). Airborne precautions (i.e. use of N95 mask) are only required when performing aerosol generating procedures such as nebulisers or NP swabs.
- The influenza and cold season is coming, we know this, and so we will be prepared.
- COVID-19 is an official notifiable disease in NZ and requires reporting in AUS. Your local PHU is the main source of information and guidance here is a list of NZ Public Health Units
- NZ MOH has activated the “Influenza Pandemic Plan: A framework for action”. Here is a good basic summary of it: COVID-19: What’s in NZ’s pandemic plan?
- We identify and isolate suspected individuals based off the CASE DEFINITION from the MOH.
- The use of surgical masks for staff is only where active droplet precautions are in place (symptoms present). Wearing a mask as a preventative measure for staff has been shown to be counterintuitive. This is because a mask encourages more frequent touching of the face and can contribute to staff performing less adequate hand hygiene as they feel they are protected.
Where to go for the right COVID-19 information:
- New Zealand Ministry of Health: COVID-19- Current Situation and Resources
- Australian Department of Health: COVID-19 Resources for health providers and healthcare managers
- The World Health Organisation: COVID-19 Technical Guidance
- The Ministry of Civil Defence & Emergency Management, Resilient NZ, WorkSafe NZ and Business.govt.nz.
- You can find an updating timeline and resource page for COVID-19 on the Bug Control Website.
- Consult your Bug Control IPC manual, under Section B4: Management of an outbreak of infection.
- Check out some available workshops and online training around outbreak management and standard precautions on the Bug Control LMS and APIC.
- NZ MOH released general information for Aged Care Providers on March 5th, 2020. This includes recommendations on general cleaning practices, visitation guidelines, staff illness and general health professional resources.
- Be prepared for unwell staff, increased use of PPE and your legal obligation to staff (and the general public) safety. Here is a good summary of the expectations within NZ. Employers and Coronavirus – it’s a serious business
- As a LTCF, you already have an outbreak management plan for influenza, from a PPE and precautions point of view, this is the same for COVID-19.
- Ensure senior staff and managers are familiar with the NZ Pandemic Plan so that they know what is expected and what to prepare for if we move on to the next phase within the national emergency framework. NZ Influenza Pandemic Plan: A framework for action.
- Direct yourself and your staff requiring sick leave or self-quarantine to the local PHU, Healthline number (0800 358 5453) and the NZ MOH website on financial support advice. Welfare Support NZ MOH
- Liaise with your local DHBs about up-coming action groups and how coordination of resources would work in your district.
- Check your supplies and continue to monitor stock levels. As part of your established outbreak plan, the facility should already have a supply of STANDARD surgical masks, a stock of N95 masks (just in case) and spare stock of general PPE/alcohol-based hand gel (ABHG).
- This is a good time for some education, in-services and infographic posters in public areas on standard HAND HYGIENE and COUGH ETIQUETTE. Ensure you include any care-recipients and visitors where appropriate.
- Make the signage and in-services memorable and fun. There are some songs that people can sing to ensure enough time for effective handwashing technique. Consider hanging these in shared spaces and above all sinks. Example of handwashing songs poster. You can even make your own poster to print, thanks to a website designed by a 17-year old, which includes lyrics to songs of your choice. WashYourLyrics.com
- Utilise free training tools and resources such as the free online training video being released this coming week from Altura Free Aged Care Coronavirus Training Video On It’s Way. There is also WHO’s free “Emerging respiratory viruses” online course.
- Print out the guidelines from the MOH and have a sign off list to show that all members of staff have updated themselves on the policies.
- Consider the use of spot checks from the manager on the floor. Spend some time having a general survey of your staff’s hand hygiene. Make it a goal to check one person’s PPE and handwashing technique per day. This includes ALL levels of staff, everyone from other managers, to tradesman to the kitchen staff. This is an opportunity for coaching rather than taking any punitive measures. If you make it part of your managerial checklist and document your checks, this can also be used as evidence towards the upcoming audits for IPC on how you are preventing COVID-19 outbreaks.
- Ensure all your computers have the NZ/AUS MOH websites bookmarked or highlighted so that everyone is using the same accredited sources for updates rather than the media.
- Keep an eye on the NZACA discussions with the NZ MOH around LTCF-specific policy.
- Most important of all, KEEP CALM, COVER YOUR COUGHS AND WASH THOSE HANDS.
Apologies to those who have practiced their Thunderdome wrestling moves, charcoal eyes and built their toilet paper forts. Our Mad Max fantasies are going to have to be put on hold this time, as we aim for the best while preparing for the worst.
If you have any questions about managing COVID-19 in your facility, please don’t hesitate to check out our COVID-19 information page. It contains relevant links to health authorities in Australia and New Zealand. Failing that, you’re always free to contact us with your questions.