The LTC STATeam Outbreak Protocol

The LTC STATeam Outbreak Protocol

Involves three main phases:

  • Early Detection: Universal serial PCR testing within 24-48 hours of a suspected outbreak.
  • Isolation and Containment: Swift isolation and contact tracing to prevent further spread.
  • Treatment and Recovery: Monitoring, treating, and vaccinating residents and staff for a smooth recovery process.

The first phase involves universal serial PCR testing, serving as our first line of defense against disease spread. In line with IDPH’s guidelines, we begin by testing within 24-48 hours of a suspected outbreak and continue every 3-7 days until no new positive cases are identified for 14 days. Conducting testing on an affected floor/unit or facility-wide proves to be an effective measure in preventing COVID-19 outbreaks. With the help of PCR testing, we are able to swiftly identify both symptomatic and asymptomatic cases, reducing further transmission and enabling subsequent phases of the protocol.

Rapid outbreak testing results (less than 24 hours turnaround from lab receipt) help the LTC STATeam advise LTC facilities on phase 2 protocols. As cases are identified, it is important to move residents into isolation and perform contact tracing. Cohort isolation for positive residents alongside widespread screening has also been acknowledged as an efficient approach to curb the spread of the virus. In the final phase, recovery includes monitoring, treating, and eventually vaccinating residents and staff. Throughout the pandemic, several proposed treatment options have been identified and utilized. Emergency Use Authorization was granted to Paxlovid, a combination medication composed of nirmatrelvir and ritonavir. A large retrospective cohort study looking at high-risk COVID-19 patients in Israel, demonstrated Paxlovid as being highly effective at reducing severity of illness. Therefore, timely and appropriate treatment not only improves prognosis for individuals with the disease but also curtails the overall duration of the outbreak by reducing the period of infectiousness. A study published in The Lancet, Global Health, “Use of antiviral drugs to reduce COVID-19 transmission” found that the use of antiviral drugs shortly after symptom onset reduced infectiousness by reducing viral shedding. Targeted prophylactic treatment of contacts even reduced the risk of becoming infected.

 

As shown above, the LTC STATeam launched its Outbreak Protocol within an impacted LTC immediately after a suspected outbreak. Two weeks after rapid deployment of testing, this LTC experienced a complete elimination of new COVID-19 cases, a full two weeks sooner than the national average of outbreak duration in LTCs across the United States. Through diligently coordinated isolation and treatment plans, the team facilitated a smooth recovery process, enabling a seamless return to normal operations.