Residential aged care facility COVID‐19 outbreaks and magnitude of spread among residents: observations from a Victorian residential in‐reach service

Abstract

There is a paucity of Australian literature exploring the spread of COVID‐19 among residents living in residential aged care facilities (RACF). In this case series of COVID‐19 outbreaks in six RACF, we collected data on the cumulative proportion of residents who tested positive for COVID‐19 within 21 days of the index case being identified. We describe the observations of a Residential In‐Reach service within these six RACF and found that rapid cohorting strategies, personal protective equipment availability and adequacy of use, embedded infection control staff, and adequate outbreak preparedness plans may have influenced the differences observed between RACF in the containment and minimisation of the spread of COVID‐19 amongst residents.

Why are some outbreaks worse than others? COVID-19 outbreak management strategies from a PHU perspective

“…(44,11) While PHUs often advise on the speci c PPE required, there is clearly a need to encourage education on donning and do ng protocols, as well as reinforcing the importance of regular and adequate hand hygiene. (45,16) With cessation of the requirement for close contacts to isolate on the 28th of April 2022 (46), management of COVID-19 exposed residents and staff became a key responsibility of RACFs. Few RACFs had the resources to furlough close contact staff during their incubation period, with exposed staff largely required to attend work which thus posed a risk of internal transmission.…”

“…RACFs who allocated staff to work within a single area were often able to prevent spread to multiple areas. (45,16) Interestingly, some facilities have adopted staff cohorting as a permanent practice to effectively contain any COVID-19 transmission within limited sections of the facility.…”

Application of six sigma and the system thinking approach in COVID-19 operation management: a case study of the victorian aged care response centre (VACRC) in Australia

“…In addition, there has been little focus on aged care facility planning in Australia during the COVID-19 pandemic. Viray et al ( 2021 ) studied six RACFs in Victoria and observed residential in-reach (RiR) services within these facilities. RiR services in Victoria typically consist of small teams of senior medical doctors and nurse specialists operating out of each public hospital network.…”

Site of care and factors associated with mortality in unvaccinated Australian aged care residents during COVID‐19 outbreaks

“… 11 InReach services continue to provide core medical and sometimes logistical support to RACFs during COVID‐19 outbreaks. 12 The pandemic has prompted an international expansion of such geriatrician‐led mobile units to support care facilities, 13 , 14 with observational data suggesting lower mortality, improved symptom control and lower hospital transfers. 15 The relative outcomes of hospital transfer versus InReach‐based management for RACF residents swabbed for COVID‐19 during the pandemic remains unknown.…”

“…Residential InReach presents an alternative to hospital admission, which may reduce emergency department presentations by providing specialist‐level care within‐facility 11 . InReach services continue to provide core medical and sometimes logistical support to RACFs during COVID‐19 outbreaks 12 . The pandemic has prompted an international expansion of such geriatrician‐led mobile units to support care facilities, 13,14 with observational data suggesting lower mortality, improved symptom control and lower hospital transfers 15 .…”