Coronavirus and memory care facilities; Any ideas as to how to manage and minimize risk?

Every hospital and elder care facility I have been in has had sanitizer at the door, masks available for those who have any respiratory symptoms and a sign asking visitors not to enter if they are sick. When there is an outbreak within the facility there will also be a sign at the door (here it is a big red stop sign, hard to miss) with details.

I just did an updated posting in the Covid-19 discussion on Aging Care from earlier this month that TNTechie started. You might want to read that thread, especially TNTechies posts, as great suggestions.

As of 1:00 PT there’s 2 confirmed in a LTC facility in Washington state in Kirkland, WA. 1 resident & 1 health care worker. It’s going to be quite the challenge for US health care system as no single payor system.

wash your hands and often
try to not touch your face
keep your house clean, especially that bathroom!
limit unnecessary trips
get whatever medications you need refilled now if you can
get a box or 2 or 3 of disposable exam type gloves - if the CVS is out & WalMart too, hit one of the beauty supply places (like Sally); the gloves you put on when you go to the NH, grocery store, etc. & throw them away into a ziplock bag afterwards.
word seems to be no n-95 masks, although I know someone who got a box of masks close to N-95 type at paint supply store yesterday
stay hydrated
wash your hands again!
stay polite & don’t panic
& remember.... wash your hands!

The coronovirus is a cold virus. It will spread quickly when it hits senior living, or any other place where people are congregated together. It has already hit one facility. Given the death rate is high for those who are elderly or immune compromised this is a serious concern. Do keep in mind, however, that death rate from this illness overall is currently thought to be 2%, which is quite a low rate of death. The virus will enter the facility from without, that is from workers coming and going and from visitors. I am surprised that more facilities are not having a plan, but seems they do not yet have a plan. Of most concern is the response from authorities overall, because there are not enough test kits. California last week had FIFTY in total. My daughter, in Washington State, lives in the county with the first death, and her fellow teacher went to ER with 103 fever. They sent her home with a shot of tamiflu. There is no testing going on. So you can imagine. We will have to take this as it comes, and deal as we can with it, but yes, you are correct, any area with seniors in confinement is the sitting duck for this or any other communicable disease, including flu.

I had a scheduled office visit with my PCP on 2/19. He is part of a large group of physicians who are located in a clinic type facility so lots of patients on a daily basis. Upon entry to lobby, they were setup to stop and ask patients and visitors if they were sick and if they had recently returned from a trip to Asia. I imagine now they're asking if you travelled to Italy, Iran, California or Washington.

Wash your hands with soap and water and don't touch your face. Washing hands before and after contact with your loved one is important. Unless you want you or your loved one to live like bubble boy, washing hands, following sneeze etiquette and not touching your face are your best bet.

The ED of my mother's Memory Care ALF sent out an email asking that anyone who's traveled anywhere to please stay OUT of the ALF for 14 days before visiting a loved one who resides there.

I have no greater fear of the residents contracting this virus than the flu, which has a MUCH higher incidence of death associated with it than corona. Just b/c the media is amping this up does not mean we all have to amp it up.

Here's a list of the viruses that have broken out over the years, in case we've forgotten:

90's: Mad Cow
2004: SARS
2008: Avian (Bird) Flu
2010: Swine Flu (pandemic)
2012: MERS
2014: Ebola
2016: Zika
2018: Ebola

We shall survive the latest in a long line of viruses. Wash your hands & use common sense, that's the best advice ever.

At the Costco we went to yesterday, employees were wiping down our hands with sanitizer wipes. We were appreciative!

Not to panic--common sense is the key. I am immunocompromised due to 6 months of chemo last year and I simply stay home when I know there is an outbreak of flu in the neighborhood. People have been good to not try to visit me when they have little ones with colds--which is just being smart.

Probably one of the worst places to go was Costco, as per usual, it was packed. we got in and out as fast as possible.

DH travels all the time for business. He will probably have to shelve that for a few months--IDK, he goes all over the country and is also immunosuppressed due to a liver transplant.

The NH my father is in had an outbreak of respiratory then gastrointestinal illness late Dec. early Jan. As of late last week some patients have the flu. They quarantine patients to stay in their rooms (except to go to therapy or to outside appointments). They close the dining rooms and cancel activities. They eat in their rooms and get daily puzzle packets. They also discourage visiting during an outbreak. There is always hand sanitizer at the entrance and the elevator doors. With masks at the entrance too. My father did get the respiratory illness in January and they put a cart at the door with disposable gowns, gloves and masks for anyone who entered the room.

I don't have anything to add. Just want to thank everyone who has chimed in with helpful, non-freaked-out suggestions!

As others have said... hand washing is key- even preferable to the sense of security hand sanitizer brings. The CDC indicates PROPER hand washing is more effective.
They suggest a 5 step process:
"Follow these five steps every time.
1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds. Need a timer? Hum the 'Happy Birthday' song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry them."
We should probably expect to hear of more senior living facilities reporting incidences of the virus, so I would think it's most important to respect what the facility recommends in terms of visiting.

Memory Care facilities, Assisted Living facilities are "hot beds" for all sorts of things.
Noro virus, Staph, MRSA, C-dif, Flu, scabies, bed bugs and on and on and on.
Any one of these can be deadly given a population that is immune compromised, frail, and in a large population.
The mortality can be high given any of the contagious conditions going around at any given time.
Your best course of action would be if you are ill obviously stay home but if anyone in the facility where your loved one is is ill stay home. (When I say facility I do not mean the entire building but in the general area if your loved one is in a Memory Care wing if there is illness in that wing of the building, stay home.)
Wash your hands when you arrive, or use sanitizer and when you leave your loved ones room, wash, when you enter the room wash, helping with a meal or snack, wash your hands before and wash after. When you leave the facility wash. These are precautions that should be taken all the time and if you see staff that are not following proper hand washing you should have a discussion with a supervisor.

With coronavirus, you are contagious before you show symptoms (at least that is the current information). So, maybe don't visit for 2 weeks even if you are feeling well. Call every day instead. That's what I'm doing. Especially for the sake of those facility residents with COPD or other respiratory problems, diabetes or compromised immune system issues. FYI hand sanitizer has been proven to give people a false sense of security.
http://www.cidrap.umn.edu/news-perspective/2019/09/hand-sanitizer-shown-less-effective-hand-washing-against-flu

There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory diseases, including:
Avoid close contact with people who are sick.
Avoid touching your eyes, nose, and mouth.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Follow CDC’s recommendations for using a facemask.
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.

From the CDC website regarding coronavirus:
"Can someone spread the virus without being sick?
- People are thought to be most contagious when they are most symptomatic (the sickest).
- Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads."

You do not need to feel or be actively sick to spread this virus!

The real "funny" thing here about the "new" Corona Virus...
I have a package of Household Surface Wipes that has been in my kitchen cabinet for over 1 year. And the first thing that it lists that it kills is Corona Virus!

Please do not panic! I will say the media THRIVES on getting everyone whipped up into a panic, especially with an election approaching.

Remember how the world was supposed to go off the rails at Y2K?
Remember West Nile and Zika virus?
Remember SARS, MERS and Avian Flu and how those were the next "pandemic"?
Regular influenza kills hundreds of thousands worldwide yearly.

The term coronavirus is a generic term for many viruses that share it's similar shape. They are giving it a more specific name now that they have more info about it. Covid-19. There are common colds that are coronaviruses. Then they mutate and the fun begins.

Seconding Geaton777's comments. There is more than one type of coronavirus, thus the designation (before Covid19 was introduced as this one's name) "novel coronavirus."

I really don't think there is a whole lot any of us can do to prevent/avoid this. Some will get it, some won't. Some will get very ill and possibly die, some will hardly feel much at all. Sure, take preventative action when you can, but we can't live in fear of whatever the next "threat" might be!

The bigger issue is the media hype on this right now. Fear mongering. Every time some new "disease" pops up, that's all we hear about. Should we have some concern? Sure. Given the fact that it is a virus (think cold, but more virulent), there are no real preventatives. This one seems to be transmissible even without/before symptoms, so what are we all supposed to do, shut ourselves in for weeks, just to be sure? No need to get panicked, just be aware, keep hands clean and hope for the best! Those like MidKid58 and hubby and others (aged, infirm) do have to be more concerned, but the rest of us, not so much.

As for a "plan" in MCs, NHs, ALs, there really isn't much that can prevent infection. Even if the residents remain shut in, the staff is NOT shut in and they have to tend to residents, prepare and deliver foods, clean rooms, etc, so there is no way to isolate any of the residents really. That cruise ship was "isolated" so as to not bring infection onshore, but 640+/- on board became ill and several died. I'm sure many just stayed in their rooms, but once Pandora's Box is opened, it will spread.

For all we know, this "scare" can disappear as quickly as it showed up. SARS was big in the news, and then it seemed like it just vanished. Although it "infected a little more than 8,000 people, and killed 774 people" and this virus seems more virulent, it could still go away. Ebola is also a virus and was spreading like wild-fire, HUGE media hype, yet now you hear almost nothing about it ("More than 28,000 people were infected, and 11,000 people died before the international public health emergency ended in 2016.) MERs "has infected 2,442 persons and killed 842 worldwide..." Yet, where are these now? In the article below, it does mention that SARs hasn't been seen since 2004, although MERs is still around, a bit. Never hear anything about either. Ebola has been around for a long time, and isn't likely to go away - hopefully that one will STAY away! One take-away from the article is that a coronavirus (SARs and MERs are this type) is more like a cold on steroids. These are "new", typically some virus that mutated from an animal virus, and therefore our bodies might not have the antibodies needed to fight it off yet. Typical of all viruses, they mutate. They could mutate themselves out of human disease, or become worse. Only time will tell.

Good sum up/comparison:
https://www.sciencenews.org/article/how-new-wuhan-coronavirus-stacks-up-against-sars-mers
It does mention that this "version" appear to be more apt to "stick" into the lungs deeper and lead to pneumonia, so perhaps ensure your loved one has had the pneumonia shots?

(I don't recall which "scare" it was (might have been one of the "flus"), but at work were signs everywhere telling you basically if you looked at someone who was ill, you HAD to stay home for 2 weeks!!! If not ill, would I get paid then? Geez... Masks, sanitizers, etc. No thanks.

Also, we went to see a movie around the early days of SARs, and one preview had shadowy figures moving about, monkey sounds, etc and my son says "SARs, The Movie"! Turns out it was a flick called 28 Days Later. What I found scary was the extras on the DVD, talking about how diseases spread and showing/talking about the "Mad Cow" epidemic in England. THAT was real and THAT was scary!!!)

You could take your parent out, as a protective measure.

Any time people are living in such close quarters, the risk will be increased.

You can only do what the facility advises. If you have any symptoms stay away, but after that it is down to the facility to take necessary precautions and manage the situation. Like any cold or flu some will get it some won't, some will survive some won't - different bugs are going around all the time. Even if you took them home you wouldn't be able to guarantee your LO would not catch it if they were going to.

Don't underestimate the traditional remedies: vitamin C, garlic, onion, homemade chicken soup, oregano, thyme.

Many facilities provide masks for visitors. But sometimes I think this makes it more difficult for our loved ones to recognize us. Check with the facility to find out what they recommend.

I sent the .facility that my sister is in a note asking them what steps they were going to take. Here is a link to the CDC: .https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html


As to your behavior, assume that you are carrying the virus and that you will come in contact with the virus.

Of course don't visit if anyone in your family has symptoms of a cold. or a fever; check your own fever.

The facility should have everyone stop by a desk and check in. The facilityshouldprovide everyone with a mask and have them wash their hands before visiting. The love one should be provided with a mask to wear doing a visit. Be sure to wash your hands before leaving. Don't touch your face or nose (including removing the mask) until you have used hand santizer. and then wash your hands again.

Don't rely on the facility doing an adequate job. Push them. Because the death rate among the elder is 14%.

Treat it like any other contagious disease: through washing of hands is the no. 1 method of prevention.

I have to admit. Some of the responses here seem so cavieler. There are pleny things the long term care facility should be doing and that you can do. Saying that people are going to get sick from something and die is mind-blowing. Here is a link to what the CDC recommends https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html

With a current 14% mortality rate among people over 70. the virsus is no small risk.

Doubt that covid19 will live up to its hype. Just follow common sense protocol.

Many of you may know the following but for those who don't, the most recent statistics regarding mortality rates for COVID-19 compared to flu in the GENERAL POPULATION in the US are as follows: flu deaths 0.1%
COVID-19 deaths 2.0%. This means the risk of dying from COVID-19 is 20 times greater than the risk of dying from the flu for the AVERAGE PERSON. However, the death rates for people over 65, the frail, elderly, those with compromised immune systems, those with diabetes and people with heart disease have a significantly higher chance of dying from coronavirus than 2.0%. Another issue which makes the coronavirus more prevalent than the flu is that there is currently no vaccine as there is with the flu. The international medical consensus along with the CDC is that a rushed vaccine could be available as early as a year and half without human trials and Israel in particular seems to be making some headway in creating a vaccine. However in the US the cost to individuals for the vaccine, once it is available, is estimated to be substantial due to trademark protections and other US pharmaceutical industry standard practices. The coronavirus is a dangerous pandemic with no cure and so far no medical intervention to protect people from getting it. In addition, compared to past epidemic preparedness in the US, the US is having a particularly difficult time containing, managing, documenting, testing, and efficiently communicating about COVID-19 within the medical and scientific communities compared to our prepared responses to diseases such as SARS, MERS, Avian flu, ebola and others in the past. Wash hands, do not touch your mouth, nose, or eyes and if you begin to have a fever wear a mask, seek a diagnosis and stay home for 2 weeks or until your doctor gives you the all-clear to resume normal activities.

14.9% mortality rate among people with heart disease is my understanding..

The most important aspect of infection control is good and vigilant hand washing. By that I mean: under warm to hot running water, using soap wash your hands up to the wrists and in between thumb and index fingers. Wash for 30 seconds. (Hum the Jeopardy tune). Rinse. Turn off the faucet using a paper towel. Dry hands. Use a paper towel to open the door if you are in a rest room. If no running water is available hand sanitizer is acceptable. However, it should not be used in place of through hand washing. The staff at the facility should be washing their hands before touching a resident. They should also wash hands while giving care or dispensing meds. In general, washing your hands is especially important before touching your face (mouth, nose, and eyes).