Scenarios for COVID exposure / positive in LTC and AL
What are the Medical Health Office Scenarios for COVID exposure / positive monitoring in LTC and AL?
January 13, 2022
Scenario 1 – Staff Only Cases
Sites with identified staff cases of COVID-19 (and no resident cases) will self-manage with Public Health support.
The site will determine whether the staff member worked during their infectious period. If yes, facility will follow these protocols:
Protocols:
a. Initiate twice daily symptom screening of staff and residents and have a low threshold for testing any symptomatic staff or residents.
b. No isolation/droplet precautions of residents unless they are symptomatic
c. Continued group activities.
d. Continue with communal dining.
e. No change to social visits.
f. Cohorting staff on the affected Unit.
g. No asymptomatic/point prevalence testing of residents or staff.
h. Notify Public Health COVID-19 LTC HUB if there are positive resident cases identified.
i. The site can stop monitoring 7 days after the positive staff member(s) last worked if no other cases are identified
b. No isolation/droplet precautions of residents unless they are symptomatic
c. Continued group activities.
d. Continue with communal dining.
e. No change to social visits.
f. Cohorting staff on the affected Unit.
g. No asymptomatic/point prevalence testing of residents or staff.
h. Notify Public Health COVID-19 LTC HUB if there are positive resident cases identified.
i. The site can stop monitoring 7 days after the positive staff member(s) last worked if no other cases are identified
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Scenario 2 – Resident Cases
Sites with identified resident cases of COVID-19 will be on Enhanced Monitoring. Public Health will continue to monitor sites which identify symptomatic residents who test positive for COVID-19.
Protocols:
a. Initiate twice daily symptom screening and have a low threshold for testing any symptomatic staff or residents.
b. Symptomatic residents and residents who test positive are to be placed on isolation/droplet precautions.
c. Asymptomatic residents are no longer routinely isolated.
d. Communal dining on the affected unit is stopped.
e. Group activities on the affected unit are stopped.
f. Social visits on the affected can continue
g. No asymptomatic/point prevalence testing of residents or staff
b. Symptomatic residents and residents who test positive are to be placed on isolation/droplet precautions.
c. Asymptomatic residents are no longer routinely isolated.
d. Communal dining on the affected unit is stopped.
e. Group activities on the affected unit are stopped.
f. Social visits on the affected can continue
g. No asymptomatic/point prevalence testing of residents or staff
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Scenario 3 – Resident Cases and Ongoing Transmission
Sites where there is ongoing, concerning transmission among residents. Public Health may declare an outbreak. When an outbreak is declared, the site is to implement the following measures:
Protocols:
a. Sites will have a low threshold for testing any symptomatic staff or residents
b. Symptomatic residents and residents who test positive are placed on isolation/droplet precautions.
c. Asymptomatic residents are no longer routinely isolated.
d. Group activities on the affected unit are stopped.
e. Communal dining on the affected unit is stopped.
f. Social visits on the affected unit on hold until approved by the MHO
g. No routine asymptomatic/point prevalence testing of residents or staff.
h. Outbreak Response Lead support may be provided to the site.
i. The outbreak will generally be declared over when no new symptomatic resident cases are identified and it has been 10 days since the last resident case has tested positive
b. Symptomatic residents and residents who test positive are placed on isolation/droplet precautions.
c. Asymptomatic residents are no longer routinely isolated.
d. Group activities on the affected unit are stopped.
e. Communal dining on the affected unit is stopped.
f. Social visits on the affected unit on hold until approved by the MHO
g. No routine asymptomatic/point prevalence testing of residents or staff.
h. Outbreak Response Lead support may be provided to the site.
i. The outbreak will generally be declared over when no new symptomatic resident cases are identified and it has been 10 days since the last resident case has tested positive
