On February 29th, the first case of COVID-19 was announced, occurring in Washington state in the Kirkland nursing home.  Geriatricians around the country immediately knew what this meant. CALTCM went into action and had our first webinar on March 9.  It’s six weeks later and we’d like to give everyone direction. For anyone who has not watched our webinars, we will redirect you to the most important, in the order that they should be watched.  Keep in mind, if you’re already far along the curve, some of this might seem remedial. We can assure you, it’s not.   

Let’s set the stage.  Nursing homes are an accelerator for the COVID-19 infection.  We must literally put a “moat” around every nursing home in order to protect, contain and mitigate the impact of this virus on our residents and staff.  We believe that there are three key pillars that form the base of providing the highest quality of care. They are not in any particular order. Every nursing home’s Infection Preventionist (IP) must dedicate 100% of their time to their job.  They can not be pulled off for other duties (3/9 webinar). Every facility needs an abundance of Personal Protective Equipment (PPE) and the wherewithal and training to use it effectively (4/6 webinar). In an ideal world, which hasn’t occurred yet, every facility should have the ability to test all of their staff and any possible COVID-19 residents.  

Your staff is going to struggle and morale will be a challenge, we’ve got a webinar for that (3/30 webinar).  You’ll also be addressing serious goals of care discussions (4/13 webinar).

I haven’t mentioned the first webinar that everyone should watch, but it’s critical.  In order to prevent your facility staff from “drinking through a firehose” every day, you must operate in Incident Command mode (3/25 webinar).  Here is the order of webinars. Pour a glass of wine, relax, watch them all at once, or spread them out over a couple of days. The March 16th and 23rd webinars are also of value, but these should really cover all the bases. 

• 1st webinar:  3/25
• 2nd webinar: 3/9
• 3rd webinar: 4/6
• 4th webinar: 3/30
• 5th webinar: 4/13 

I wanted to comment briefly on Dr. Gieseke’s excellent discussion of preparing your facility to deal with COVID19.  One note of caution. Without a significant increase in resources (staff and supplies), even the best nursing facility will buckle under the strain of this virus.  Excellent clinical leadership from geriatricians, advance practice nurses and geriatric pharmacists, combined with dedicated staff (including that full-time IP), will fail without adequate staff, abundant PPE, and readily available testing.

Be safe and thank everyone for serving and protecting the most vulnerable members of our society.