Nursing home best practices helped prevent COVID

As the United States struggles to test all citizens exhibiting symptoms of coronavirus, Australia and Canada are offering lessons about best practices for preparing for a pandemic. Having learned from previous outbreaks, these countries implemented protocols such as a national hotline, easy-access to information about testing sites, and "an agency to coordinate and help finance testing and treatment during any kind of viral or disease outbreak" – all of which help make testing more efficient.

The Green House Project, which is a network model of nursing homes across states, has been able to largely avoid the spread of Covid-19 amongst residents, with five times fewer cases than the national nursing home average. While the small size of the nursing homes has played a role, it has also been beneficial that each resident has their own bedroom and bathroom and that staff employ a universal worker model that limits the number of nursing assistants coming and going from each facility.

Two community living facilities have played integral roles in combatting the spread of diseases throughout New York's history by relying on mutual aid models. In the 1980's the Manhattan Plaza residence started the AIDS Project, which "assigned care partners to every person who got sick and deployed volunteers to deliver meals and get people to doctors." Now, as the COVID-19 pandemic poses a threat, similar efforts are underway by a younger generation at the Manhattan Plaza as well as at Penn South where the focus has been on keeping senior citizens safe.

As Covid-19 spread throughout regions of South Africa, public health clinics began reporting seeing fewer patients for HIV viral load testing due to shelter-in-place orders. In trying to mitigate the longterm implications of people missing their appointments, a few HIV specialists have joined the frontlines in local communities to act as both coronavirus testers and information conduits for HIV programs.

Baltimore has reported approximately 10,000 cases of Covid-19, but the local Maryland Baptist Aged Home hasn't had a single senior resident infected due "a relatively small population of 29 residents, a strong history of infection control, a dedicated staff and...the cynicism that comes with residing in an underserved community." Leadership at the nursing home acted before local government officials did, implementing a strict lockdown and widespread testing protocols while also relying on measures already in place such as thorough infection-reducing cleaning regimens.

Rwanda, a country with the same population of Ohio, has emerged as an example of how to slow the spread of coronavirus, with only 1,500 cases reported so far. Besides initiating a lockdown, implementing free testing, and recruiting community health care workers, police, and college students to be contact tracers, officials also used "the same structure, same people, same infrastructure and laboratory diagnostics" that had been working to contain the spread of HIV.

Quick, restrictive and decisive action helped the "oldest African American owned and operated nursing home" in Maryland remain free of Covid-19 cases. With only 15 cases reported in the country, the nursing home didn't wait for government direction to take action. Instead, they immediately eliminated visitations and enacted their protocols for combatting infectious diseases which included procedures such as limited travel from the facility, increased cleaning protocols and health checks, and elimination of community meals.

When virologists and genomicists in Seattle, Washington realized that COVID-19 was likely to spread to the United States, they began to research ways to keep vulnerable poplulations safe. So far, early success has come from replicating the Seattle Flu Study, which uses a swab test to "reveal the trail that the flu takes as it passes around households, homeless shelters, office parks and communities in the city," and now investors are putting money towards getting these tests into households.

E25Bio created a rapid COVID-19 test soon after the pandemic began and had an existing factory that could be repurposed to quickly manufacture tests. The prototypes, priced under $10 each, attracted major donors and would have made at-home antigen tests that identified around 80% of contagious cases available from the pandemic’s early days. Instead, an unclear FDA review process that prioritized higher detection rates over inexpensive ways people could test often, as well as resistance from medical device regulators, prevented the company from producing the tests for the public early in the pandemic.

Political cooperation and an infrastructure of existing relationships and trust built by NGOs and community leaders during Hurricane Maria and a devastating 2019 earthquake allowed for a quick public health response to COVID-19 focused on prevention and vaccination. All trusted public figures, across political backgrounds, advocated wearing masks and getting vaccinated. As a result, Puerto Rico achieved the highest COVID-19 vaccination rate among all other U.S. state or territory. It also had among the lowest Covid-19 death rates since the start of the pandemic.