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1.
Healthc Pap ; 20(1): 40-50, 2021 09.
Article in English | MEDLINE | ID: covidwho-1524616

ABSTRACT

A coherent workforce strategy and consensus on essential staffing requirements are needed to ensure quality in long-term care (LTC) homes. We have neither in Canada. No Canadian studies, investigator driven or commissioned, exist to guide us. We generally rely on 20-year-old US recommendations, although we have never actually implemented them. During, and in the wake of the COVID-19 pandemic, it is clear that an insufficient workforce was at the root of much of the failure in LTC to manage the pandemic. This commentary frames research on staffing and LTC homes and the impact of COVID-19. It then outlines key ingredients, such as knowledge of residents, the workforce and the care environment, that are needed in order to estimate staffing needs. Recommendations for decision makers are provided.


Subject(s)
COVID-19 , Long-Term Care , Adult , Canada , Humans , Nursing Homes , Pandemics , SARS-CoV-2 , Workforce , Young Adult
2.
BMJ Open ; 11(8): e052282, 2021 08 20.
Article in English | MEDLINE | ID: covidwho-1367439

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has an excessive impact on residents in long-term care facilities (LTCF), causing high morbidity and mortality. Early detection of presymptomatic and asymptomatic COVID-19 cases supports the timely implementation of effective outbreak control measures but repetitive screening of residents and staff incurs costs and discomfort. Administration of vaccines is key to controlling the pandemic but the robustness and longevity of the antibody response, correlation of neutralising antibodies with commercial antibody assays, and the efficacy of current vaccines for emerging COVID-19 variants require further study. We propose to monitor SARS-CoV-2 in site-specific sewage as an early warning system for COVID-19 in LTCF and to study the immune response of the staff and residents in LTCF to COVID-19 vaccines. METHODS AND ANALYSIS: The study includes two parts: (1) detection and quantification of SARS-CoV-2 in LTCF site-specific sewage samples using a molecular assay followed by notification of Public Health within 24 hours as an early warning system for appropriate outbreak investigation and control measures and cost-benefit analyses of the system and (2) testing for SARS-CoV-2 antibodies among staff and residents in LTCF at various time points before and after COVID-19 vaccination using commercial assays and neutralising antibody testing performed at a reference laboratory. ETHICS AND DISSEMINATION: Ethics approval was obtained from the University of Alberta Health Research Ethics Board with considerations to minimise risk and discomforts for the participants. Early recognition of a COVID-19 case in an LTCF might prevent further transmission in residents and staff. There was no direct benefit identified to the participants of the immunity study. Anticipated dissemination of information includes a summary report to the immunity study participants, sharing of study data with the scientific community through the Canadian COVID-19 Immunity Task Force, and prompt dissemination of study results in meeting abstracts and manuscripts in peer-reviewed journals.


Subject(s)
COVID-19 , Sewage , Antibody Formation , COVID-19 Vaccines , Canada , Disease Outbreaks , Humans , Long-Term Care , Pandemics , Prospective Studies , Public Health , RNA, Viral , SARS-CoV-2
3.
Facets ; 5:651-691, 2020.
Article | Web of Science | ID: covidwho-781233

ABSTRACT

The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to inform their decisions. This paper reports the findings of the CVOID-19 Long-Term Care (LTC) working group addressing a preferred future for LTC in Canada, with a specific focus on COVID-19 and the LTC workforce. First, the report addresses the research context and policy environment in Canada's LTC sector before COVID-19 and then summarizes the existing knowledge base for integrated solutions to challenges that exist in the LTC sector. Second, the report outlines vulnerabilities exposed because of COVID-19, including deficiencies in the LTC sector that contributed to the magnitude of the COVID-19 crisis. This section focuses especially on the characteristics of older adults living in nursing homes, their caregivers, and the physical environment of nursing homes as important contributors to the COVID-19 crisis. Finally, the report articulates principles for action and nine recommendations for action to help solve the workforce crisis in nursing homes.

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