In consultation with the Medical Health Officer (MHO), Dr. Murray Fyfe, the Island Health Long Term Care (LTC) program is continuing to refine its plan and recommendations to reduce the likelihood of a COVID19 outbreak in one of its LTC facilities. This plan is based on daily consultations with the MHO and the evidence emerging from other jurisdictions.
We are preparing to cohort COVID19- infected LTC residents in dedicated LTC sites in North, Centre and South Island. These sites will be supported with essential PPE and staff, and will receive appropriate COVID-19 infected LTC residents. The stability of the residents’ medical condition AND the residents’ MOST status should guide the physician/NP as to the appropriate care site to reduce unnecessary transfers between acute and LTC COVID cohort facilities.
Due to lengthy transportation issues, (rural & remote location, weather delays), or if a resident is actively dying or likely to die during transfer, some LTC MRPs in collaboration with the MHO may elect not to transfer infected residents. Therefore, all LTC sites must continue to prepare to safely isolate, cohort and care for possible or confirmed COVID-19 infected residents and manage outbreaks.
FOR LTC RESIDENTS WITH A CONFIRMED POSITIVE TEST AND DECISION TO TRANSFER:
PHASE 1: TEMPORARY until LTC cohort units are ready to receive patients
LTC resident will be transferred to a COVID-19 cohort unit in acute care at RJH, NRGH or CVH. This transfer should take place unless the resident is likely to die within 24 hours or because of transportation issues as above. Patients should be cared for based on their goals of care and MOST status. Each LTC site will follow the LTC Covid -19 transport algorithm which is attached for your reference.
PHASE 2: First LTC COVID cohort site open (The Summit, Geo 4, approx. April 20)
LTC resident will be transferred EITHER to the nearest acute care cohort site OR to the Summit cohort unit located in Victoria if this is appropriate based on their MOST status, medical stability and their geographic location.
PHASE 3: Second and Third LTC COVID cohort site open in Geo 2 and Geo 1 (specific locations TDB, end of April/ early May)
LTC resident will be transferred EITHER to the nearest acute care cohort site OR nearest LTC cohort site based on their MOST, medical stability and geographic location.
Please see attached COVID-19 Transport Algorothm
Dr. Margaret Manville, FCFP (COE)
Medical Director, Long-Term Care, Island Health
Division Head, Department of Primary Care, Geography 4