Some Fraser Health long-term care patients showing symptoms of having COVID-19 may continue sharing rooms with asymptomatic patients until it is confirmed they have the virus.
That has alarmed some familiar with the practice, and federal and provincial guidelines suggest such patients should be moved to single rooms when possible. But Fraser Health’s chief medical health officer says it’s safe for symptomatic patients to continue sharing a room with others prior to confirmation of their diagnosis, so long as a curtain is erected around the patient, appropriate distancing between beds exists and advanced hygiene measures are in place.
“We have to remember, COVID-19 is spread by direct contact and by droplets, so those measures are sufficient to prevent the spread,” Dr. Martin Lavoie told The News. “This is not airborne. So having a curtain, having the physical distance between the beds, which is sufficient as well, the hand-washing, the use of proper PPE, all these measures are excellent at protecting against the spread of COVID-19.”
It’s unclear how prevalent the practice is in Fraser Health or in other health authorities. The scenario usually only occurs during the time between the onset of symptoms and the arrival of test results, at least in Abbotsford. When a positive case is confirmed, patients are usually transferred to a specialized unit at Abbotsford Regional Hospital where all those being treated all have COVID-19.
Lavoie was clear Thursday that when a symptomatic person is in a room with multiple others, curtains can and are used to separate them from others.
But while he said the situation isn’t unsafe, guiding documents from both the British Columbia Centre for Disease Control (BC CDC) and the federal government say it’s not preferred.
In March, the BC CDC issued guidelines for how long-term care homes should handle suspected COVID-19 cases. That document [read here] says:
“Any resident who is identified with respiratory symptoms should be placed on additional (Droplet/Contact) precautions without delay and should be placed in a single-bed room, if possible. If not possible, a separation of two metres must be maintained between the bed space of the ill resident and all roommates, and privacy curtains should be drawn.”
The federal government issued similar guidelines at the start of April.
That document says:
“A resident with suspect or confirmed COVID-19 infection, or who is a high-risk contact of a confirmed COVID-19 positive person, should be cared for in a single room if feasible, with a dedicated toilet and sink designated for their use. If this is not possible, a separation of two metres must be maintained between the bed space of the affected resident and all roommates with privacy curtains drawn. The resident should be restricted to their room or bed space.
“Clear (multilingual signage as required) signage that indicates Droplet and Contact precautions needs to be in place, posted in such a way that it is clearly visible to all entering the resident room or bed space.
“Posters illustrating the correct method for putting on and removing PPE should be displayed inside and outside of each COVID-19 resident’s room or bed space for easy visual cues.
“Roommates of symptomatic residents should not be moved to new shared rooms, and instead should be moved to a new single room for isolation and monitoring for symptoms, or maintained in place if a two-metre separation and privacy curtain can be implemented.”
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Saskatchewan and Alberta each have similar guidelines. In Saskatchewan, patients with suspected cases of COVID-19 are among the highest priority when it comes to deciding who should be placed in a private room.
Fraser Health has a long-standing shortage of care beds, with the situation particularly acute in Abbotsford, where officials have been promising to build hundreds of new care beds for nearly a decade. Those beds have never been built and the strain on the system has only increased as the province has worked to move as many seniors out of hospital as quickly as possible to free up space for a potential influx of COVID-19 patients.
The News asked Fraser Health Thursday why it might not be possible to put every suspected COVID-19 patient a private room, as the provincial guidelines suggest. Fraser Health has not responded yet.
The News also asked the Ministry of Health about the appropriateness of keeping such patients in rooms with those who are asymptomatic, but has not heard back. The News will update the story if and when more information is provided.
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