CVHC Long Term Care Strike Team

*Proposal Information

VDH LTC Task Force

Mission

To effectively and efficiently identify, triage, isolate, treat, and track a surge of potentially infectious residents and staff, and to manage the uninjured, asymptomatic persons, family/guardians, and media.

Plan Concept

For Facilities with NO reported Cases:

  • Send in Testing Team to verify that they have no infected staff or residents.
  • Follow with Site Assessment and Training Team – Focus is on PREVENTION.

For Facilities with a FEW reported cases:

  • Send in Testing Team to identify the extent of positive cases and infected staff members. 
  • Send in the Site Assessment and Training Team to determine the facility’s risk for a more severe outbreak, and to ensure staff are adequately trained and protected to manage the outbreak.
  • If needed (per the recommendations of the Assessment Team) send in the On-Site Medical Triage, Treatment, and Stabilization Team to manage the outbreak 

Three Teams

1. COVID-19 Testing Team:

  • 3 Person Team:
    • Sample Collector (Collects the swabs and places in the test tubes)
    • Sample Collector Assistant (Completes collection forms and labels)
    • Sample Packer (Prepares samples for transport to laboratory)
  • Mission: conduct testing of all residents and staff at the facility to determine prevalence of COVID-19 infections in the facility
  • Length of Mission:  4 hours/facility.  Should arrive 2 hours prior to shift change to get both day and night shift

2. Site Assessment and Training Team:

  • 6 Person Team:
    • Site Assessment Section: 2 Team Members: review facility procedures, identify weaknesses/areas for improvement and brief facility leadership on findings.
    • PPE Training Section: 2 Team Members: Provide training to Staff on Donning and Doffing PPE,  and safe extended use/reuse of PPE
    • Fit-Testing Team:  2 Team Members: Provide Fit-Testing to facility staff
  • Mission: Assess the capability of the facility to prevent and respond to COVID-19 outbreaks and provide focused training to leadership and staff
  • Length of Mission: 4-8 hours per facility

3. On-Site Medical Triage, Treatment, and Stabilization Team

  • 6 Person Team:
    • Infectious Disease Physician
    • 5 Registered Nurses
  • Mission: Respond to outbreaks at facilities.  Establish COVID-19 treatment areas (hot zones) and non-COVID-19 treatment areas (cold zones). Implement enhanced infection control practices.  Evacuate urgent and critical care patients to hospitals.  Manage care of low acuity COVID-19 patients within the facility. Train facility staff
  • Length of Mission: 4 – 14 days per facility.  Mission ends when all COVID-19 patients are evacuated or recovered and there is no continued threat of an outbreak OR when the facility can adequately manage the outbreak with their own personnel.

Staffing the LTCF Strike Teams:

Option 1: State Level LTCF Strike Teams, consisting of a mix of the following:

  • VDH Central Office Team members (Infection Control experts, to include former Local Health District Epidemiologists and PHNs with experience in LTCF outbreak management)
  • Contract wage personnel (i.e., hire physicians and nurses that are out of work due to reduction of elective care and outpatient services in the community)
  • National Guard members
  • MRC Volunteers

Option 2: District Level LTCF Strike Teams: each Health District would create its own team, pulling from the following:

  • District Director or Designee
  • District Epidemiologist and/or Disease Control PHN
  • MRC Volunteers

Option 3: LTCF staffed and operated Strike Teams: each LTCF or LTCF network (if LTCF is affiliated with a network) provides their own teams.  VDH could provide training and in-service to these teams.

* This is a proposal created internally by CVHC. This has not been approved or endorsed by any local or state agency. Our hope is the LTC Taskforce created by the Governor will include this in their recommendations to the Governor.