Nova Scotia shares plan for potential second wave of COVID-19 with nursing homes

Those in charge of long-term care at Nova Scotia's Department of Health are planning to handle a resurgence ofCOVID-19 infections differently than the initial wave of the pandemic,in partbecause of weaknesses identified during the past seven months.

A 10-page document shared Thursday with the province's 130 long-term care facilities, including nursing homes,outlines what the department is calling its "Wave 2 Plan."

Although the document states the "plan will continue to evolve to account for changes in community epidemiology, sector input and emerging best practices," it represents a marked change in direction from the way authorities handled the situation in care homes starting in mid-Marchwhen infections were first detected in Nova Scotia.

In laying out the context for the changes, officials acknowledgethe Department of Health andthe Nova Scotia Health Authorityissued"several protocols and guidelines at different times" during the first wave of COVID-19,"which created confusion for service providers."

The department also acknowledges staff shortages were exacerbatedby "the introduction of the Canada Emergency Response Benefit (CERB),personal fears and a lack of child care."

Facilities struggled to keep up

The rapid pace in which the research evolved around COVID-19 also did not help, according to the document.

"New and evolving information constantly emerged making it difficult for organizations to keep current with and access information, which contributed to varying practices across the sector."

To ensure a more co-ordinated and reasoned response, the province has created what it calls continuing-care rapid response teams "as a single point of contact for [home care]and [long-term care]providers experiencing a COVID-19 outbreak."

The province is also looking to designate regional care unitswithin some nursing homes where individualswho test positive for COVID-19 canbe treated.

"Units will provide expert care and reduce risks to other residents by removing them fromtheir home-based facilities," the document says.During the first wave, each home was required to look after sick residents under their own roof.

Volunteers to play greater role

When it comes to ensuringcare homes have enough staff, assistance and protective equipment to handle an outbreak, the Health Department is promising to shift resources quickly, provide mental health support to those who are providing care, and allowvolunteers to help out.

With new protocols for masking and infection control, as well asthe availability of personal protective equipment, "it is intended that volunteers will play an important role during a potential second wave," the document says.

A pilot project in Lunenburgallowing the use of home-support aides will be expanded to other areas of the province. These aides perform light housekeeping duties, meal preparation and do other tasks that do not require the training of a continuing-care assistant.These aides will be allowed to work in areas of the province experiencing a shortage of continuing-care assistants.

The province will provide face shields, masks, gowns and other protective equipment tocare homes.

"The workforce will not face supply shortages in the face of a potential second wave," states the plan.

As a precaution and due to concerns of asymptomatic transmission of COVID-19, "plans are being developed to conduct serial asymptomatic testing of [long-term care] staff, designated caregivers, and volunteers involved in direct resident care."

Well-being of residents 'critical'

There's also concern the restrictions placed on residents during the first wave of the pandemic havecaused undue harm to their well-being.

The plan is to further ease existing restrictions "to reunite residents with their loved ones" and to allow for volunteers to return to facilities. The document does not say when that might happen.

The document also suggests the government may not have to go as far as it did with restrictionsduring a second wave and will have to determine which rules "may or may not need to be reinstated."

"Balancing the physical health and well-being ofresidents with their mental health and well-being is critical to ensuring a holistic andsafe approach to supporting continuing-care residents/clients and their families during the COVID-19 pandemic response."