Geriatric medicine experts have released new COVID-19 preparation guidelines emphasizing stringent infection prevention and control to reduce mortality risk among eldercare community residents and staff.

In the absence of vaccines and antivirals, appropriate coronavirus preparedness should address five key goals, write David Dosa, M.D., MPH, from Brown University, and colleagues.


  • Reduce morbidity and mortality among those infected
  • Minimize transmission
  • Ensure protection of healthcare workers
  • Maintain healthcare system functioning
  • Maintain communication with worried residents and family members

To reduce the risks of introducing COVID-19 and transmitting it within a facility, operators should activate airborne disease transmission protocols, including a respiratory outbreak preparedness checklist. “Plans previously developed for pandemic influenza can be repurposed for COVID-19,” the authors write.

Particular care should be taken to reduce transmission from asymptomatic staff, who may unknowingly shed the virus to surfaces or by direct contact with residents, they add.

Once an infection begins to spread in a community, these measures should be supplemented with visitor limits and staff screening on entry for fever or respiratory symptoms. Meanwhile, cleaning staff should clean daily with Environmental Protection Agency-registered, hospital grade disinfectants. These measures will be crucial to containing the disease, especially in high-traffic areas such as dining halls and living spaces, the authors explain.

“Early suspicion and detection of a case will help identify which resources can be deployed to further prevent or reduce the spread of the disease,” they conclude. 

The full article, Long-Term Care Facilities and the Coronavirus Epidemic: Practical Guidelines for a Population at Highest Risk appears online in the May issue of JAMDA.