Industry advocates, along with federal and state officials, are joining operators to encourage strict new visitor guidance in a nationwide race to keep the coronavirus from entering eldercare facilities.

The push comes during what one industry leader has called “perhaps the greatest challenge we’ve seen in the history of our sector.” 

“The grim reality is that for the elderly, COVID-19 is almost a perfect killing machine,” Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, told CNN on Tuesday, a day before the World Health Organization officially declared the coronavirus’s spread a worldwide pandemic. “We’re taking bold steps to do whatever we can to keep coronavirus from getting into our buildings.”

While some facilities have banned visitors outright, AHCA / NCAL is recommending that assisted living communities and nursing homes restrict visits from family and nonessential staff. Activities that may put elders in contact with potential disease carriers should also be curtailed, it said. In the meantime, setting up remote communication via phone or tablet may help to keep residents connected, suggested AHCA/NCAL Chief Medical Officer David Gifford, M.D., MPH, in a Wednesday C-Span interview.

The organizations also are recommending that facilities require all staff members to step up infection control efforts at building entrances. Visitors should be asked whether they have been exposed to COVID-19 by travel or through contact with infected patients or residents, and whether they have symptoms, Gifford said.

Operators already have put these measures in place. Among other protocol, Spring Hills Senior Communities instructs visitors not to visit if they have respiratory symptoms, said Lesa Scott, RN, VP-clinical service and compliance. The Edison, NJ-based operator also uses front desk infection-control stations, has ramped up surface sanitization and has posted information on hand and respiratory hygiene along with cough etiquette for staff, visitors and residents alike.

Some states have made these guest limits official. Ohio Gov. Mike DeWine on Wednesday said he wasn’t yet ready to “ban all visitors” but issued strict rules affecting nursing homes and assisted living, McKnight’s Senior Living reports. Ohio facilities should permit only one visitor per resident each day, have a single point of entry to aid infection control, and check the temperatures of staff and vendors when they arrive on site, the requirements state.

Meanwhile, the AHCA and NCAL are working with the White House and government health agencies to reinforce the groups’ recommendations, Parkinson reported. The Centers for Medicare & Medicaid Services has posted suggestions for identifying suspected coronavirus infections and restricting visits in nursing homes and hospice facilities. And the Centers for Disease Control and Prevention recommends “aggressive visitor restrictions and enforcing sick leave policies for ill healthcare personnel, even before COVID-19 is identified in a community or facility.”