Protecting long-term care residents from outbreaks requires different infrastructure, proper staffing conditions and a culture of quality assurance, researchers at the University of Waterloo have found.

The experts further determined that designing smaller, more homelike spaces would minimise the spread of viruses while promoting better health and quality of life for residents. “Community outbreaks and lack of personal protective equipment were the primary drivers of outbreak occurrence in long-term care homes, and the built environment was the major determinant of outbreak severity,” said George Heckman, a professor in Waterloo’s School of Public Health and Health Systems and Schlegel Research Chair in Geriatric Medicine with the Research Institute for Aging.

“We need to distinguish between small-scale living and small-scale housing, using architectural features to create uncrowded and home-like spaces – but within a sufficiently resilient infrastructure to avoid critical staff shortages such as those experienced by some very small homes in Italy and the United States.”

In the U.S., data from geospatial analysis and cellphone tracking showed that outbreaks were more likely when staff commuted from neighbourhoods with high viral circulation, and in large homes with more staff traffic.

The researchers said that in the case of Ontario, simulations found that 31% of infections and 31% of deaths could have been prevented if all Ontario long-term care residents had had single rooms. However, 30,000 new private rooms would have been needed.

“Policymakers need to reimagine long-term care infrastructure in a post-pandemic world, keeping in mind that smaller homes support better resident outcomes and are more resilient against infectious outbreaks,” Heckman said. “New large-scale long-term care home developments should be strongly discouraged.”

Other factors that would improve resident well-being and curb the spread of viral infections include a dedicated infection control officer in all long-term care homes, proper staffing conditions and high-quality assurance frameworks. WITH ANI INPUTS