COVID-19 Contact Tracing Can Help Predict & Prevent the Spread

The Current State of Senior Living Communities and COVID-19  

Senior living communities have long been wary of viral infections, and for good reason. According to the American Academy of Family Physicians¹, one-third of all deaths in seniors—people aged 65 or over—results from an infectious illness. 

Seniors’ weakened immune systems combined with chronic conditions increase the risk of developing severe health complications. For many senior living community operators, COVID-19 exposed some weaknesses in how they keep their residents and staff safe and healthy. 

The most vulnerable during this time has been and will continue to be the elderly population, who account for more than 79 percent² of all COVID-19-related deaths. The risk has been magnified by the fact that a resident can spread the disease for several days before showing symptoms. Coupled with asymptomatic transmission, the illness becomes extremely difficult to contain. 

To slow the spread, many senior living communities have made the difficult decision to quarantine their vulnerable populations and restrict access to facilities. This is not a sustainable model, especially if a predicted second wave³ does return in the fall. Lockdowns also cause a host of issues to a community, including:

• Secondary health complications due to isolation – The consequences of isolating healthy residents can trigger secondary issues⁴–including depression, anxiety, and neurocognitive decline–which put older adults at greater risk. 
• Staffing Challenges – When caregivers don’t come to work, either because they have contracted a contagious strain or they want to protect themselves from getting it, residents receive less care and attention. 
• Lost revenue – Lockdowns and fears over safety can dissuade potential residents from joining the community or cause current residents to leave. In fact, many communities halted new move-ins this spring, as Lynn O’Connor from Ingleside notes in this Senior Housing News Transform podcast.

To better protect their residents, senior living communities are actively searching for technology solutions and installing proactive measures to combat the spread. By doing so, they hope to manage this current pandemic, future waves of the pandemic, and the upcoming 2020 flu season. 

They can start by using technology to perform modern contact tracing. This makes it easier to predict exposure and then act before transmissions occur.

What is Contact Tracing? 

Contact tracing creates a transmission spider web that saves lives. It helps diagnose infected individuals earlier, improves the chance that they’ll be cured, and reduces the likelihood that they spread the illness to others. According to Crystal Watson⁵, a senior scholar with Johns Hopkins Center for Health Security: “It’s used to break chains of transmission, to manage epidemics of this virus at an ongoing low level, to prevent future waves or surges of cases.”

Per the CDC⁶, there are four fundamental concepts to the practice of contact tracing: 

1. Trace and monitor contacts of infected people – Notify the patient of their exposure and then find out with whom they might have interacted and passed the illness to.
2. Support the quarantine of contacts – Ensure that residents can safely and effectively quarantine to thwart further transmission. 
3. Expand staffing resources – Build up the necessary team of contact tracers.
4. Use digital tools – Adopt digital technologies to expand the reach and efficacy of contact tracing. 

The Historic Limitations of Contact Tracing 

Historically, contact tracing has been used to help combat a host of maladies and infections, including tuberculosis, ebola, measles, HIV, and novel infections like COVID-19. The eradication of smallpox⁷ was partially due to exhaustive contact tracing efforts. 

Traditional contact tracing methodology has noticeable shortcomings, such as:  

• It relies on having the proper manpower and infrastructure to combat the spread
• It’s a slow, painstaking process that can quickly be outpaced, particularly when the contagious growth rate is greater than one (R0>1)
• It depends on the veracity of human memory
• For illnesses like COVID-19, which have a longer incubation period, an individual would have difficulty recalling and then tracing all the places and people with whom they have interacted 
• The efficacy of tracing is reduced by the fact that a significant percentage of the infected population have mild cases or are asymptomatic

Technology can help expedite and modernize contact tracing processes, especially within confined spaces.

How Technology Can Help with Contact Tracing in Senior Living Communities 

Effective contact tracing leverages sophisticated real-time location sensors to answer “Who was where? With whom? And for how long?” This digitized line of questioning empowers staff to make the best operational decisions at a moment’s notice. 

Typically, technology-driven tracing can be broken into three key utilities:

• Immediately identify who’s at risk – After an infected resident has been identified, staff can use RTLS to retrace their steps. Retracing answers all of the important questions about infected residents, including:
  • Who is infected?
  • Where did they go?
  • With whom were they in contact?
  • How long were they in contact?

It establishes a web of relationships at multiple levels, including 1st person contact, 2nd person contact, etc. With this technology there’s no need to rely upon the resident’s memory of where they were, what they did, and with whom. 

• Leverages an established protocol – Once a resident has been identified and then quarantined, staff act quickly to manage the care of that resident, while keeping others safe. Top priority is to manage the case efficiently. While a community’s EMR can help, leveraging a tool designed uniquely for this purpose simplifies the process. Data sharing with the EMR helps capture the procedures for historical purposes. To keep other residents safe, communities with sophisticated RTLS, can establish a geofence around quarantined residents. Should the resident leave or someone enters the perimeter, staff will be immediately alerted. 
• Simplify long-term protocol management – To prevent transmission going forward, communities need to think about longer term strategies. The RTLS technology built into Ensure360 can help communities enforce social distancing by allowing staff to set occupancy counts in larger rooms. These are the maximum amount of residents a room can safely hold. So, if the room is set for 6 people and a 7th person enters the room, the system can alert staff that the count has been exceeded.  

Together, these contact tracing technologies provide a powerful defense mechanism for contagious infection mitigation and prevention. 

Protecting Your Vulnerable Population 

The last few months have taught us a great deal about COVID-19 and how to mitigate its spread. As the battle rages on, senior living communities must continue to act boldly and embrace novel solutions to keep their seniors safe.  

Fortunately, cutting-edge, sensor-based technologies have made contact tracing within senior populations easier.  You no longer need to depend on the clarity of a resident’s memory or the time of valued staffto create an accurate infection web. 

The communities that embrace powerful new technologies and take proactive measures will be able to better protect and support their residents today, tomorrow, and far into the future.   

Looking for a contact training solution? Ensure360 combines sophisticated eCall and RTLS-based contact tracing and case management into one easy-to-use platform.

 

Sources:

1. American Family Physician. Common Infections in Older Adults. https://www.aafp.org/afp/2001/0115/p257.html
2.  CDC. Provisional Death Counts for Coronavirus Disease 2019 (COVID-19). https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#AgeAndSex
3. AMA. Harvard epidemiologist: Beware COVID-19’s second wave this fall. https://www.ama-assn.org/delivering-care/public-health/harvard-epidemiologist-beware-covid-19-s-second-wave-fall
4.  COVID-19 and the Consequences of Isolating the Elderly. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104160/
5. WebMD. What is ‘Contact Tracing’ and How Does it Work? https://www.webmd.com/lung/news/20200504/what-is-contact-tracing-and-how-does-it-work#1
6.  CDC. Contact Tracing. https://www.cdc.gov/museum/pdf/cdcm-pha-stem-lesson-contact-tracing-lesson.pdf
7. Miami Herald. From smallpox to HIV, here’s how contact tracing helps control outbreaks like COVID-19. https://www.miamiherald.com/news/coronavirus/article242135616.html