Epidemics Murcia | With the arrival of winter, health care tightens the fight against viruses in residential buildings

With the coming of the season winter virusesThe Ministry of Health is already working in prevention protocols to reduce risks among the most vulnerable population, in this case elderly people living in residential buildings. To this end, he has just published Update of the Guidelines for the Prevention and Control of Outbreaks of Acute Respiratory Infections for Nursing Homesfocusing this time on closer surveillance of outbreaks that may pose a greater risk.

The epidemiological service notes that outbreaks of acute respiratory infections (ARI) “They are a public health problem.”and factors related to the occupants themselves (dependency, frailty or comorbidities) and the environment (services, use of common areas or air quality and ventilation) may contribute to its occurrence and severity.

Among respiratory infections caused by viruses, the most common are COVID-19, influenza, respiratory syncytial virus (RSV) and human matapneumovirus, and among infections of bacterial origin, pneumococcal pneumonia and polymicrobial aspiration pneumonia are the most common.

In this new guide, the Ministry of Health of the Region of Murcia gives recommendations for actions if one or more cases of infection are detected acute respiratory infections in nursing homes to avoid outbreaks. Moreover, the group led by Councilor Juan José Pedreño insists that “the measures included in this protocol They must be applied in all residential centers.

vulnerable people in the Murcia region, regardless of their form of ownership, whether public, private or consensual.

The data managed by Social Policy is 84 nursing homes and 40 nursing homes Region.

The updated guidance represents a regional adaptation of the national protocol and states that all ARI outbreaks occurring in designated centers must be reported to the epidemiological service of the General Directorate of Public Health.

Among the preventive measures proposed in the document, for example, propaganda vaccination of residents and specialistsTherefore, immunization campaigns against influenza and COVID-19 are starting in residential homes. To this should be added precautions such as proper hand hygiene and use of personal protective equipment. (PPE) such as gloves, masks and disposable gowns when caring for a symptomatic resident.

No strict isolation

One of the most criticized measures during the COVID-19 pandemic was the complete isolation imposed on elderly people in nursing homes due to fears of an unknown virus, a measure that has since been heavily criticized. For this reason, the new guide to the Murcia region insists that “strict isolation of people with symptoms is not recommended” and it is only assumed that, although they have symptoms, avoid using enclosed common areas.

The Director General of Public Health of the Region of Murcia, José Jesús Guillén, states that “the implementation of the guidelines is an example of effective collaboration between health authorities, those responsible for social policy and residential centers”, while emphasizing that ““Its application allows us to continue to improve our ability to respond to these respiratory diseases.”.

Thus, “it became possible to create integrated surveillance system “which allows for early detection of cases of both influenza and COVID-19, two respiratory diseases that can have serious consequences in older adults,” explains Guillen.

According to the Ministry of Health, during the 2023-2024 season, when these outbreaks began to be declared after the publication of the first guidance, 1,325 cases of respiratory viruses were recorded in residential buildings. 75.4% were caused by SARS-CoV-2, 5.8% by influenza virus and 1.1% by RSV (respiratory syncytial virus), while the remaining ARI outbreaks were mixed.

The public health official insists that “this collaborative approach with residences “This allows us to optimize resources and gives a more complete picture of the epidemiological situation.”

Professionals overlook more coordination and ventilation measures

One of the shortcomings of the system identified during the coronavirus pandemic was lack of communication and coordination between residential buildings and the healthcare system, a problem that remains unresolved by those responsible for coordination at the time, and which is not addressed in detail in the ministry document.

Doctor Abel Novoawho coordinated the Advanced Chronic and Social Health Care Team (Corecaas) of the Murcia Health Service (SMS) during the health crisis, qualifies public health guidance as “very general” and there are no measures in place to ensure that residents do not have to go to hospital emergency doors in the event of a respiratory infection, “because moving them exposes them to other viruses “which can cause complications.”

The specialist notes that influenza outbreaks are very frequent in nursing homes, which leads to high mortality, and recalls that during Covid they worked with early diagnosis protocols,”antiretroviral treatment recommendations in the first 48 hours, the use of which is not currently mentioned in the guidelines.

Dr. Novoa also fails to note that the document preventive measures relate to ventilation“when it is proven that it is important for planned prevention, both room ventilation and air renewal systems.”

It was from Korekaas that the message was made about How healthcare in nursing homes must change to avoid a new crisiswhich argued that residential homes had been disconnected from the health care system for decades and that during the pandemic, “residents have suffered not only from COVID-19, but also from measures taken during outbreaks, and that “they are affected, infected and unaffected.”

The study produced results that showed the healthcare needs of the very elderly population, of which 47.3% were frail; 45.4% had severe dementia; Up to 43.7% were completely dependent and 72.9% used diapers.

Communication nurses

To try to alleviate some of the disconnect between residential homes and health centers, a number of liaison nurses were introduced with professional in each of the nine areas of health care to distribute and manage health carealthough professionals report that these positions began to disappear in 2024.

However, the Ministry of Health states that “the medical group in residential buildings continued to function, always adapting resources to the epidemiological situation,” although they currently only have dedicated liaison nurses in four health areas, “while this figure is being adjusted and recalculated.” Otherwise, he said, it is a collaboration between a team of nurses who respond to requests and resolve incidents in coordination with management at each hospital and health centers.