COVID-19: Universal Masking for Long-Term Care Facility Staff 

On March 28, the Philadelphia Department of Public Health released a Health Advisory regarding guidance for universal masking of staff at long-term care facilities related to COVID-19:

Summary Points:

  • Long-term care facilities are likely to be disproportionately affected by COVID-19.
  • Universal masking for all LTCF staff should be implemented to reduce the risk of SARS-CoV transmission in LTCFs and protect both residents and staff.

As SARS-CoV-2, the virus that causes COVID-19, continues to spread in our region, there are an increasing number of cases among staff and residents of long-term care facilities (LTCFs). To date, 14 Philadelphia LTCFs have reported residents or staff with COVID-19. This is particularly concerning since LTCFs serve persons at highest risk for severe disease due to COVID-19.  While many facilities have taken several steps to prevent the introduction of SARS-CoV-2, cases have continued to emerge among staff and visitors who acquired infection from community exposure.  To minimize the risk of transmission in LTCFs, the Philadelphia Department of Public Health strongly recommends the following steps in addition to current infection prevention and control strategies:

  • Universal masking for all clinical and non-clinical staff who work in LTCFs.  Surgical face masks should be worn by all staff while at work.  Universal masking can prevent the spread of SARS-CoV-2 from infected staff to residents and infected residents to staff.  Persons with COVID-19 may become contagious as symptoms begin, before infection is suspected. Thus, continuous mask use while interacting with other staff and residents can help minimize the risk of transmission in LTCFs.  To ensure that universal masking can be implemented safely, emphasize the following practices:
    • Avoid touching the outer surface of the mask.
    • Perform hand hygiene every time the mask is touched.
    • Discard masks that are torn, wet, visibly soiled or hard to breathe through.
    • Follow recommendations for the safe conservation of PPE to address supply limitations.
  • Daily symptom screening.  All staff should be screened for fever through temperature monitoring and any respiratory symptoms, including cough, sore throat or shortness of breath, at the beginning and end of their work shift.  Staff reporting any of these symptoms should be immediately sent home.
  • Visitor restriction.  Adhere to strict visitor restrictions, including visits from ancillary therapeutic services (e.g., physical therapy) that can be safely suspended.   
  • SARS-CoV-2 Testing.  Do not perform routine laboratory testing of asymptomatic staff or residents for COVID-19. Test results do not predict whether a person will become ill or contagious in the future.  Testing asymptomatic employees who have been quarantined for 7 days is one option to expedite return to work when there are staff shortages. All staff or residents with COVID-19 compatible symptoms should be tested for SARS-CoV-2.

These measures should be implemented alongside other recommended strategies as outlined in previous guidance.  Please see Guidance for LTCFs on the Health Information Portal COVID-19 page for additional information:

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