March 12, 2021

Post-Vaccine Pilot Modification of Protective Measures

 

AFRH has undertaken a pilot program to modify some of the protective measures implemented during the COVID-19 pandemic.  As over 97 percent of AFRH residents have received both doses of the COVID-19 vaccine, and positivity rates in communities local to the two campuses are lower, we are adjusting several of the pandemic-related restrictions imposed over the past year.  The information that follows describes changes that will permit more resident engagement, social interactions, and freedom of movement.

Maintaining Core Infection Prevention Protocols

Although some measures are being loosened, we MUSTmaintain our core infection prevention protocols: wear masks, maintain at least 6 feet of social distancing, and wash or sanitize hands frequently.

At all times, residents and staff must self-monitor for any symptoms associated with COVID-19 (i.e., fever or chills, shortness of breath, new loss of taste or smell, headache, fatigue) and if they occur, immediately self-isolate and notify the Wellness Center staff who will provide further instructions.

All are reminded that the vaccine, while being 95 percent effective in preventing symptomatic illness from COVID-19 during limited clinical trials, is not a complete shield against the disease.  As the virus and the vaccine are both still very new to us, research continues to evolve, and new variants emerge, it is important not to take unnecessary risks and to maintain the core infection control protocols.

Pilot Program Conditions

It is important to understand that AFRH priority remains to keep the two communities safe, and that some limits will remain in place and others may have to be restarted should the virus be reintroduced to either campus or if local community conditions become more dangerous.  We are modifying some of these measures as a pilot, with the hope that conditions will continue to improve allowing us to advance.  This is based on two key conditions:

  • Local positivity rate, as reported by CDC, must remain below 8 percent.  Protective measures will be reintroduced above 8 percent until the rate drops below 8 percent.  Additionally, modifications may occur depending on local trends.
  • Positive cases on campus.  If any resident, staff, or contractor has a confirmed positive case, protective measures will be implemented.  To reduce the possibility of unvaccinated staff or contractors bringing the virus onto the campus, and preserve reopening measures, they will be rapid-tested every Monday or their first day returning to work.

Definitions

Quarantine vs Isolation  These terms have been used interchangeably during the pandemic but are different:

  • Quarantine keeps someone who might have been exposed to the virus away from others.
  • Isolation keeps someone who is sick or tested positive without symptoms away from others.

Localities  AFRH consults the CDC county view positivity rates and other data available online at https://covid.cdc.gov/covid-data-tracker/#county-view.  For Gulfport we consult Harrison County, MS.  For Washington we consult Washington, DC as well as Prince George’s and Montgomery counties in Maryland because they are so close to the campus. 

Independent Living (IL) and Independent Living Plus (IL+) Residents

Local Trips

IL and IL+ Residents who have been vaccinated will be able to come and go for local trips without a requirement to quarantine upon return to campus.  Vaccinated residents are strongly encouraged to:

  • Limit activities and contact with others for the 7-day period after returning
  • Request a rapid COVID test in the Wellness Center taken no earlier than 5 days after returning to campus

Observe Infection Prevention Protocols Off-Campus

Residents should make every effort to avoid off-campus areas with known high positivity rates or concentrations of people.  These include restaurants, bars, shopping malls, events, and entertainment venues such as casinos and theaters.  Look for places that are well-ventilated—outdoor is better than indoor.

Despite relaxation of local requirements on mask wearing, gatherings, and capacities, we remind all residents and staff to continue observing these protocols at all times when off campus, and that federal rules and orders apply on AFRH property.

Residents are encouraged to interact off campus with family or friends, as long as everyone adheres to the infection control practices of wearing face coverings, social distancing, and proper hand washing.

Residents should not share a vehicle if social distance cannot be maintained.

Visits

Between residents  Vaccinated IL and IL+ residents may visit other vaccinated IL and IL+ residents in their rooms as well as in common areas.  There is no limit on the duration of these visits, however residents should limit the number in an apartment to 2 individuals. All must still maintain social distancing and remain masked.  

Family and friends  IL and IL+ residents may have visitors outside the buildings and in pre-designated areas inside the buildings.  Residents and visitors must follow core infection prevention protocols at all times and visitors must remain in pre-designated areas to minimize contact with other residents and staff.  Indoor visits must be scheduled in advance due to space limitations and to aid contact tracing if needed.

Assisted Living, Long-Term Care, and Memory Support

Local Trips

Current CDC guidance continues to endorse quarantines up to 14 days for vaccinated residents in healthcare settings:

…vaccinated inpatients and residents in healthcare settings should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19. … This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings.
https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html

Healthcare settings include AFRH’s upper levels of care: Assisted Living, Long-Term Care, and Memory Support.  While the pilot program is underway for IL and IL+ residents, we are evaluating options for healthcare residents to make trips off campus that will reduce exposure risk that triggers the need to quarantine.

Visits

Healthcare residents may:

  • Visit each other within their level of care
  • Visit a resident from a different level of care, or with family and friends, in pre-designated areas.  Visits with healthcare residents must be scheduled in advance due to space limitations, staff requirements, and to aid contact tracing if needed.

Participating residents and visitors may not be under quarantine and must follow the core infection prevention protocols at all times.

Amenities and Services 

Residents may use AFRH amenities as described below while maintaining the core infection prevention protocols:

Amenities with shared equipment   Clean hands when arriving and departing, avoid touching your face, and wipe touched equipment after use

  • Fitness center, bowling
  • Swimming pool—masks must be worn when poolside.
  • Art, woodworking, crafts
  • Library, computer lab
  • Cards, games, puzzles—residents may organize games in communal rooms, limited to gatherings of four people.  Avoid games with passed cards or pieces.

Personal services   Only remove mask when directed by service providers

  • Physical and occupational therapy
  • Barbershop/hair salon
  • Medical care—all disciplines may provide services at the Wellness Center.  Visits to an outside physician’s office should be followed by a rapid COVID test taken on the 5th day after the visit.
  • Dental—vapor and aerosol-producing equipment (i.e., cavitron, polishing equipment, drills, sprays) will not be used, or will be supported with additional vacuum.
  • Housekeeping—campus administrators may allow housekeeping services in resident rooms, provided that the cleaning staff shows proof of receiving the vaccine at least 2 weeks before entering the room.

Group activities

  • Chapel
  • Dining/Bar/Lounge  Residents may share a table if they are able to maintain 6 feet distance.  Masks must be worn when not eating or drinking.
  • Smoking area/lounge  Minimize contact time, and wear mask when not smoking.

Leave and Travel

Travel increases your chance of spreading and getting COVID-19 and CDC recommends that you do not travel at this time.  If you must take leave or travel, take these steps to protect yourself and others from COVID-19:

  • Get tested 1-3 days before your trip.  Make sure you have the results of your negative test before you travel.  Keep a copy of your results with you during
    travel; you might be asked for them.  Do not travel if you test positive.  Immediately isolate yourself and follow public health recommendations.
  • Residents returning from leave or travel must self-quarantine for 7 days and take a COVID test no earlier than the 5th day after returning to AFRH.
  • Check https://covid.cdc.gov/covid-data-tracker/#county-view prior to making any travel plans to avoid areas where the county positivity rate is above 8 percent.

Shuttle Buses and Shared Vehicles

Drivers and passengers must sit so as to maintain 6 feet separation, wear masks at all times, and maximize ventilation.

Visitors

All external visitors (family and friends of residents, volunteers, construction/delivery/service vendors) will be considered unvaccinated and potentially infectious.  They must:

  • Screen and disinfect on arrival
  • Follow core infection prevention protocols at all times
  • Limit movement and activities to the areas assigned/directed

Campus Administrators may allow volunteers on campus for activities in IL, IL+, and common areas.  Volunteers will not be permitted in AL, LTC, and MS at this time.

Tours for Prospective Residents

Prospective residents who are vaccinated and submitted preadmission medical records will be allowed to tour the facilities. They will not be permitted in upper levels of care.

New Admissions

AFRH will admit new residents within the parameters of local positivity rates as outlined above.  Incoming residents will follow protocols including testing for COVID-19 prior to arrival, having a health screening upon arrival, and self-quarantining for 14 days if not vaccinated.  Incoming residents will also follow all outlined rules if a companion is needed to assist them with their move-in, or if a moving company is needed.  

Conclusion

AFRH will continue to assess the safety of the Home and local conditions, and further relax protective measures as the environment becomes safer.  We still remain under Department of Defense for oversight and approval of our measures, and must also comply with DOD’s HPCON status as well as Presidential directives and CDC guidance.   Our ultimate goal has been, and continues to be, to maintain a safe environment for our veteran population.

 

JAMES M. BRANHAM

JAMES M. BRANHAM
Chief Operating Officer