The Ministry of Health advises residences to submit workers who refuse to be vaccinated or have not completed the pattern to temperature controls and at least two weekly diagnostic tests, and even consider their transfer or do not incorporate those who are not immunized.
The document “Adaptation of measures in residences for the elderly and other residential social service centers in a context of high community transmission”, seen in the Interterritorial Council, advises not to incorporate new professionals until they have started their vaccination schedule “unless is strictly necessary “.
This is a series of recommendations prepared by the alert presentation and approved by the Public Health Commission, which insists on the importance of all people passing through a residence, whether they are workers or visitors, vaccinated or not. , maintain hygiene and prevention measures to stop the rebound in cases that is occurring.
For new entrants, the presentation proposes guaranteeing their vaccination with sufficient notice; If they are urgently admitted and not vaccinated, “precautionary measures” will be taken until the regimen is completed and a diagnostic test for active infection will be carried out upon arrival.
In the case of non-vaccinated residents, it proposes this same measure “in certain situations taking into account the epidemiological situation of the geographical area in which the residence is located or the profile of the outings” according to their duration or the activities carried out.
They will be closely monitored for symptoms, in which case preventive isolation and immediate testing will be carried out.
For vaccinated residents, it is not advisable to carry out periodic screenings or serologies to verify the effectiveness of the vaccination; in situations of high community transmission, the community will study whether a test is made upon leaving and / or re-entering the center after prolonged absences.
If the level of transmission is high, the location and organization of the visits, their supervision or not and the number of visitors, as well as the organization and duration of the outings, “will be set by the competent authority, always guaranteeing the measures of adequate prevention “.
Regardless of whether or not he is vaccinated, the visitor will have to maintain non-pharmacological measures to prevent transmission; when the situation is low community transmission and if they are vaccinated, “one could consider making these measures more flexible.”
All personnel will have to have specific and updated information and training on prevention measures before joining the job.
The paper rules out forcing them to be vaccinated, but it does advocate recommending “actively” that new staff do so, “since a new worker should not be incorporated into a residential center until they have started their vaccination schedule, unless it is strictly necessary. “.
If this is the case, “your vaccination will be scheduled as soon as possible and precautionary measures will be taken until the vaccination schedule is completed.”
For those who are already active but do not want to be vaccinated or have not done so in full, it proposes reinforcing the prevention and control measures of transmission, in particular the use of appropriate respiratory personal protective equipment (PPE) “throughout the day labor”.
And it proposes to carry out, taking advantage of the resources of the centers, to carry out daily temperature controls and diagnostic tests for active infection on a regular basis (minimum 2 times a week) “taking into account the risk to third parties that this situation entails.” Even “the job change can be assessed.”
In any case, it advises to actively promote vaccination among workers, identify the causes that reduce access to the drug or its acceptance, and develop strategies to maximize coverage for this group.
In those who are vaccinated, and if there is a situation of high community transmission, he recommends periodic tests “once a week or every two weeks and upon return from absences for vacation or other reason.”
If they are close contact, they will be exempt from quarantine, as stated in the Strategy for Early Detection, Surveillance and Control of COVID-19; They will be followed up with PCR preferably and if not possible, with another.
“Ideally, two tests will be carried out, one at the beginning and another around 7 days after the last contact with the confirmed case. They should take extreme measures of prevention, including the use of appropriate PPE,” says the text, which opens the door to that public health authorities can establish exceptions “in certain situations” after a risk assessment.
Before the appearance of a suspicious case in a vaccinated resident or worker, they will be isolated until the result of the test is obtained: if it is positive, the isolation will be maintained and close contacts will be studied, as well as a sectorization in living units stable that facilitate the development of residential benefits and the traceability of possible cases.
Protection should be special in unvaccinated residents, if possible by placing them in individual rooms. The detection of a single case in these institutions will be considered an outbreak for intervention purposes and will involve the application of the necessary action measures.
The regime of visits and exits of residents who are not in isolation or quarantine “will generally be maintained normally”, although it may be adapted based on the assessment made by those responsible for public health, in coordination with those responsible for social services the community, the epidemiological situation and the structure of each center.