Long-Term Care Facilities (LTCFs) During the COVID-19 Pandemic—Lessons From the Asian Approach: A Narrative Review

Abstract

Objectives

The COVID-19 pandemic put into question the organizational skills of LTCF. The containment measures implemented in several Asian countries avoided heavy death tolls in LTCF in contrast to other countries across the globe. The aim of this review is therefore to investigate and illustrate the measures that were undertaken in Asia to contain and prevent the spread of the COVID-19 pandemic in LTCF.

Design

Narrative review.

Setting and Participants

Asian older subjects institutionalized in LTCF.

Methods

Broad literature research from July 2020–April 2021. The following search terms were used: “COVID-19 Nursing homes” AND the country of interest or “contact tracing.” Eligible categories for inclusion comprise editorials, reviews, government guidelines, letters to the editor, and perspectives. The COVID-19 measures were then subdivided into different sections and compiled into an evidence table.

Results

Prompt measures were put into action since the beginning of the pandemic that avoided the spread of COVID-19 in LTCF. Examples range from simple acts of proper hand hygiene and environmental disinfection, swab testing, social distancing, preventive measures on health care workers, organizational measures such as quarantine, outbreak control, visitor restrictions, relationship with acute hospitals, and admission policy. Technology also played a fundamental role in promoting social distancing by using specific robots and in managing contact tracing.

Conclusions and Implications

The Asian preventive control guidelines are similar to those recommended elsewhere. Difference in timing and past experience with prior outbreaks such as SARS and MERS might have favored the Asian response. Furthermore, sociocultural values toward older persons by protecting and making sure that LTCF are part of the health care system could have also played a role.