OAKLAND (CBS SF) — Following increasing reports of coronavirus infections at nursing homes in California and the Bay Area, Alameda and Contra Costa counties have issued an order for all skilled nursing facilities to follow new guidance to stop the spread of the infection.

Alameda County Health Officer Dr. Erica Pan and Contra Costa County Health Officer Dr. Chris Farnitarno issued an order for all licensed facilities, contractors and essential visitors entering those sites to comply with, beginning at 12:01 a.m. on Tuesday.

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Among other things, the order requires everyone coming into a nursing home to have their temperature taken before coming inside the facility, and would prohibit anyone from entering who has a temperature of 100 degrees or higher.

The order would also require people at care facilities to wear masks that cover the nose and mouth at all times and for residents to wear them at all times when outside of their rooms.


“People living and working in congregate living settings, like skilled nursing and residential care facilities, are at increased risk of infection because COVID-19 spreads between people who are in close contact with one another,” said Dr. Pan in a prepared statement. “Due to underlying health conditions and age, the residents face higher risk of serious health consequences including hospitalization and life-threatening illness.”

“This order is another precaution we can take as a community to protect our vulnerable residents,” said Farnitano.

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According to the order, all licensed facilities and agencies must:

  • Implement temperature screenings for all staff, contractors and other essential visitors before allowing entrance or commencing services in the facility.
  • Ensure all individuals who enter or provide services to the facility self-evaluate for mild to moderate symptoms related to COVID-19. Symptoms include fever, sore throat, coughing, shortness of breath or general weakness in the past 7 days.
  • Prohibit entry to anyone who has a temperature of 100.0° F or 37.8° C or greater, feels like they have a fever, or has symptoms identified through self-evaluation.
  • Implement masking among staff, residents and other essential visitors to cover their nose and mouth while in the facility and, for residents, outside their rooms. Appropriate and recommended Personal Protective Equipment must be worn by staff when available if there is a confirmed or suspected case of COVID-19 at the facility.
  • Cancel all group activities and communal dining. Staff and residents who must leave their rooms should practice physical distancing and remain six feet apart.
  • Notify acute care hospitals, Emergency Medical Services and transport agencies if a resident who is suspected or confirmed of having COVID-19 is being transferred to an acute care hospital. If the facility already has COVID-19 case(s), then they must notify EMS and the receiving hospital of potential COVID-19 exposure.
  • Avoid, as much as possible, staffing scenarios that use employees who have worked at another Licensed Facility or Other Agency in the past 14 days while maintaining adequate staffing at the facility. Facilities must keep a daily log of employees present, identifying any other facilities the employees have worked at in the previous 14 days, and that log must be produced immediately if requested by any staff member of the Alameda or Contra Costa County Public Health Departments.

“This order outlines public health guidance that was given previously and that all facilities should be following,” said Terry Hill, MD, COVID-19 Medical Director for the Alameda-Contra Costa Medical Association. “Now that we are seeing increasing cases and outbreaks in long-term care and residential facilities, we believe this new Order will help keep patients safer by making compliance mandatory.”

Jaime Patino, a Union City councilman whose grandmother–a Gateway resident–died Monday evening after testing positive for COVID-19, said the county’s new rules are “too little, too late.”

“.Where were you two or three weeks ago? This should have been done a long time ago? Now you’re barely doing it after they had the outbreak? There has to be better oversight once we get through this,” Patino said.

Alameda County has also activated a Long Term Care Facilities Task Force to work with facilities to prevent and mitigate outbreaks.  On Friday Gov. Gavin Newsom announced the state has launched “SWAT teams” of infectious disease experts to stem growing outbreaks of coronavirus in senior care facilities across the Bay Area and the state.


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