Why are the PCHs following guidelines that are sometimes different than what is recommended to the public?  

Personal Care Homes follow different guidelines as residents tend to be older, tend to have pre-existing medical conditions, and live in shared spaces, which puts them at risk for more severe disease and higher mortality if infected with COVID-19.  The Public Health guidance identifies long term care as a setting with high risk or vulnerable populations.  The public health orders do ‘not apply to a facility where health care or social services’, allowing for different direction to be provided.

Why do PCHs need these guidelines if the residents are vaccinated?

Vaccines add significant protection from COVID, but does not result in zero risk.  There are lots of things residents can do with less risk, when they and their loved ones are vaccinated.  Vaccinated residents can go on social outings, and entertain general visitors in their room.   Although vaccines add protection, public health guidance still requires that we should all be cautious in confined spaces, in crowds, and in close contact with others.  This is because individuals may still be able to carry the virus and may be able to spread it to others, even if they are vaccinated or not showing any symptoms. Physical distancing, hand hygiene and personal protective equipment, such as masks and eye protection, continue to be necessary to keep our residents safe.

Why can hairdressers not work in more than one PCH?

Hairdressers work closely with many residents during the course of their day.   COVID-19 can spread more easily in shared living situations and when individuals are in close contact with one another. Hairdressers wear medical masks and eye protection to reduce the risk of COVID-19 transmission, and restricting their work to only one PCH is another strategy to reduce the risk of infection.

Why is physical distancing still necessary between residents if they are fully vaccinated?

The vaccine will help to protect individuals from getting ill from COVID-19, however even if they don’t get ill they may still be able to carry the virus and may be able to spread it to others.  Physical distancing is a strategy to mitigate and reduce the potential risk of spread of COVID-19.

Why are group sizes in the public different than what is allowed in a PCH? 

Current Public Health Orders provide exceptions to a facility where health care or social services are provided, including Personal Care Homes. The group sizes for residents and their visitors are outlined in the LTC Resident Visitation Principles.  Group sizes can vary and are dependent on COVID-19 activity and pandemic level (which is determined by the Chief Provincial Public Health Officer), and the amount of space and support available at the site to allow for physical distancing.

For recreation activities, sites are following the Infection Prevention and Control Guidelines.  During group activities, residents and staff are spaced to maintain 2 meters/6 feet between them.  The size of the group will be dependent on the amount of space and support at the site to allow for physical distancing.

Why can the PCHs not open the doors and allow all vaccinated or unvaccinated visitors come in as they would like (i.e., any hours and any days of the week)?

COVID-19 remains a threat.  To minimize the risk of Covid-19 outbreaks in Long Term Care, the resident visitation principles remain in place.  The number of visitors a resident can have varies, and is dependent on COVID-19 activity and pandemic level (which is determined by the Chief Provincial Public Health Officer) and the amount of space available at the site to allow for physical distancing.  Visiting hours and number of visitors to the facility are determined by the facility operators, in order to ensure they have the resources available to manage the visits in a safe manner.

Why can fully vaccinated residents not go on outings to multiple locations at one time i.e., shopping in different stores?

The more contacts an individual has, and the more time an individual spends in close proximity with others, the more opportunity there is to catch Covid-19.  In an effort to keep all residents of the care home safe, direct travel to a destination and back to the facility is recommended.

For outdoor visits, why are masks and physical distancing still required? 

Masking and physical distancing are still strongly encouraged as COVID-19 can spread even if residents and visitors are vaccinated and residents are considered more vulnerable than the general population.

If I am a fully vaccinated visitor or designated family care provider, why do I still need to wear personal protective equipment?  

Personal protective equipment (masks and eyewear) is effective at preventing and reducing the spread of COVID-19.  Vaccination status does not guarantee COVID-19 cannot be acquired or spread.

Why do General Visitors have to maintain the 2m/6ft distance when they are fully vaccinated and Designated Caregivers do not have to be fully vaccinated yet can come within 2m/6 ft? 

General visitors and designated family care givers are both recommended to maintain 2 metres/6 feet of distance between themselves and the resident.  However, designated family caregivers play a role in the care of the resident, which may mean they are at times unable to maintain physical distancing.  Designated family caregivers are provided with a procedure mask (level 1) and eye protection, and are provided education in infection prevention and control measures in order to minimize the risk of spreading COVID-19.

Why do volunteers need to show proof of vaccination to go to more than 1 PCH?

Volunteers are included in the Public Health Order that restricts staff movement at personal care homes.  These orders require that volunteers limit their service at one personal care home unless they show proof of vaccination.

VARIATION BETWEEN PUBLIC HEALTH ORDERS & PCH GUIDANCE FREQUENTLY ASKED QUESTIONS

1. Why are Personal Care Homes (PCHs) following guidelines that may be different than what is recommended/required by public health orders that apply to the public?

Personal Care Home residents are generally older, with pre-existing medical conditions and live in shared spaces. These put them at risk for more severe disease and higher mortality than the general public if infected with COVID-19.
Public Health identifies long term care as a setting with high risk or vulnerable populations and public health orders do not apply “to a facility where health care or social services” are provided. Throughout the pandemic specific guidance has been followed to keep this population protected.

2. Residents are now vaccinated, so why do PCHs continue to need these guidelines?

Vaccines add significant protection from COVID, but they do not result in zero risk. With high vaccination rates in PCHs, there are a number of activities that residents are now able to enjoy/resume with less risk, such as social outings and the ability to entertain general visitors in their room.  Although vaccines add protection, public health guidance still requires caution in confined spaces, in crowds, and in close contact with others. Individuals may still be able to carry the virus and may be able to spread it to others, even if they are vaccinated and/or not showing any symptoms. Physical distancing, hand hygiene and appropriate use of personal protective equipment, such as masks and eye protection, continue to be necessary to keep PCH residents safe.

3. Why is physical distancing still necessary between residents if they are fully vaccinated?

Vaccinated individuals may still be able to carry the virus and may be able to spread it to others.  Physical distancing is a strategy to mitigate and reduce the potential risk of spread of COVID-19.

4. Why are group sizes in the public different than what is allowed in a PCH?

Current Public Health Orders provide exceptions for facilities, including PCHs, where health careor social services are provided. The group sizes for residents and their visitors are outlined in the LTC Resident Visitation Principles.  Group sizes can vary and are dependent on COVID-19 activity and pandemic level (which is determined by the Chief Provincial Public Health Officer), as well as the amount of space and support
available at the site to allow for physical distancing. Recreation activities follow Infection Prevention and Control Guidelines, including physical distancing of 2 meters/6 feet between residents and staff. The size of the group will be dependent on the amount of space and support at the site to allow for physical distancing.

5. Why aren’t visitors (vaccinated and unvaccinated) allowed to come and go from PCHs as they please (e.g. any hours, any days)?

COVID-19 remains a threat to PCH residents who may be more vulnerable to serious illness if they contract the virus. To minimize the risk of COVID-19 outbreaks in Long Term Care, resident visitation principles remain in place.  The number of visitors a resident can have varies, and is dependent on COVID-19 activity and pandemic level (which is determined by the Chief Provincial Public Health Officer) and the amount
of space available at the site to allow for physical distancing. Visiting hours and the number of visitors permitted are determined by individual facility operators, in order to ensure they have the resources available to manage visits safely.

6. Why are fully vaccinated residents not able to go on outings to multiple locations at one time (e.g. shopping trips to multiple stores)?
The more contacts an individual has, and the more time an individual spends in close proximity with others, the more opportunity there is for exposure to COVID-19.  In an effort to keep all PCH residents as safe as possible, residents who leave the facility for a social outing are recommended to travel directly to their destination and back to the facility.

7. Why are masks and physical distancing still required during visits that occur outdoors?

Masks and physical distancing are still strongly encouraged as additional protection for PCH residents, even if they are fully vaccinated, as an additional protection for residents (who are considered more vulnerable to serious illness from COVID-19 than the general population).

8. I am a fully vaccinated designated family caregiver or visitor. Why do I need to wear personal protective equipment when I visit?

Personal protective equipment (masks and eyewear) is effective at preventing and reducing the spread of COVID-19 and continues to be required as an additional protection for PCH residents.

9. Why do fully vaccinated General Visitors have to maintain physical distancing when visiting? Why is this different from the requirements of Designated Family Caregivers?

Physical distancing of 2 meters/6 feet continues to be recommended whenever possible, including for designated family caregivers. As important partners in the care of PCH residents, designated family
caregivers often perform tasks that make physical distancing not possible. They are therefore provided with additional personal protective equipment (level 1 mask and eye protection) and
education in infection prevention and control as protection for moments and tasks when maintaining physical distancing is not possible.

10. Why do volunteers need to show proof of vaccination to be able to work at more than one PCH?

Volunteers are included in the Public Health Order that restricts staff movement among more than
one PCH. For volunteers who wish to work at more than one PCH, these orders require proof of vaccination.

Aug. 4, 2021 COVID-19 Public Health Orders vs PCH Guidance – FAQ
2

With increasing Covid-19 vaccination rates among our residents, staff, and in the community, and following the provincial announcement of the change to Pandemic Level Orange, we are pleased to announce further enhanced visitation opportunities and support social leaves for residents.

Enhanced Visitation:

End of Life: Increased visitation timeframe (4 weeks), up to 4 Designated Family Caregivers (2 may visit at a time), up to 2 unvaccinated/vaccinated general visitors

Designated Caregivers: no change to current visitation.

General Visitors (indoor/outdoor):

• In the resident’s room- up to 2 vaccinated general visitors
• All-Season Visitation Shelter/Designated Indoor Visitation Room – up to 2 unvaccinated/vaccinated general visitors
• General visitors from out of province may visit in the all-season visitation shelter/designated indoor visitation room with proof of vaccination
• Outdoor Visits – a reasonable number of general visitors per resident may visit at a time if physical distancing can be maintained; outdoor visitation capacity will vary by site

The principles of frequent hand hygiene, physical distancing, and visitor screening continue to be important, effective measures to minimize the risk of Covid-19.

Criteria for Social Leaves:

If the resident AND driver are fully vaccinated –

• Social leaves are permitted up to full day, overnight stays are not recommended
• Direct travel to the destination and back to facility is recommended to minimize exposure and contacts.

If either the resident or the driver is NOT fully vaccinated:

• Each resident can designate up to a maximum of two drivers/escorts.
• Passes are limited; a maximum of 2/week for a maximum of 2 hours.

Physical distancing and masks are required in the vehicle and recommmended to be worn unless for the purpose of eating/drinking. Perform hand hygiene frequently.

Please contact recreation department to schedule a social leave, or to designate your 2 unvaccinated driver/escort.

Fully immunized residents and visitors are those who have received both doses of the COVID-19 vaccine, and whose second dose was received more than 14 days before the planned visit. Both the resident and the visitor(s) must meet these criteria, visits must be scheduled and visitors will be required to demonstrate proof of full immunization and photo identification before entry.

Please note, visitation changes will take effect July 5, 2021. Friends and family can call our Recreation Department at 1-204-482-6601 ext. 125 to book a scheduled visit or a Social Leave.

We know the last number of months have been difficult and have required limits on social visits and interaction. We look forward to continuing to support time spent with your loved ones.

All visitors will continue to be screened before entry, masks must be worn, and anyone with symptoms of COVID-19 will not be admitted.
We will regularly review opportunities to improve and will learn as we go. We are grateful for your continued cooperation and patience.

As levels of COVID-19 remain high in Manitoba, our efforts to provide residents with safe access to
visits by friends and family members continue. We continue to take every precaution to keep your loved
one safe however we know that social visits are so important to the health and well being of our
residents.

With high vaccination rates among our residents and staff, and in the community, we are so pleased
to be able to offer expanded social visitation for our fully immunized residents and their fully
immunized visitors.

This will include the ability for general visitors to visit residents, indoors, including in some instances in
the resident’s room or in the courtyard. In addition, where physical distancing can be maintained, more
than one visitor at a time may also be present. Please check with us to confirm whether this is possible
for visit appointments with your loved one.

Please note, this change will take effect June 21. 2021. Please contact our Recreation Dept.
(204) 482-6601 Ext: 125 after June 16, 2021 for information or to book a visit.

Fully immunized residents and visitors are those who have received both doses of the COVID-
19 vaccine, and whose second dose was received more than 14 days before the planned visit.
Both the resident and the visitor(s) must meet these criteria, visits must be scheduled and visitors will
be required to demonstrate “proof of full immunization” and “photo identification” before entry.

Please note: this change only applies to general visitors. There is no change for designated family
caregivers. Full details are available in the attached frequently asked questions document.

We know the last number of months have been difficult and have required limits on social visits and
interaction. We look forward to welcoming fully vaccinated visitors back into our facility and we know
you and our residents will be excited by this small step toward “normal” too.

As we slowly expand visitation, we must all continue to take every possible precaution to protect the
health of your loved ones. All visitors will continue to be screened before entry, masks & eye protection
must be worn, and anyone with symptoms of COVID-19 will not be admitted.

We will regularly review opportunities to improve and will learn as we go. We are grateful for your
continued cooperation and patience.

Across Manitoba, personal care homes and other long-term care facilities have taken every possible step to decrease the risk of COVID-19 within our facilities. This has included strict
infection and control precautions, enhanced cleaning protocols, visitor restrictions, daily screening of staff before shift and the introduction of personal protective equipment. These
efforts continue at all facilities.

For the safety of your loved ones, and at the requirement of public health officials, a single-site staffing model for nursing and support staff working in licensed personal care homes was
implemented in May 2020. This limited the number of licensed personal care homes that nursing and support staff work in to one.

In recent months, Manitoba’s COVID-19 immunization program has prioritized Personal Care Home residents and employees for access to the vaccine. With most PCH residents now
vaccinated and all staff eligible to receive the vaccine, personal care homes may begin considering exemptions to the Single Site Staffing Order.

Families and residents can be assured that the exemption process will be very carefully managed. Only those staff who have acquired protection from the virus will be approved for the
exemption and facilities will continue to support the option for staff to work in a single site wherever possible.

Eligible staff are those who have been immunized with at least one dose of the COVID-19 vaccine. Immunized staff must have received the vaccine dose more than 14 days prior to the
exemption being granted). Staff must also provide proof of immunization and will be required to provide proof of receiving the second dose.

We understand you may have questions about other changes that may occur as more Manitobans are vaccinated. At this time, all other preventative measures remain in place. Visitor
restrictions continue to be reviewed, with the latest information available at: https://sharedhealthmb.ca/files/covid-19-pch-visitation-principles.pdf

Manitoba continues to pursue the implementation of the COVID-19 vaccination program for residents in personal care homes, given the particular vulnerability of our resident population.

Vaccination is one of the many tools in place to prevent COVID-19 transmission that is being implemented in addition to the many other precautions we have put in place over the past year to protect your loved one.

While we understand the COVID-19 mRNA vaccine to be approximately 95 per cent effective after 7-14 days following the second dose, we do not yet know much about how long protection lasts or whether vaccinated persons can still unknowingly infect others. While evidence continues to emerge, our residents remain a high-risk population for severe illness related to COVID-19 and we must continue to be vigilant with efforts to prevent cases of COVID-19 within our facility.

This means that preventative measures will remain in place at our facility for the foreseeable future. This includes:

• staff, resident and visitor screening (including designated family caregivers and general visitors as well as anyone else seeking entry to our facility);
• 14-day isolation of newly admitted or readmitted residents;
• frequent and thorough hand hygiene;
• physical distancing;
• appropriate use of non-medical masks and/or facility-provided personal protective equipment; and
• visitor restrictions including limits to the number of permitted visitors, requirements of where visits may occur, and limitations on leaves of absence for non-essential or social purposes.

We are carefully balancing these precautions with the known benefits of socialization and recreational activities. For facilities that are not experiencing a COVID-19 outbreak, the following activities may occur, with the noted precautions in place:

Hairdressers may be permitted, but are only permitted to work in one PCH. Screening must be in place prior to entry, as well as physical distancing, occupancy limits in the designated resident hair care area, and enhanced cleaning and disinfecting protocols must be followed. Masks must be worn by all hair salon staff as well as residents who are able to tolerate wearing a mask.

Recreational and group activities may be permitted, with physical distancing between residents and any other participant. Participation must be limited to residents from a single unit or single floor and materials may not be shared unless they can be cleaned and disinfected between each resident.

Covid-19 Vaccine: All Tudor House residents that consented to receiving the Covid Vaccine received their 2^nd dose today by IERHA Public Health FIT Team Nurses. The Vaccination process went very well this morning and everyone was done by lunchtime. The few new residents that received a first dose will be followed up by Public health at a future visit for the 2^nd Dose.

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New Admisions during Pandemic Response System Level RED (CRITICAL):  We are providing advance notice to all families with residents in Private Rooms that during the Pandemic Response System Level RED (CRITICAL) it will be necessary to “Temporarily” move a resident in a private room to accommodate a New Admission being placed in “Quarantine” for a full 14 days. New residents from hospital, other nursing homes and the community need to be placed in isolation to protect our other residents and ensure there is no COVID infection risks to the facility. We definitely do not want to go back into an Outbreak situation again.

To be fair and equitable to all residents we are trying to take turns so it is not always the same resident that must move. Families will be notified in advance when this is occurring and which double room they will be moving to for the two weeks. Before they return to their own room it will be cleaned & disinfected and the room will be restored to as close as we can to how it was. We will move only stable residents and only within the unit or cohort. Residents on end-of-life or with special care needs will not be moved.

We sincerely regret the necessity for needing to do this but it is very necessary to keep all our residents safe.   Our building is very old, 50 years, and we have many double rooms and shared washrooms, hopefully in the future we can get renovations that will make this process unnecessary as each resident will have a private room. We are advocating for these infrastructure improvements and hopefully they will come soon.

If you have any questions or concerns please speak to your assigned Nurse Manager for more information. They can be contacted at the below contact information. Again, thank you for your patience and support during these difficult times. Stay safe, wear a mask and social distance. 😊

Majel Dignadice RN Maples Hall
Tel: (204) 482-6601 Ext: 138

Laetitia Martyniw RN BN Poplar Oak Hall
Tel: (204) 482-6601 Ext: 139