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A Study on the COVID‐19 Outbreaks in Long-term Care Facilities of Seoul and the Related Issue

Author: 
Chang-Woo Shon · Min Suk Yoon · Seong-Ah Kim · Yun-Jung Cho

Of the 3,595 long-term care facilities in Korea, 46 long-term care facilities (1.3%) had COVID‐19 outbreaks, and a total of 1,139 people were confirmed with COVID‐19 in relation to long-term care facilities. In Seoul, 13 out of 205 long-term care facilities (6.3%) had COVID‐19 confirmed cases, and the number of confirmed cases in the long-term care facilities was 185 (65 workers, 120 residents). 
Because elderly people with underlying diseases live in groups in long-term care facilities, once COVID-19 has been introduced into a long-term care facilitie, it has the potential to result in high death rates among residents. Of the 981 deaths of COVID-19 in Korea, the number of deaths from long-term care facilities was 105 (10.7%), accounting for relatively high proportion (as of January 4, 2021).
Several problems were diagnosed as a result of focus group interviews with Seoul city officials and directors of long-term care facilitiess including ① lack of timeliness and practicalness of the COVID-19 prevention and control guidelines, ② absence of risk communication system and channels, ③ lack of infection prevention education system for care workers in long-term care facilities, ④ document-based formal and passive infection monitoring, ⑤ lack of comprehensive supports for elderly, ⑥ lack of manpower for care workers for emergency and increased work of care workers in long-term care facilities, ⑦ multiple occupancy rooms structure, and so on. 
Future tasks to strengthen response capacity for COVID‐19 of long-term care facilities in Seoul should include ① reinforcement of standards for nursing staffing for long-term care facilities, ② expansion of visiting care workers, ③ establishment of infection prevention education system for care workers in long-term care facilities, ④ establishment of risk communication system and channels, ⑤ normalization of the operation of long-term care facilities, ⑥support for economic losses due to the operational restrictions of long-term care facilities, and ⑦ conversion of monitoring method for long-term care facilities. In addition, there should be consideration for institutional improvement related to the operation of long-term care facilities such as ① strengthening cooperation between long-term care facilities and local medical institutions and introduction of telemedicine, ② structural transformation to reduce population density in long-term care facilities, and ③ redefining the function of long-term care through the establishment of community care.