With the ILC Global Alliance marking its 30th anniversary this year, members came together to share their perspectives on the impact of COVID-19 on long-term care. While the coronavirus has indiscriminately hit most countries of the world, its impact has been disproportionately felt by the most vulnerable in society, including those receiving long-term care. In Europe alone, it is estimated that up to half of the total number of coronavirus deaths have occurred in long-term care facilities. In order to ensure that our older population is sufficiently protected while still receiving the care they need, will countries have to urgently rethink and adjust how long-term care is provided?

1. A caring world – responding to
the impact of the coronavirus on
long-term care
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2. Welcome from Chair
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Mary Ann Tsao, President, President, ILC
Singapore; co-President, ILC Global Alliance

3. Panel 1
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4. Singapore Czech Republic Netherlands FranceAustralia
https://covid19.who.int/region/euro/country/fr
New cases 14 June 2020, total confirmed cases up to 14 June 2020, Total deaths up to 14 June 2020

5. Professor Julie Byles
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President, ILC Australia

6. 15 cases in last 48 hours (11 June 11.26am)
102 deaths/ 26 deaths in residential aged care
First four cases NSW, all linked to the
Wuhan outbreak, identified in Sydney
in late January – no transmissions
Late Feb - Cases from
Iran, Italy, USA
Late March – cruise ships
Newmarch House
Cedar Meats
NW Tasmania
McAnulty and Ward NSW Health,
New England J Med 8 May 2020
LUCKY !!! 2nd wave ??
Aged care lockdown
Flu-like Sx
73% not tested
May – outbreaks
Figure: https://www.abc.net.au

7. Dr Iva Holmerova
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President, ILC Czech Republic

8. Czech Republic:
SARS-CoV-2 Infection and Long-term Care
Restrictive measures (government) :
No visits to and from nursing homes
Lockdown
Effective– but severe side effects (depression, isolation, anxiety,
neglect…)
Self-restriction (staff stayed with clients – isolated usually 2 weeks-
2 months)
Preventive measures (both official and civil society,
professionals, volunteers,..) :
- Face masks (obligatory but not provided, therefore voluntary
„face masks and PPE movement“)
- distancing, barriers against infection, desinfection…
- Information, education, staff training in preventive measures
Effect ive - with minimum side effects
NO OFFICAL DATA ABOUT LTC YET
• Activity of ILC- Czech Republic
- PhD students active in the face masks and PPE „movement“
- Communication with media (every day for 2 months) – explanations, information, guidance,
support for older people and care workers
- „12 principles: COVID-19 and older persons“- broadly disseminated
- Guidance (with the State Health Institute) – prevention and care of people with SARS Cov 2
positivity
- Recommendations (with the Czech Geriatric Society) for medical care of SARS COV 2 positive
persons
- Translation of Alzheimer Europe recommendations…

9. Singapore Czech Republic
10 million population
Netherlands FranceAustralia
https://covid19.who.int/region/euro/country/fr
New cases 14 June 2020, total confirmed cases up to 14 June 2020, Total deaths up to 14 June 2020

10. Professor Tineke Abma
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President, ILC Netherlands

11. Longterm care in the Netherlands: update
Prof. dr. Tineke Abma
8 June 2020

12. • February 27th first case, Brabant epicenter, first deaths in LTC
• June 2020 more than 6000 deaths, 90% 60 years and older
• Underreported COVID-19 deaths (restrictive recording)
• Limited capacity: personal protective material and testing
• Decision-making: led by medical experts, ‘tyranny of the urgent’,
exclusion other voices
• Now need for reflection on moral dilemma’s and values: freedom vs
safety, health vs wellbeing etc.
• Mediatisation and framing pandemic (IC beds, hospitals ..)
ILC the Netherlands

13. Rijnsburgerweg 10 | 2333 AA Leiden | 071-524 0960 | info@leydenacademy.nl | www.leydenacademy.nl

14. Dr Didier Halimi
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Scientific Advisor, ILC France

16. Mary Ann Tsao
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President, ILC Singapore; co-President, ILC
Global Alliance

17. NURSING HOMES
Strict social distancing policies imposed early, with restrictions on visits
Two small clusters of outbreaks with sporadic cases scattered across other 16,000+ beds
All staff and residents regularly swabbed for Covid
Staff housed onsite or in hotels and highly subsidized by the state
Total deaths of 26, of which 4 are nursing home residents
COMMUNITY BASED LONG-TERM CARE
All community-based care disrupted due to suspension of
center-based care; only essential home-based services delivered
IMPACT ON OLDER PEOPLE & CAREGIVERS
Caregiver distress due to 24/7 responsibility
Persons with dementia particularly affected
Older people experienced increased mental health issues and
functional decline
IMPACT OF COVID-19 ON LONG-TERM CARE IN SINGAPORE
*Tan, L. F., & Seetharaman, S. K. (2020). COVID-19 outbreak in nursing homes in Singapore. Journal of Microbiology, Immunology, and Infection.
https://www.channelnewsasia.com/news/singapore/covid-19-coronavirus-dementia-circuitbreaker-caregivers-12721144
https://www.straitstimes.com/singapore/health/elderly-hit-hard-by-social-isolation-amid-circuit-breaker-measures

18. Q&A
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19. Panel 2
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20. Canada Argentina South Africa Dominican RepublicUnited Kingdom
https://covid19.who.int/region/euro/country/fr
New cases 14 June 2020, total confirmed cases up to 14 June 2020, Total deaths up to 14 June 2020

21. Margaret Gillis
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President, ILC Canada

22. Canada: Challenges to a Caring World
• Pandemic has revealed severe human rights abuses in LTC.
• As of June 2020, >90,000 of COVID-19 cases. 7,800 deaths, 82% in
LTC. First death in LTC on March 9th, by early April a national crisis.
• Horrific abuses documented in media and by the Canadian Armed
Forces who were called into worst LTC homes.
• Outcome: Rise in activism, need for reform and a UN Convention.

23. Baroness Sally Greengross
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President/ Chief Executive, ILC UK

24. COVID-19 and care in the UK
 Government care home support package and
£600m to support providers
 More than half (57%) of all COVID-19 deaths
in the UK projected to be in care homes
(LaingBuisson, 2020)
 Significant delays in getting PPE to frontline
care staff, making testing available and
publishing guidance
 Care home residents initially omitted from
daily statistics on COVID-19 fatalities
 1 in 4 people who have died of COVID-19 in
the UK had dementia (Alzheimer’s Society)
In the current climate, would you be
happy for one of your close family
members to go into residential care
or retirement housing?
Yes No

25. Professor Ricardo Jauregui
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Member of Board of Consultants and Former
Executive Director, ILC Argentina

26. José R Jauregui MD PhD
Former Executive Director ILC Argentina
IAGG President Elect 2021-2025
A caring world – responding to
the impact of the coronavirus on
long term care

27. The impact of
COVID–19 on
Older Persons on
Long Term Care in
Argentina
• In Buenos Aires we have till today 93 official LTC residences, 502
positive cases and 77 death.
• This situation implies that of the 18.500 old persons living there.
There´s a rate of 2,7% of positive cases, a total mortality rate of
0.4%,
• in those that have COVID, the rate is 15%.
• The mortality rate in those over 80 yr. in the community is higher,
about 20%.
• In Argentina, we´ve 28764 confirmed, 802 death, 2.7% case-fatality
and 1.76 death/100k pop.
• It is not known for sure what it´s happening with caregivers at
home
• Infections are focused on big cities, such as Buenos Aires and great
Buenos Aires.
• OP are figthing really well, they show in some samples good levels
of resilience, and others of course are in a precaurious situation cos
their low incomes or their Fragility levels.
• We have good protocols in our residences, the problem is the wide
variety of them, in terms of human resources quality, PPE
availability, costs, circulation and multiple jobs of the people
working there.
• All the digital and IA technology are been used to connect and
support our elders.
• At the present time, Gerontological arena, goverment officers,
health and security workers and big part of the community are
involved in caring for them.
• Worst situation is that Winter is already here……

28. Sebastiana Kalula
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co-Director, ILC South Africa

29. International Longevity Centre Global Alliance Webinar, 18 June 2020
A caring world - responding to the impact of the Coronavirus on long-term care.
The case in South Africa
• Demographic and epidemiological profile
• Population profile (59 M, age ≥ 60 yrs =5.3 M (9%))
• Covid-19 in South Africa (1st +ve case 5th March, lockdown 26 March. Cases & fatalities)
• The LTCF population
• Residential care facilities (1150 LTCF; 415 (0.36%) registered with govt)
• Government subsidy (cover 25-52% frail care cost
• Government’s response to Covid-19
• Directive, protocol and guidelines
• Infection prevention/management challenges
• Resources 200 masks, 50 l sanitiser
• Infection control (Cost PPE; challenges isolation; social distancing; Staff (public transport, staff replacement)
• Retaining connectedness with family and friends
• No visitation (Telephone, video call, WhatsApp –challenges)

30. Rosy Pereyra
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M.D., President, ILC Dominican Republic; ILC
Global Alliance Co-President

31. A Caring World Responding to the impact of Corona Virus
on Older People in Long Term Care
• The first case of COVID 19 in the Dominican Republic was diagnosed on the 1st of March. It was imported from
Italy by a 64 years old man that had entered the country on the 22nd of February. He was inmediately put on
isolation.
• The Ministry of Health activated then an Emergency Committee that would organize the protocols to manage
what later would became a pandemic but at first did not do enough testing to isolate and follow up contacs.
• To the 16th of June we have 23,686 confirmed cases. 615 confirmed deaths. Death rate 2.5
• The majority of them are registered in the main urban áreas, though the first hot spot developed in San Francisco
de Macoris, a province in the north of the country.
• However, we have not done too bad regarding our long term care facilities. The DR has 49 registered long term
care facilities. We have only confirmed cases in 5 of them. In total we have 16 confirmed cases with 5 deaths.
• The success has ben the protocol implemented with no visits from the begining of the pandemic and closed
vigilance of health care workers and personnel working in those institutions. The residents have been able to keep
in touch with their relatives through What’sApp calls, Zoom and face time. One of our private homes installed an
area where relatives can come and see their loved ones through a glass and there is a microphone that allows
communication.
• We have been in quarantine since the 10th of March and that includes, the closure of all activities except essential
services, public transport was suspended and it was accompanied by a curfew from 5: 00 Pm to 5:00 Am. This state
of emergency has been recently extended till July 1st though we have started the escalation of the measures. The
wearing of face mask in public places is compulsory.
• Challenges: Now that the opening of the economy has started we have seen, as any other country an increase in
new cases and it will depend on the citizens how that is going to progress.

32. Q&A
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33. Closing remarks
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Rosy Pereyra, M.D., President, ILC Dominican
Republic; ILC Global Alliance Co-President

34. Thank you
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