Facilities for out-of-home isolation and quarantine

A checklist for setting up policies and facilities for out-of-home isolation and quarantine

Checklist

1. Budget

• Determine available budget and existing resources.

  • Cases and contacts who are at highest risk for not meeting basic needs in a way that is safe for themselves or others should be prioritized to receive housing support.

2. Alternative housing services

• Determine alternative housing to support people in isolation or quarantine. See Sample eligibility criteria for out-of-home isolation or quarantine.

• 2.a For non-hospitalized cases. On a voluntary basis, alternative and safe housing, with wrap-around and social services, should be offered to all cases who:

  • live with elderly or other high-risk individual

  • are precariously housed

  • are unsheltered or homeless

  • live in group settings and are unable to maintain physical distance from others

  • otherwise cannot remain in their current residence

  • prefer to stay out-of-home

  • have fewer resources historically

• 2.b Relocation for contacts in quarantine. Consider offering alternative housing to contacts entering quarantine who:

  • live with elderly or other high-risk individuals and are unable to maintain physical distance from others

  • are precariously housed

  • are unsheltered or homeless

  • live in group settings and are unable to maintain physical distance from others

  • otherwise cannot remain in their current residence

  • have fewer resources historically

3. Accommodation service provider

• Contract with existing facilities, such as hotels, dormitories, or temporary housing facilities (converted convention centers, schools, arenas, etc.) to provide safe accommodation. Depending on need and size of available facilities, multiple contracts may be required. See Template scope of work (facilities).

  • In some situations, there may be cultural norms around inter-generational living that will preclude individuals from moving outside of their homes despite not being able to isolate or quarantine safely. If relevant, consider instituting “cultural brokers” that can work with those populations to develop plans that works for them, such as video chats while living out-of-the-home.

• 3.a Develop protocols to prevent spread of infection within facilities.

  • Single-room occupancy for residents only

  • OSHA consultation and environmental control assessment

  • Cleaning protocols for common areas, including bathrooms

  • Separate exits/entrances for staff and residents; maintain a “safe” area for staff to take breaks where residents cannot access

  • Keep confirmed cases, presumptive cases, and quarantined contacts separate from each other.

  • Adequate personal protective equipment for staff and residents, including sanitizers, masks or face coverings, gloves, alcohol-based disinfectants

  • Meals, clean bedding, and other essentials should be left outside of residents’ rooms; no group meals; no housecleaning services for individual rooms

4. Infection control

• Contract with a company to manage infection control or hire infection control personnel. See Template scope of work (infection prevention and control).

  • With numerous cases and potential cases residing in common facilities, infection control is of the utmost importance to ensure infection does not spread within the facilities (including to other residents or staff).

  • Consider contracting with a health care provider in the community or other organization familiar with infection prevention and control protocols. If not available, explore existing or hire new infection control personnel.

  • See relevant guidance in CDC’s Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Healthcare Settings.

  • See CDC's Guidance for Cleaning and Disinfecting.

5. Linkage for cases and contacts

• Ensure the link to alternative housing is made for cases and contacts, as appropriate.

  • Train contact tracing staff to assess an individual’s ability to isolate or quarantine at home in a way that is safe for them and others.

  • Contact tracing staff should link people with alternative housing services based on their eligibility and interest.

  • People in alternative housing must also be linked to wraparound services and other social supports, as appropriate.

  • Forms and protocols used by contact tracing staff should include questions and prompts to guide this process.

Implementation Tools

• Template scope of work (facilities)

• Template scope of work (infection prevention and control)

• CDC: Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Healthcare Settings

• CDC: Guidance for Cleaning and Disinfecting

• Sample eligibility criteria for out-of-home isolation or quarantine

LIVING DOCUMENT This playbook is a dynamic, “living” document. Global knowledge pertaining to COVID-19 is rapidly evolving. Feedback and suggestions can be sent to [email protected].