Jorge Browne, Gerardo Fasce, Ignacio Pineda, Pablo Villalobos

The full report is available here:

Key points:

• To date, the number of new cases remains high. Nearly 80% of cases occurred in the highly-dense populated Metropolitan Region which accounts for nearly 40% of the country’s population. Older people (60+) have been disproportionately affected; they represent only 15.7% of the cases, but 48% of hospitalizations and 89.6% of all deaths. 
• The COVID-19 response started in early March with the cooperation of several actors. The Ministry of Health (MoH), the National Service of Older People (Servicio Nacional del Adulto Mayor, SENAMA), the Chilean Geriatrics and Gerontology Society (GGS), and the main non-profit organizations started a working group to coordinate the implementation of prevention and control measures.
• In all long-term care facilities (LTCFs) visits to people were banned, sanitary barriers for assessing temperature and symptoms were implemented and the entry of new residents was halted. There were also a series of non-enforceable infection prevention measures, guidance on how to use personal protective equipment (PPE), cleaning and disinfection guidance, and guidance on isolation areas for COVID-19 suspected cases.
• For the public, non-profit, and vulnerable for-profit organizations (average out pocket payment less than 820 USD/month) SENAMA provides face to face technical support, PPE, field testing with rt-PCR using relaxed access criteria that include atypical presentation, and temporary transfer of COVID-19 residents to sanitary houses.
• Information was identified as a key issue for long-term care facilities (LTCFs) in the COVID-19 context. To date, there is no official data on the number of cases and deaths coming from these facilities. Moreover, the lack of complete and updated data on the facilities, residents, and staff constitutes a broader barrier for the design and implementation of policies in the area.
• The adequate implementation of infection prevention and control measures needs strong technical face-to-face support, especially to ensure the adequate use of PPE and the implementation of isolation areas. The COVID-19 challenges coexist with deeper social challenges such as inadequate infrastructure and staff shortage. These challenges are especially relevant among informal (unregulated) nursing homes and represent a relevant implementation barrier for COVID-19 prevention and management measures.
• In the long run, strong infection prevention and control measures for COVID-19 and other infectious diseases will need to be structurally implemented in LTCFs. The adequate implementation of these measures, we believe, needs strong coordination and surveillance from the MoH, SENAMA, and the technical support of the Geriatrics and Gerontological Society.