6.15 Physical distancing

2 metre physical distancing within the general community and healthcare and residential settings was introduced at the start of the COVID-19 pandemic as a mitigation measure to prevent transmission of the virus between individuals.  Following the roll out of the successful vaccination programme, expansion of testing and the use of face coverings by the general public, physical distancing is no longer obligatory in the general community.

However, care homes house some of the most clinically vulnerable in society and whilst the COVID-19 pandemic remains a threat, it is recommended that physical distancing remains although reductions from 2 metres to 1 metre or more can now be advised in some areas.  The maximum distance for cross transmission from droplets has not been fully determined, although a distance of approximately 1 metre (3 feet) around the infected individual has frequently been reported in the literature as the highest area of risk.  By applying physical distancing of 1 metre or more within care homes we can help mitigate against risk of transmission via pre-symptomatic and asymptomatic individuals. Physical distancing will continue to be reviewed regularly over the winter season and any changes will be informed by COVID-19 prevalence, and nosocomial transmission data of COVID-19 and other respiratory viruses.

Summary of key points

In order for COVID-19 transmission risk to remain low in care homes and residential settings, whilst also recommending a reduction to physical distancing, it is essential that all staff, individuals/residents and visitors adhere with other pandemic measures which remain in place to mitigate risk including;

Staff and residents are also encouraged to complete COVID-19 vaccination to further help reduce the risk of COVID-19 transmission.

Physical distancing amongst staff in care homes

Physical distancing amongst staff may now be reduced to 1 metre or more across care homes and residential settings provided FRSMs are in use.

Where staff remove FRSMs for any reason e.g eating, drinking, changing, staff are advised to maintain 2 metre physical distancing.  This is because 2 metres is still used to assess contacts and failure to physically distance by 2 metres or more when not wearing an FRSM may result in high numbers of staff within the care home setting being considered as a contact and requiring exclusion from work until they can return as per the appropriate requirements associated with Staff exclusion from work. Staff should be supported by their organisation to remind their colleagues when they drop their guard during application of COVID-19 controls.

Outbreaks amongst staff have been associated with a lack of physical distancing in changing areas and recreational/rest areas during staff breaks as well as car-sharing and it is particularly important to utilise all available rooms and spaces to allow staff to change and have rest breaks without breaching 2 metre physical distancing (recognising that staff will not be wearing FRSM in these areas).  Car-sharing should still be avoided whenever practical and mitigations should remain in place.

Staff previously identified as having been on the shielding list may wish to discuss how physical distancing impacts them with their line manager and/or occupational health.

Residents/Individuals living in the care home/residential setting

Residents/individuals who live in the care home are not expected to physically distance from each other.

Where able, residents should be reminded to report any symptoms of COVID-19 to care home staff. Staff should remain vigilant for early onset of any symptoms amongst residents/individuals taking account of atypical symptoms in the elderly and where symptoms do develop, act promptly by isolating the resident/individual in their own room and following guidance within the Scottish COVID-19 addendum as per high risk category.

Staff are also reminded to encourage and where necessary support residents/individuals to perform hand hygiene regularly and practice good respiratory hygiene.

Visitors

Visitors should maintain 1 metre or more distancing from staff and general residents/individuals within care homes. 

They may have touch contact with loved ones (hug/kiss) however are reminded that maintaining 1 metre or more distancing outwith direct touch contact wherever possible will help reduce the risk of transmission of COVID-19 and other respiratory pathogens.

Visitors are asked to avoid circulating around care homes unnecessarily and remain seated at the bed/chair side of their loved one wherever possible.

Visitors answering yes to any of the triage questions should not visit until they have completed their self-isolation period.