I agree, it would have made a big difference in death rate, if LTC and ALF employees isolated. I think its an economic issue, most of the support staff at LTC and ALF are very low wage positions, shift work. Most are women and mothers, and some work two jobs, they don't have the financial means or family support to self isolate.
All facilities have patients leaving the faculty, even during Convid. Trips to dialysis, treatment and some ER visits. Most all have an isolate wing, and require 14 days. Moo, exposures is happening on the out of facility trips, these folks are immune compromised, at high risk, I think that's the enter point.