NURSING HOMES running low on masks, gowns.
WASHINGTON — Many nursing homes risk running out of protective masks and gowns by next week because of the coronavirus, and at least one facility already had to resort to using plastic garbage bags to make gowns, an industry group warned Wednesday.
Also on Wednesday, federal health officials said staff members who worked while sick at several long-term-care facilities contributed to the spread of covid-19 among vulnerable elderly in the Seattle area.
“We really need to take drastic action to conserve masks and gowns going forward,” said Dr. David Gifford, chief medical officer at the American Health Care Association, one of the main trade groups representing the nation’s 15,600 nursing homes.
The industry group is calling on its members to stretch the use of personal protective equipment and asking other health care facilities such as dental offices to consider providing any unneeded supplies to nursing homes.
The federal government seconded the conservation effort Wednesday. Seema Verma, head of the Centers for Medicare and Medicaid Services, recommended that doctors, dentists and hospitals postpone nonessential procedures in order to preserve supplies. That would not only help nursing homes but also hospitals preparing for an increased number of coronavirus cases.
Along with cruise ships, nursing homes have emerged as a focus of heightened concern in the global pandemic.
Thirty-five of the 65 coronavirus deaths in Washington state have been linked to Life Care Center in Kirkland, Wash. A report Wednesday from the U.S. Centers for Disease Control and Prevention provided the most detailed account to date of what drove the outbreak still raging in the Seattle area where authorities closed restaurants, bars, health clubs, movie theaters and other gathering spots this week.
Sick workers may well have contributed, although investigators haven’t tied the spread to “any particular staff member” and don’t know how the infection was introduced or spread, said Dr. Jeff Duchin, public health officer for Seattle and King County, during a phone briefing for reporters Wednesday.
“They need the money. They don’t have sick leave. They don’t recognize their symptoms. They deny their symptoms,” Duchin said. And in mid-February, awareness of the virus was low.
“Nobody was thinking about covid-19 at this point,” Duchin said.
Verma had said Tuesday that her agency is focused on whether facilities are taking required measures to control infections and that nursing homes in the Seattle area, California and New York are currently the main areas of concern.
Gifford said based on a survey his group estimates that 1 in 5 nursing homes could run out of protective equipment
next week, and a similar number the week after.
The group is looking to the CDC to issue guidance on how nursing homes can safely stretch supplies. The CDC’s Kara Jacobs Slifka said Tuesday that the agency is working on it. One suggestion is for staff members to use the same face mask for an entire shift, provided they don’t touch it or it doesn’t get damp or soiled.
About 1.4 million patients are cared for in nursing homes and rehab facilities within such homes, mainly elderly and severely disabled people who are especially vulnerable to the coronavirus. Government programs like Medicaid and Medicare cover a significant share of the cost, with Medicare paying for rehab services only.
Mark Parkinson, CEO of the American Health Care Association, the industry group, said the nation’s response now could literally save tens of thousands of lives. “We really have to take this quite seriously,” he told reporters in a call Wednesday. Officials are optimistic that eventually they’ll have enough supplies available, but they’re concerned about getting through the next few weeks.
For most people, the coronavirus causes only mild or moderate symptoms, such as fever and cough. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia. Worldwide, at least 214,000 cases have been reported, and while most people recover in weeks, about 8,200 have died.
Last week, nursing homes around the country shut down visits to residents, and facilities have taken steps to isolate residents from one another by ending common activities and serving meals in rooms. Some residents don’t understand why family visits have been interrupted, increasing the anxiety level within facilities.
Gifford said the industry group has heard of 20 to 30 nursing homes that are dealing with outbreaks, but that’s based on media reports. For maximum safety, all facilities should operate as if the virus had already gotten inside, he said.
A survey last week of nursing homes and assisted-living facilities found that personal protective equipment and disinfecting supplies are scarce at many.
The survey was conducted March 6-15 by Premier Inc., the top group purchasing organization for U.S. hospitals and nursing homes.
About two-thirds of the facilities answering the survey reported that they have little to no ability to purchase face masks, face shields, sterile gowns, hand sanitizer, wipes or disinfectant sprays. Nearly one-third said they had no N95 masks, which provide higher protection than surgical masks.