Infections, deaths surging even with facility lockdowns

Nursing homes across the country have been in lockdown for weeks under federal orders to protect their frail, elderly residents from coronavirus, but a wave of deadly outbreaks nearly every day since suggests that the measures including a ban on visits and daily health screenings of staffers either came too late or were not rigorous enough.

Recent outbreaks in Tennessee, New Jersey, Ohio, West Virginia and Maryland have pushed the death toll at the nation’s nursing homes to at least 450 and highlight the biggest gap: Screenings of doctors, nurses, aides and other workers do not involve actual testing but the taking of temperatures or asking health questions that still allow infected, asymptomatic people to slip through.

“It’s still been like Swiss cheese with people coming in and out of there, and thus you’ve got these explosions in senior facilities,” said John BaRoss of Long Valley, N.J., who recently removed his 85year-old mother from an assisted-living center out of fear of infection.

After an outbreak of 100 infections and four deaths at the Gallatin Center for Rehabilitation and Healing near Nashville, Tenn. — where the National Guard was called in to help evacuate the facility — Sumner County Mayor Anthony Holt blamed staff members who came to work despite showing symptoms of COVID-19 and “exposed a lot of patients.”

“Things got out of hand,” Holt told The Associated Press. “Once employees became symptomatic, they should have asked them to go home immediately and called the health department. I don’t think that occurred.”

After an outbreak near Dayton, Ohio, killed eight people and infected about 50 at a pair of nursing homes less than 10 miles apart, health officials began scrutinizing medical specialists such as phlebotomists and respiratory therapists who work in multiple facilities per day. One such health worker who visited both homes tested positive for COVID-19.

In Maryland, Gov. Larry Hogan said an outbreak that spread like “wildfire” at a Mount Airy nursing home, killing five and infecting 77, apparently began with an asymptomatic health worker who made it past a temperature check screening and “infected the population.”

Relatives of those at the Sundale nursing home in Morgantown, W.Va., where 29 residents and staff tested positive, say more should have been done to keep coronavirus out before the federal restrictions took hold in mid-March.

“The day before the shutdown, we just walked in wherever. There was no sign-in. There was nothing,” Courtney Templeton said of her last visit to her 69-year-old mother.

Templeton also faults the home for not testing residents fast enough and not keeping healthy ones separate from those just back from a nearby hospital showing COVID-19 symptoms, including her mother’s roommate.

“She came back coughing and had a fever,” Templeton said of a visit two weeks ago, after which she began begging the home to protect her mother. “Can’t you keep the incoming patients separate? Can’t you keep them quarantined for 14 days?”

Last week, Templeton was told that both the roommate and her mother had the disease.

Though the federal government has not been releasing a count of its own, an AP tally from media reports and state health departments indicate at least 450 deaths and nearly 2,300 infections have been linked to coronavirus outbreaks in nursing homes and long-term care facilities nationwide.

And for the nation’s more than 15,000 such facilities and the 1 million people who live in them, experts say the situation could get worse before it improves. They say the crisis has only deepened a chronic staffing shortage at nursing homes because more workers are self-quarantining or staying home with their children. There is still not widespread testing of staff or patients, and shortages of masks and other protective gear persist.

“It’s an emergency situation; it’s just been totally neglected in all the national policy,” said Charlene Harrington, a professor emerita at the University of California-San Francisco and a former state health official. “They’re not focusing on the fact that these are the most vulnerable people in the whole country.”