Nursing facility cases surging
49 positive at Orinda Care Center; infections jump from 11 to 20 at San Jose’s Canyon Springs
The number of residents and staff members infected with COVID-19 at Bay Area nursing homes is surging, including one in the East Bay that has nearly 50 positive cases and one death, and a San Jose nursing home that has reached 20 cases, with more tests pending.
The cases at both facilities rose sharply since late last week. At the Orinda Care Center, 49 people — 27 residents and 22 staff members — have tested positive for the virus. Four residents have been hospitalized while the rest remain at the facility, according to officials at
Contra Costa Health Services.
Meanwhile, at Canyon
Springs Post-Acute Care in
San Jose, the number of infections among patients and staff jumped from 11 to 20 since Friday, with 16 people awaiting test results. A spokesman said that negative results came back on eight patients and eight employees who had shown symptoms of the virus.
County health officials began investigating the outbreak in Orinda early last week after two staff members sought medical care for coronavirus symptoms. By Friday, test results showed 27 people — 24 residents and three employees — were infected. Since then, the number of positive test results among staff in particular has soared, according to the new data from the health department.
One person at the facility who had tested positive for COVID-19 and already had been in hospice care died over the weekend, according to a health department spokesman.
The outbreaks at the facilities in Orinda, San Jose and several other Bay Area nursing homes and elder residences have alarmed experts. Just Monday afternoon, a new cluster of 10 cases was reported at a Pleasant Hill senior facility.
“The situation is very serious, and we are deeply concerned about residents of our senior care facilities in Contra Costa County,” health officer Chris Farnitano said Friday. “That is why
we need everyone to follow the stay-at-home order, social distancing guidance and other measures in recent health orders — to protect the people in our community who are vulnerable to severe illness from COVID-19.”
Mehrdad Ayati, a doctor of geriatric medicine who teaches medicine at Stanford, said he and his colleagues also have been very worried about the vulnerable populations in nursing homes. Hearing about the outbreaks, he fears it might be too late.
“We need to be massively testing the skilled nursing facilities. … These are going to be the people overwhelming the acute care centers,” he explained. “Community hospitals will be overwhelmed. Then we’ll have a high number of mortalities.”
It was at a nursing home in Kirkland, Washington, that the first outbreak in the United States exploded. Eighty of its 120 residents tested positive, and more than 30 died from the virus. In the Bay Area, two residents at Atria Burlingame
Assisted Living and Memory Care died after contracting the virus last month. At the Pacifica Nursing and Rehab Center, at least five residents have tested positive, and one died.
Farnitano said Friday that his agency also was investigating and testing staff and patients at two other senior care facilities in the county, calling the outbreak “a very serious” situation.
The results were in Monday for one of those facilities: Three residents at Carlton Senior Living Facility in Pleasant Hill tested positive and are in the hospital, and seven staff members also have tested positive. There are 145 people who live there. Carlton has locations in Pleasant Hill, as well as senior apartments in Concord.
It’s unclear how many other nursing facilities have been hit with the virus. County health departments have kept a tight lid on information about nursing home cases. While Berkeley’s public health department said it had no reported cases at nursing facilities, San Mateo, Santa Clara and Alameda counties did not return requests for that information. In Los Angeles County, in contrast, nursing home cases are regularly posted on a public website.
But as more nursing home outbreaks become public, Ayati said he only gets more concerned.
Shortages of personal protective equipment — including N95 face masks and face shields — have hospitals, nursing homes and other medical centers jockeying for supplies, as the effort to get more protective equipment has focused on acute care hospitals before skilled nursing facilities and other senior care centers, Ayati said.
He and colleagues have been trying to secure more protective gear for nursing facilities, but it’s not the only challenge. Without enough testing, he said, staff who are infected but have no apparent symptoms continue to work — with many employed at multiple facilities — and possibly spread the disease.
Guidance from the state to skilled nursing facilities about the coronavirus has been frequently changing, in the form of new letters sent to the facilities and posted on the state department of health’s website.
While Contra Costa County tested all the residents and staff at the Orinda Care Center, for instance, other counties have been testing only nursing facility residents and staff who have shown symptoms. Experts agree that the disease can spread even from asymptomatic people.
Ayati worries that it’s too late for many nursing facilities, especially those with large outbreaks.
“Skilled nursing homes were kind of abandoned, without good regulations,” he said, noting that at first many “didn’t know — if they had positive patients — whether to transfer them to the emergency room or not. Then it was, the emergency room is busy, so keep them there. Honestly, there was not a universal guideline.”