Hogan creates ‘strike teams’

Group will respond to outbreaks at nursing homes

Maryland Gov. Larry Hogan on Tuesday announced the creation of “strike teams” to provide immediate support to nursing homes experiencing outbreaks of coronavirus cases across the state.

At least 90 such facilities have confirmed cases of the virus in Maryland, Hogan said. One in Carroll County — Pleasant View Nursing Home in Mount Airy — has experienced at least 17 deaths as of Tuesday and dozens of other infections among residents and staff.

The strike teams, composed of healthcare workers from local hospitals, National Guard members and other front-line public health personnel from state and local health departments, will be capable of providing three forms of support, Hogan said.

They will oversee testing and guide efforts to separate exposed residents and staff from others; provide logistics support and equipment while helping to triage patients who are believed to have been exposed; and bring medical supplies and workers directly to the facilities to help avoid unnecessary transfers of patients to local hospitals, Hogan said.

“We’re the first state in the nation to launch such a coordinated response effort,” Hogan said. “The goal here is not to replace a nursing home’s medical or clinical team, but to provide immediate support and assistance to help protect residents.”

The announcement followed Hogan’s emergency order Sunday that mandated nursing homes use expedited testing options to identify infections more quickly among symptomatic residents and staff, and required that all nursing home staff wear masks, gowns and other protective equipment when interacting with residents.

Hogan said the efforts were meant to help save lives in the state, where there are 226 licensed nursing homes.

However, the mandates fall short of requiring all staff at nursing homes across the state to be tested for the virus — despite signs that such action could be a major factor in preventing further spread. That’s partly because of a lack of tests nationwide.

Some industry leaders question whether the state efforts will be enough to slow the spread of the COVID-19 illness in nursing homes given that lack of testing, and a similar lack of protective gear.

Both Hogan and Fran Phillips, deputy secretary of the Maryland Department of Health, have said they believe the coronavirus is spreading through the state’s nursing homes — and entered Pleasant View — via staff members who are not showing any symptoms of infection.

“There were no symptomatic staff. No visitors. It must have been staff coming into a nursing home and unwittingly carrying the virus,” Phillips said Monday in an interview with The Baltimore Sun.

Phillips said the state is testing all nursing home workers that have symptoms of coronavirus, but is not able to test asymptomatic staff due to the lack of tests.

“We are still in a national shortage of the basic raw materials that are necessary to do these tests,” Phillips said. “It is a continuing source of frustration.”

At Pleasant View Nursing Home, where some staff also work at other facilities, Phillips said it’s important to track where the infection came from.

But she and other state officials have not answered questions about what tracking efforts may be underway to determine the movement of those workers, and what role the state and local health departments are playing in that effort.

At Pleasant View, there are now temperature checks and screening questions to the enter the facility, she said.

Phillips said the state is following CDC guidelines for how to use its limited testing resources. Once enough tests are available, she said, “we want to test a huge range of people.”

She also cited the new mandate for all nursing home staff to wear protective gear when they interact with patients.

“That’s as important as testing to interrupt the spread,” Phillips said.

Phillips said nursing homes are expected to purchase supplies, but the state would offer help for nursing homes that need more resources.

“I know everybody is nervous about that,” she said of supply shortages.

Allison Ciborowski, president of Leading Age Maryland, an association of nonprofit homes in the state, said nursing home leaders welcome Hogan’s efforts to reduce the spread of the virus, including the directive to have staff wear protective gear. While the industry has long emphasized the importance of preventing infections, the novel coronavirus presents new challenges, she said — especially with asymptomatic workers.

Still, it’s not yet clear if the measures being put in place will be enough to stop the spread of the virus in nursing homes, especially as tests, masks and other gear remain in short supply, industry leaders said.

Kevin Heffner, president of LifeSpan Network, a state nursing home industry group, said staff still have to use any available tests “judiciously,” with not nearly enough to go around for staff and residents who may be at risk but appear healthy.

Ciborowski said she expects cases to continue to rise.

“The steps Governor Hogan has taken I think are important to slowing the spread, but I don’t think anyone can predict exactly when things will get better,” she said. “We’re doing the best we can with what we have.”