Nursing homes still seen as hotbeds of virus cases
Workers unable to self-isolate may be a major factor
For nearly two months, many nursing homes nationwide have been on virtual lockdown.
Families of residents are not allowed inside, vendors have to drop deliveries outside, and the only people coming and going are health care workers and assistants.
Despite all that, the outbreaks continue — possibly spread by the same nursing home workers risking their lives to tend to some of society’s most vulnerable. In response, many workers are significantly increasing their own vigilance, nursing homes are adding safety measures, and the testing of residents and workers is steadily increasing, though experts say much more is needed.
“Many residents are asymptomatic, and so are the staff, so they don’t always know that they have it,” said Charlene Harrington, professor emeritus at
University of California, San Francisco’s nursing school.
More than 23,000 people in the U.S. have died in long-term care and nursing home facilities since the first coronavirus outbreak in a nursing home was reported in Washington state in February, according to a tally by The Associated Press.
On March 13, federal officials limited visits to essential health care workers and told facilities to halt communal dining and group activities and screen staff for fevers or cough. Many of the outbreaks have come since then, including in California, Texas, Minnesota and West Virginia.
There is no national tally on the number of nursing home workers, ranging from nurses to assistants, who have had the virus, in part because many don’t necessarily feel sick or get tested.
Mark Parkinson, president of the American Health Care Association, said officials were slow from the start to help prepare and protect the country’s skilled nursing and assisted living facilities. While the initial focus was on urgent hospital needs, workers in these centers struggled for weeks with a lack of personal protective equipment and limited testing.
“The inability to access a sufficient supply of masks has made it virtually impossible to stop the virus inside buildings,” Parkinson said.
The organization is also pushing for expanded, rapid testing for all facility residents and workers because many can still carry the virus without showing symptoms.
Neighboring nursing homes in Riverside, California, underscore the difficulty in keeping the virus out from a host of facilities.
So many staffers failed to show up for work at Magnolia Rehabilitation and Nursing Center — some sick, some reportedly scared — that 82 residents were evacuated April 8.
Several employees said the facility, which had a below-average rating from federal regulators and was slated for a program aimed at improving troubled centers, had problems before the virus infected nearly three dozen residents and five staff. Employees’ paychecks had bounced, prompting protests. Some staff were dismissed and others quit.
While visitation stopped in early March, Magnolia was still receiving patients from hospitals, including a man with pneumonia who later tested positive for the virus, according to a worker who requested anonymity, fearing a backlash.
A facility administrator from Magnolia declined comment.
Around that time, the virus had also reached a facility next door.
Valeria Viveros, a 20year-old certified nurse assistant at Extended Care Hospital — which has a five-star rating from federal regulators — was rushed to the hospital April 4 after being sick for about a week, her uncle, Gustavo Urrea, said.
That was a day before county officials reported 30 patients and staff tested positive for the virus and the same day they conducted widespread virus testing at Magnolia.
Viveros died within days. “More than likely, she got it from work,” Urrea said.
“Where else?”
Trent Evans, a lawyer for Extended Care, said the facility was grieving the loss and had taken numerous precautions, including limiting visitors, since early March.
At Redwood Springs Healthcare Center in Visalia, California, health officials got involved after residents already had virus symptoms, and the source of infection — which has affected a third of staff and two-thirds of the patients — is still unknown, said Carrie Monteiro, a Tulare County spokeswoman.