Although they have been sequestered within their walls for more than eight months, almost completely isolated from family members and the outside world, residents of long-term care facilities in California are now facing another dangerous spread of the coronavirus among them.
By Thursday night, the number of active cases of COVID-19 in qualified nurses had reached at least 1,543, more than double earlier this month, according to data released by the state health department.
The increase comes after the number of new cases has largely decreased since August and reflects what is happening over the same period in most of California’s population.
Healthcare workers are also being hit ̵
The picture is just as worrying in life support centers, which, like non-medical facilities, are regulated by the state Department of Social Services. The total number of COVID-19 cases among patients and staff there reached 1,437 by Thursday.
Perhaps no group of Californians is more vulnerable to the virus.
The total of 61,088 cases in skilled nurses and life support facilities since the onset of the pandemic is only a small fraction of the 1.06 million cases nationwide over the same period. But the number of patients and staff who died from COVID-19 accounted for 33 percent of California’s 18,466 coronavirus deaths to date.
Locally, one of the largest recent outbreaks occurred at San Thomas Rehabilitation Hospital in San Jose, where 104 residents and 61 health workers tested positive for COVID-19, according to government figures. As of Friday, seven patients still had COVID-19, and one employee was in isolation, according to a facility official.
State figures show that 20 San Thomas residents who recently suffered from COVID-19 have died.
The facility posted a statement on its website stating that its mitigation plan – based on public health guidelines – included isolating residents with COVID-19 and instructing sick staff to stay home.
The Atria Willow Glen life support facility in San Jose also had an outbreak in which 33 residents and employees tested positive for COVID-19 and one resident died, according to Atria Regional Vice President Jason Waltour.
Such outbreaks are common at the beginning of a pandemic. Although they are becoming rarer as the number of cases decreases between August and November, the latest jump raises new fears.
In a statement, Waltour noted that almost everyone who took the tests showed no symptoms of COVID-19, a reality that experts say underscores why regular testing should be a priority for residents and staff of long-term care facilities. Wearing personal protective equipment around residents and maintaining appropriate infection control practices is also crucial.
And while doctors, administrators and lawyers agree that nursing homes do better at testing, maintaining protective equipment and controlling infections, there is more room for improvement.
“I’m still not happy with where we are,” said Dr. Michael Wasserman, a geriatrician and former president of the California Long-Term Medicine Association. “While older people are dying faster than normal, we have no business to win laps.”
The long-term care industry is also struggling to keep patients safe while allowing the resumption of limited visits. Prior to the pandemic, many care facilities relied on family members to help loved ones bathe, eat, and stay hydrated during their visits. They also served as an additional set of eyes to make sure patients were well.
But when the pandemic struck and shelter orders were issued in mid-March, the facilities virtually turned off all visitors in a desperate desire to prevent vulnerable residents from contracting the disease. For months, even legally authorized ombudsmen were barred from nurses, leaving families and lawyers with little information.
The ombudsmen returned and the state allowed some visits from family members or friends according to certain guidelines, which mostly depended on the case numbers of the districts as well as the cases of each facility – but the visits were still very limited.
According to state guidelines, visits should be carried out outdoors or in large common areas with physical barriers, if possible.
Nicole Howell, executive director of the ombudsman services of Contra Costa, Alameda and Solano, said residents and families are beginning to fear that with the growing number of COVID-19 cases across the country, limited visits will be lifted even more.
“It will have lasting effects on residents and families,” Howell said. On the other hand, she added, “part of the precaution when setting up a visit is that they are worried about putting the virus in their building. It’s hard for them. “
Prior to the pandemic, geriatrician Dr. Teresa Palmer will visit her mother regularly at the Jewish Home and Rehabilitation Center in San Francisco. But the pandemic stopped this, leaving her to communicate with her mother only through Zoom calls several times a week.
She was recently allowed to visit her physically every three or four weeks, but that’s not enough, Palmer said.
This week, she learned that her mother had been exposed to an infected staff member a few days ago and was due to be tested this weekend.
“The last time this happened, there were two exhibits and she was detained for a month,” Palmer said. “She was very depressed, she stopped eating and drinking properly, but now she bounced back.”
“They sacrificed themselves by being isolated for the past eight and a half months,” Wasserman told residents of qualified nurses and life support facilities. “To say, go back and isolate again, I have a problem with that. For the last eight and a half months, I have wanted homes for the elderly to be prioritized, but not by making prisons. “
An expert who analyzes data in nursing homes across the country for the Associated Press estimates that for every two people who die from COVID-19 in long-term care, another person dies prematurely for other reasons, suggesting that care in institutions are compromised by the staff stretched by the virus and its requirements.
“The health care system is somehow on the brink, right on the border, so if there’s a crisis, we can’t handle it,” said Stephen Kay, a professor at the Institute of Health and Aging at the University of San Francisco who conducted the analysis, the Associated Press said. “There are not enough people to take care of the residents of the nursing home.”
And while some changes – such as codified by a new law that forces nursing homes to provide full-time infection prevention specialists – have addressed certain conditions that exacerbate the risk for patients earlier in the pandemic, the problem of chronic staff is not fully resolved.
Elderly home workers still earn mostly low salaries and are not always entitled to paid sick leave, and many of them work in multiple establishments or other jobs, which means they are at greater risk of contracting the virus. and its distribution.
So if you work part-time and depend on your job to feed your family, but you show symptoms of COVID, you have every incentive not to call the sick, “said Mike Dark, a California attorneys for staff reform lawyer. home for the elderly.
As a result, Dark and other advocates are urging people to maintain their security to protect the elderly and other residents of long-term care facilities from the virus as the winter months begin.
Tragically, Dark added, “many of the most vulnerable are already dead.”
Staff writer Maggie Angst contributed to this story.