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“It is impossible for us to stop the spread”

Published on April 7th, 2020

Because of inadequate staffing, lack of personal protective equipment, and poor infection control procedures, the coronavirus is spreading through the nation’s nursing homes.  Over the past month, coronavirus infections at nursing homes have skyrocketed: More than 500 long-term care facilities around the United States now have infected residents, according to the Centers for Disease Control and Prevention — a 172 percent increase in a single week.

Industry apologists argue that nursing homes have been unable to get enough protective gear and tests because hospitals are getting the supplies first. Protective gear is especially critical in nursing homes since many residents have physical limitations or dementia that prevent them from being able to cover their mouths when they cough, or from wearing a mask themselves.  Families are worried about their loved ones especially when they can’t visit the facility, and the nursing homes prohibit video conferencing and other video communications.  There is no way to check on your loved ones. The Centers for Medicare and Medicaid Services requires nursing homes to notify family members if their relative has a confirmed coronavirus infection, but not if others in the facility have tested positive.

ArchCare is telling people to take their loved ones home.  They are admitting they can’t keep them safe.  ArchCare has been forced to outfit staff members in rain ponchos and beautician gowns to stretch their dwindling supply of protective gear, according to Scott LaRue, president and CEO of the company.

More than 200 of ArchCare’s 1,700 nursing home residents are infected with the coronavirus, and more than 20 have died, LaRue said. At least 10 staff members are also infected, with one in the hospital on a ventilator.

The risks are so serious that LaRue is advising family members to pull residents out if feasible. “If you have the ability to take your loved one home, and that’s possible, I would encourage you to do so,” he said. “There will be better isolation and better limited contact in a home than there would be in a nursing home.”  However, LaRue acknowledges that the medical and personal needs of most residents are too complex to handle at home.

The ArchCare aide said that staff members are only being given one disposable gown for their entire shift, even if it becomes soiled, and they must constantly circulate between residents who are infected and those who are not.

“How do you expect to use the same gown? We are cleaning them, wiping their mouths, there’s stuff on us,” the aide said. “I feel like I’m spreading the virus.”

While one area of the nursing home where she works had once been designated for infected residents, there are now so many who are sick that they are mixed in throughout the entire facility, the aide added.

In Washington state, which reported the first coronavirus cases in the U.S., 35 people died after an outbreak at the Life Care Center of Kirkland, a skilled nursing facility. A CDC report found that a lack of personal protective equipment and staff members who continued to work while sick helped fuel the deadly outbreak, which quickly spread to other nursing homes in the area.

Similar cases have exploded across the country. At one facility in Stafford, Connecticut, three residents have died and at least six employees are now infected, with staff reporting a lack of protective gear and limited testing. At two nursing homes in southwest Pennsylvania, infections are growing among both residents and staff, who say they don’t have enough masks to protect themselves. In Louisiana, where 13 residents have died in a single nursing home, one 130-bed nursing home reported having no personal protective gear at all.

We’re in a situation where it is impossible for us to stop the spread of the virus,” LaRue said. “They say this is our highest-risk population — the one we have to protect the most — and they’re not giving us what we need to do that.”

Supplies have been scarce on all levels of government but Trump refuses to use his power to coordinate production and distribution.  Trump has narrowly limited its use of the law and continues to tell states to try to buy the supplies themselves from private vendors. But the demand for masks, gowns, face shields and other equipment has created chaos as states, hospitals, nursing homes and other facilities are all competing to purchase the same critically needed supplies.

Nursing homes are also facing a lack of testing, which makes it even harder for them to contain the virus. Testing at nursing homes remains highly limited because of a shortage of swabs and other components needed to conduct the tests, as well as restrictive state guidelines.

That has made it impossible to identify and isolate all the residents who are infected from those who are not, LaRue said. “If I had my druthers, I’d do widespread testing, and I would test every employee.”

The problem is widespread, according to the American Health Care Association: “We have heard from many providers about residents and staff getting declined when trying to be tested. This is extremely worrisome.”

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