As governors begin to reopen states for business, medical experts fear that those most vulnerable to the coronavirus — the elderly, the sick, the poor, minorities — will disproportionately bear the risk of those decisions. Georgia Health News reported on the reaction of shock and disgust shared by the Georgia National Guard that were called into a nursing home to save the residents from any further neglect and abuse. The article was produced in partnership with ProPublica. Georgia Health News is a member of the ProPublica Local Reporting Network.
After visiting the Dawson home on March 27, Capt. Matthew Rushing called his superior officer, Brig. Gen. Randall Simmons, with some troubling news, according to interviews and emails obtained by Georgia Health News and ProPublica. During his visit, Rushing saw a disregard for basic mask and gown protocols. Residents had even mingled inside the facility, not keeping a safe distance from one another. Rushing wasn’t a medical expert, but he worried about sending his company members into the nursing home. Their mission was to sanitize facilities — and, with any luck, save lives. Their risk of COVID-19 exposure seemed too great.
Troubled by what he heard, Simmons typed out a summary to share with other high-ranking officers, including Maj. Gen. Thomas Carden. “I bet they all will have it in the end,” Simmons wrote in a March 27 email obtained by Georgia Health News and ProPublica. He added, “This virus runs through nursing homes like the Grim Reaper.”
Carden quickly forwarded the email to Dr. Kathleen Toomey, the state’s top public health official, and explained that he couldn’t send more help until the nursing home’s staff complied with guidelines for infection control. “Some very basic things need to happen there fast!” Carden wrote.
Army National Guard 2nd Lt. George Peagler was ordered to enter Dawson Health and Rehabilitation Center, a small nursing home where at least 14 of the roughly 60 residents had died from COVID-19 over the past month. Some two dozen employees of the Dawson nursing home have already contracted the coronavirus.
“If you were to see us, you would think we’ve been doing this longer than we have,” said Peagler, a native of suburban Atlanta, who, like many members of the Guard, had no formal medical experience before the pandemic. “That’s because we’ve had to pick up on it so quickly.”
Residents in long-term care facilities now face additional risks of exposure, as staffers circulate through environments where social distancing is decreasing. In Georgia, Kemp has allowed barbers, bowling alley operators and tattoo artists to reopen their businesses. Restaurants may now resume dine-in service. Governors in Alaska, Oklahoma and South Carolina have also allowed some nonessential businesses to reopen, while their counterparts in several other states have let stay-at-home orders expire this week. Each new open business presents an additional exposure risk. As nursing home workers or soldiers with the National Guard interact with cashiers and store clerks who may be infected, they bring the risk of that contact with them into those long-term care facilities, unless rigorous safety protocols are followed, public health experts said. It is up to each facility to request tests for its workers.
“If you have a high-risk population congregated in a setting that was already struggling to take appropriate care, it’s a recipe for disaster,” said Dr. Harry Heiman, clinical associate professor of health policy and behavior sciences at Georgia State University.
Dawson Health and Rehabilitation Center is a cautionary tale of the toll already inflicted on vulnerable residents and the dangers they will face as Georgia reopens.
Of the more than 1,560 infected staff members at long-term care facilities, more than 280 were employed by the southwest Georgia facilities hit hardest by the first wave of the pandemic. An analysis of state data by Georgia Health News and ProPublica found that those southwest Georgia facilities have collectively seen employee COVID-19 cases grow by 40% since April 17.
“By the time a nursing home staff member or resident has COVID-19 symptoms, you are 100% too late,” Barnett said. “There’s simply too much mingling across all the staff and residents in any nursing home, even if they shut down communal dining and visitors.”
“By the time everybody knew, and started reacting, it was too late,” said Ernest M. Johnson, a Terrell County commissioner who runs a funeral home in Dawson. “It caught us, excuse my French, with our drawers down.”
Dawson Health and Rehabilitation Center lies in Terrell County, population 8,500. The county has long been a federally designated “medically underserved area,” with two of the nearest rural hospitals closing their doors since the Great Recession of 2008. The county currently has an infection rate of 1,972 cases per 100,000, one of the highest in the country. As a state, Georgia has one of the highest fatality rates inside long-term care facilities, accounting for 41% of the state’s COVID-19 deaths, over 50% higher than the average for the 23 states that had publicly reported death data as of April 23, according to a study by the Kaiser Family Foundation.