Vt. Works To Slow COVID-19 Outbreaks At Nursing Homes As Vaccine Approaches
In recent weeks, eight of Vermont's eldercare homes have experienced outbreaks of the coronavirus, and the vast majority of the state’s recent COVID-19 fatalities have come from those events.
Nursing homes and other long-term care facilities that house elderly people are some of the most at risk for outbreaks of COVID-19. Residents are often housed in tight living situations with roommates, communal dining halls and staff who float from person to person.
Four Seasons Care Home in Northfield discovered its first case of COVID-19 about a month ago. One resident got tested when he went to the hospital for an non-COVID issue, according to co-owner Ashley Hudson.
She was surprised. None of the staff had reported symptoms in their daily screenings, and none of residents, who are screened twice a day, reported anything.
“So by the time that asymptomatic people tested positive, it was just all over,” Hudson said.
"The residents here are our family, lots of them don’t have family that even come to visit them or anything, so you kind of feel a feeling of being a failure, in not being able to keep it out of the home." — Ashley Hudson, Four Seasons Care Home co-owner
In less than a week, there were 22 cases at the 37-bed facility. Some of the residents, like 63-year old Judy West, tested positive and started to feel sick. West said she got a cough, a headache and a runny nose.
"Well, I was scared at first, 'cause you never know if you’re going to die or not,” she said.
The 32 residents were confined to their rooms and staff delivered meals. They also got commodes so they wouldn’t have to use the communal bathroom. The weekly Bingo game was canceled.
71-year old John Williams, another resident who tested positive, said being sick was worse than the isolation: “I felt so crappy, I didn’t really care about it.”
Staff were getting sick too. Nearly 38% contracted the virus, and some couldn’t work. It got bad enough that the Health Department gave Four Seasons permission to allow infected staffers who felt OK to care for sick residents.
Hudson, the co-owner, was one of those who tested positive and kept working.
“I mean, I can’t tell you how many times I cried,” she said. “The residents here are our family, lots of them don’t have family that even come to visit them or anything, so you kind of feel a feeling of being a failure, in not being able to keep it out of the home.”
A total of 31 residents and nine staff contracted the coronavirus at Four Seasons, according to Hudson. State data indicates one resident at the facility died, but Hudson said that the resident, who died this week, had tested positive several weeks ago and had no signs or symptoms of COVID-19 when he died.
But not all eldercare facilities have been so lucky. Nearly all of the 29 fatalities reported since Nov. 16 have been at long-term care facilities, and there are at least 283 infected patients and staff across eight facilities in Vermont.
State health officials have attributed the outbreaks to the rising levels of coronavirus in Vermont and said many likely stemmed from asymptomatic workers inadvertently bringing the virus inside facilities.
That’s led to the state adopting a new, more aggressive testing strategy, said Kayla Donohue, the team leader of Health Care Outbreak Prevention and Response Team at the state health department. Donohue said the state increased its testing regime so it can quickly identify positive cases and isolate them.
“Many residents and staff members at these facilities are getting tested daily while we're trying to learn more about the facility, or when there's an active outbreak happening,” she said.
While the new testing strategy might mitigate the severity of future outbreaks, for facilities currently fighting off the virus, maintaining adequate staffing levels is the immediate concern.
At Elderwood in Burlington, 59% of its 91 residents have contracted the coronavirus, and 10 have died. Another 32 employees have gotten sick. Two people working at the facility, who asked not to be named, said staff were exhausted, stressed and scared.
“You’re running around, and it feels like your head’s cut off,” said one of the staffers.
"You're running around, and it feels like your head's cut off." — Elderwood staffer
A spokesperson for Elderwood acknowledged that staff was “stretched,” and said they were working with the local health officials to keep adequate staffing levels.
One of those partners is the University of Vermont Medical Center. President and Chief Operating Officer Stephen Leffler says the hospital is in daily contact with Elderwood.
“We have physicians going there to help deal with the issues, we’ve accepted patients from Elderwood when appropriate, we’ve added support there when appropriate,” Leffler said.
The state is hoping to address future staffing shortages with a new group of trained nurses who can be deployed during outbreaks.
Monica Hutt, the commissioner of the Department of Disabilities, Aging and Independent Living, said the pool of workers could be used to relieve the initial burden felt by facilities.
“As the virus enters the facility, staff are getting sick and have to get pulled off of their shifts,” Hutt said. “So there’s always this period of time at the very beginning where, before they can stabilize their own staffing resources, they typically need some assistance.”
The recent outbreaks and deaths come just days before vaccines are scheduled to arrive.
Health Commissioner Mark Levine says 5,850 doses of the Pfizer vaccine could be here next week. And staff and residents of long-term care homes are among the first people who could receive the vaccine in Vermont.
“Pharmacies that have been contracted to provide COVID-19 vaccine at skilled nursing facilities will receive a portion of these initial doses, and may hold their earliest vaccination clinics at long-term care facilities as soon as Dec. 21,” Levine said Tuesday during a press conference.
Until then, state officials hope the stricter mitigation procedures will prevent any more widespread outbreaks.
At Four Seasons Care Home in Northfield, all but one of the infected residents has recovered. The facility started to allow communal dining on Dec. 3, and this week, group activities resumed.
On Tuesday, some residents sat in the TV room, watching the 5 o'clock news and waiting for dinner — that night, chicken nuggets and french fries.
"I mean it’s extra work for the girls... I couldn’t ask for any better, anyone to be any better than they are.” — Maude Ducharme, Four Seasons Care Home resident
Maude Ducharme, who’s 96, said during the outbreak, the staff took good care of her and the other residents.
“My gosh, they’ve been right in here cooking and like that, you know, delivering our meals, I mean it’s extra work for the girls,” she said. “I couldn’t ask for any better, anyone to be any better than they are.”
Hudson said they’re still waiting for one resident who tested positive to come out of isolation. Another resident, who tested negative, is also quarantined and waiting for the facility to be cleared of the virus. Hudson says she hopes he’ll be out of isolation just after Christmas.
Correction 10:18 p.m.: A previous version of this story said no Four Season Care Home residents died, however state data now reports one death at the facility.
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