COVID surge hits senior care, less deadly this time

The Dunwoody Health and Rehabilitation Center was among the hardest-hit nursing homes in Georgia during the early months of the pandemic. It was hit again with an outbreak recently as the delta variant sickened people across Georgia. But no residents of the home died during the latest surge. Most nursing home residents across the state are vaccinated. STEVE SCHAEFER FOR THE ATLANTA JOURNAL-CONSTITUTION

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The Dunwoody Health and Rehabilitation Center was among the hardest-hit nursing homes in Georgia during the early months of the pandemic. It was hit again with an outbreak recently as the delta variant sickened people across Georgia. But no residents of the home died during the latest surge. Most nursing home residents across the state are vaccinated. STEVE SCHAEFER FOR THE ATLANTA JOURNAL-CONSTITUTION

Staffing issues continue to plague facilities across the state

As the delta variant started sweeping across Georgia this summer, outbreaks cropped up once again in the state’s long-term care homes where thousands of vulnerable residents died of COVID-19 during the early surges.

But this time, with most residents of nursing homes fully vaccinated, the wave of infections and deaths have stayed far below the levels of prior surges, according to state and federal statistics reviewed by The Atlanta Journal-Constitution.

More than 100 Georgia nursing home residents were dying during the worst weeks early on in the pandemic. In the ongoing delta surge, the highest number of weekly COVID-19 deaths recorded at Georgia’s nursing homes — 20 — came in late August, according to the Georgia Department of Public Health

“We are seeing outbreaks in LTCF (Long-Term Care Facilities), and some residents have breakthrough infections. But, in general, we are seeing far fewer affected residents per outbreak event,” the Georgia Department of Public Health said in a statement.

Between September and February, there were 9,664 COVID cases reported by 361 Georgia nursing homes, DPH said. From March to August, just 884 cases were reported in 364 nursing homes.

Even so, the latest surge has once again upped the stress on homes that have struggled throughout the pandemic to find enough workers. Recent COVID-19 cases among nursing home workers outpaced those among residents, according to federal reports. About 80% of nursing home residents were vaccinated as of September 12. Among staff, the vaccination rate was 58%.

Every surge takes a toll. Visits from family might be restricted. Workers who test positive have to go home to quarantine. And some quit or retire amid the stress of working on the front lines of a pandemic that has lasted more than 18 months.

“While we’re trying to deal with this (surge in cases), we’re also dealing with probably the most difficult staffing situation that we have ever seen,” said Tony Marshall, president and CEO of the Georgia Health Care Association, which represents long-term care providers across the state.

Breakthrough infections

As new COVID-19 cases soared in August, Georgia entered crisis mode again. The state’s hospitals cared for a record number of COVID-19 patients. ICUs are still full, and the number of COVID-19 deaths continues to be high.

Riverview Health and Rehabilitation Center in Savannah had been free of new COVID-19 cases for weeks. But, as the delta variant started to drive up cases in July, the nursing home had a staff member test positive, according to federal reports. By the next week, the home reported five new cases among residents. By mid-September, the home had reported 37 COVID-19 cases among residents and six deaths.

State inspectors cited Riverview in an August report for failing to immediately alert the designated family members of two residents who had tested positive. While one of the residents had no symptoms, the other resident was sent to the emergency room with extremely low oxygen saturation levels. The family was alerted when the resident, who was fully vaccinated, was admitted into the hospital.

Jo Lucke, Riverview’s administrator, said there was a mix-up between two nurses over who was going to notify the family. She said notifications have been made immediately in every case since.

Riverview had to reopen its COVID-19 unit when the delta-driven surge began, and the home had to make 26 room changes to group residents for infection control protocols, Lucke said.

“We made a commitment as nurses and nursing home employees and team members to take care of sick people. And it’s hard to take care of a lot of sick people when they don’t have COVID, so can you imagine taking care of them when they do?” said Lucke, who herself got sick with a breakthrough infection during the home’s outbreak. “Despite the challenges, we’re committed to loving them and taking care of them. ... They deserve the best.”

Dunwoody Health and Rehabilitation Center, one of the hardest-hit facilities in the early days of the pandemic, has had 19 COVID cases during the latest surge. “Fortunately, we have not had any deaths as a result of COVID, and most of our residents who tested positive for COVID-19 have had either mild, cold-like symptoms, or no symptoms at all,” said Annaliese Impink, spokesperson for SavaSeniorCare, which operates the facility.

The home reported 28 deaths in the earlier surges of the pandemic. “While it has been a long and difficult 18 months for everyone, we continue with our quality improvement projects and with our efforts to explore new technologies that benefit our residents and staff,” Impink said.

Staffing challenges

While new COVID-19 cases are now declining statewide, nursing home operators continue to worry about what’s to come. The vast majority of nursing home and assisted living operators say their workforce situations have gotten worse in the last three months, according to a new survey released by the American Health Care Association and National Center for Assisted Living.

The survey found virtually every nursing home is facing a staffing shortage, with federal data showing that nursing homes and other care facilities have lost 380,000 employees since the pandemic began.

“Hopefully, the spotlight shown on the workforce crisis by the pandemic will result in long-term solutions,” said Kathy Floyd, executive director of the Georgia Council on Aging. “The bottom line is the staff in long-term care need a living wage.”

Some long-term care operators have shut down wings or limited admissions because of inadequate staff and are struggling financially, said Marshall of the Georgia Health Care Association.

“The sense of recovery, which seemed so optimistic through April, May and June, has now reversed,” he said. “A lot of the optimism that was there has been diminished.”

MaryLea Boatwright Quinn, of the Georgia Chapter of the Alzheimer’s Association, said families are worried about being banned again from visiting loved ones if outbreaks continue. That would leave them wondering whether a vulnerable family member’s needs are being met, especially with the staffing issues.

“My hope is that there is a silver lining in this whole pandemic,” she said, “that we have learned that our health care workforce shortage — from direct care workers to registered nurses, especially in these settings is so critical that we address the shortage.”

AJC data specialist Jennifer Peebles contributed to this article.