Georgia’s top public health official effectively dropped a bombshell Wednesday when she announced that 47 long-term care facilities have coronavirus outbreaks that the state is investigating. Since the first case of the infection in a senior care facility had been reported in mid-March, the Department of Public Health had been silent about the extent of the virus’s spread across Georgia’s nursing homes and assisted living facilities.
And even in announcing the new number, DPH Commissioner Dr. Kathleen Toomey offered few details about the outbreaks and didn’t name any facilities.
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Then Thursday, DPH said there were 58 facilities reporting the infection and confirmed that two nursing homes have such widespread infections that the facilities are struggling to properly function. In Albany, PruittHealth - Palmyra has 35 residents who have tested positive for COVID-19, and seven have died since March 15, the company confirmed to The Atlanta Journal-Constitution. Just north, in neighboring Terrell County, Dawson Health and Rehabilitation nursing home said it had 16 patients who tested positive and six of them have died.
The outbreaks highlight the risks residents and staff at long-term care facilities face in containing the virus once it gets into their facilities. Across the country, homes have become vessels for the rapid spread of the disease. The deadliest toll occurred in Washington State, where the first major outbreak led to 37 deaths tied to one home.
“Nursing homes are probably the highest risk situation we have, short of cruise ships,” said Toomey, speaking at Wednesday’s public briefing where Gov. Brian Kemp announced a statewide shutdown to combat the virus. “If people come in and out, whether it’s visitors or health care workers, they can bring infection with them.”
To try to protect vulnerable seniors, in early March the federal government said nursing home inspectors would focus on the outbreak. In mid-March, the agency told nursing homes to restrict visitors and nonessential personnel, and even stop communal activities inside homes. Georgia followed suit with recommendations that assisted living and personal care homes take similar steps. Families were told they could no longer visit loved ones because of the risk.
Those measures haven’t stopped the rapid spread of infections.
Elderly residents aren’t the only ones at risk. DPH said that workers at senior facilities are more at risk of being infected than workers at hospitals because they don’t have the same type of personal protective equipment and senior facilities are struggling to get masks, gloves and other gear now.
PruittHealth currently has seven facilities in Georgia that have confirmed positive tests for the coronavirus, according to its website. But the situation in Albany is the company’s biggest challenge, said Neil Pruitt, CEO and chairman of Norcross-based PruittHealth, which has more than 100 nursing homes and assisted living facilities across the Southeast.
“I’d be lying to you if I didn’t say that it’s heartbreaking that the patients and staff there are going through that crisis,” he said.
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The company believes the outbreak at the 250-bed facility is linked to one of two funerals about a month ago that have been tied to the rapid spread of the coronavirus across the city. Pruitt said health officials believe a non-patient who attended one of the funerals visited the nursing home afterward, a theory that Kemp alluded to at his press conference.
Of the 39 tests they’ve had come back on residents, 35 were positive, underscoring how thoroughly the virus can spread in the close quarters of a nursing home. The facility is awaiting pending results on tests for 38 other residents. Pruitt said once they know who has the virus and who doesn’t it will be easier to manage.
“We obviously want to get everyone tested,” he said, but as of Wednesday they had not been able to meet that goal.
Some staff have also tested positive and were out of work. To offer additional support, the company brought in a team of employees from outside Albany, including four of their top nurses, the company’s corporate medical director and a regional vice president who has taken over as the facility’s administrator during the outbreak.
The state also sent a team of National Guardsman as well as public health officials to offer guidance.
“We’re accepting all the assistance we can get,” he said.
Twenty miles away from the Palmyra home, at Dawson Health and Rehabilitation, the first signs of the outbreak appeared on March 12 when a patient exhibited symptoms. That patient was later transferred to a local hospital, according to Amy Abel, a spokeswoman for the non-profit home. The facility said they were leaving it to state health officials to determine how the virus first came to the facility.
The facility has tested all residents and is awaiting for results of 29 tests. Of the 16 patients who tested positive, eight are currently in the 74-bed nursing home. Seven staff members have also tested positive for the virus. The facility is screening health care workers before they report to work and not permitting anyone with respiratory symptoms in the building.
The facility also stopped accepting new patients during what Abel characterized as “an unprecedented crisis” providers are facing across the state and country.
“This will help prioritize resources and focus on meeting the needs of the patients currently residing in our nursing center,” she said.
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A DPH infection control team is in Southwest Georgia this week trying to prepare facilities to recognize and contain the virus, said Dr. Charles Ruis, the Department of Public Health Southwest District director, who outlined the effort in public briefing on Monday with other officials in Albany.
Ruis said in Dawson he found a staff that was compassionate and brave, but tired with several colleagues out.
He also warned that keeping the infections out of nursing homes and assisted living facilities altogether is very challenging.
“It would be naive for us to think we’re going to get through the next few weeks without some bad outcomes in long-term care facilities,” he said.
DPH apparently may soon follow other states in providing more detailed information on facilities that have had positive tests and outbreaks, information that it has held tight to up to now.
As early as Friday, the state said it expects to release updates.
That would be good news to families like Amy Mahaffey’s. Her 89-year-old mother’s nursing home in Gwinnett County has not had any positive tests, as far as Mahaffey knows. But when she saw Toomey’s pronouncement Wednesday about the number of facilities that have had outbreaks, she said that was unsettling.
“We’re really anxious to see a list of the facilities,” she said. “It’s such a scary number to us.”
Advocates say that state health officials and individual homes should be posting information about the outbreak along with their staffing numbers every day during the crisis.
“The public has the right to know,” said Richard Mollot, executive director of the New York-based Long Term Care Community Coalition.
He said states also must carefully monitor facilities for possible staffing shortages and try to find a way to allow families to safely visit. “We know residents in nursing homes are the most vulnerable population period – they’re older and medically compromised,” he said.