Southeast Ambulance employees arrive with a patient at PruittHealth — Grandview nursing home on Wednesday. Curtis Compton ccompton@ajc.com
Photo: The Atlanta Journal-Constitution
Photo: The Atlanta Journal-Constitution

Public given sparse details on deadly outbreak

Several times a week, Albany’s elected leaders and health officials deliver sobering news updates to a besieged community as it battles through one of the country’s worst coronavirus outbreaks.

The briefings are a public accounting of death and struggle. Community triumphs are shared and moments of silence observed for those lost. Top leaders at the city’s only hospital, Phoebe Putney Memorial, contribute the latest stats on testing and patient outcomes, as well as updates on the challenges their doctors and nurses face.

“I appreciate the importance of being forthright with the public,” Mayor Bo Dorough said. “You’re never going to regret telling the truth.”

» COMPLETE COVERAGE: Coronavirus in Georgia

Broadcast live, the briefings provide residents of southwest Georgia something most people across Georgia aren’t receiving from their public officials and hospitals: Consistent and complete information about COVID-19’s deadly grip.

Giant healthcare systems based in Atlanta refuse to say how many coronavirus patients they’re treating at their dozens of Georgia hospitals. They won’t reveal how many of their front-line workers have gotten sick or even died from the virus.

Nursing homes and assisted living facilities aren’t required to post information about outbreaks, and until Friday the state had not been revealing which homes have the most cases, leaving families and advocates in the dark about the conditions inside homes they’re now barred from visiting.

The city of Albany provides regular updates about the Covid-19 outbreak in the community. Photo: City of Albany Facebook page.
Photo: The Atlanta Journal-Constitution

While the governors of New York and Ohio are giving detailed, daily briefings broadcast live, Georgia’s governor has only given periodic updates to the public. And while Louisiana details the race and underlying health conditions of victims, Georgia is in the dark about the extent of the coronavirus and who may be most affected, given a massive shortage of tests and limited information it receives on victims.

It’s incumbent on public officials to provide clear, consistent messaging from credible sources and to explain what they know and don’t know, said Matthew Seeger, a public health communication expert who is a professor and dean at Wayne State University in Detroit. If not, the public will seek answers from unofficial sources, which can fuel rumors and undercut the ability of elected officials to persuade the public to take necessary steps to stop the spread of the virus.

“It’s really hard to overstate how important regular, open, honest, transparent, credible communication is in these circumstances,” Seeger said.

State information scant

Seeger has advised the CDC for 15 years and helped the agency develop a 450-page manual on how to communicate in a public health crisis.

He said concerns about a mass panic are one reason elected officials choose to withhold information or fall short of complete transparency. But the reality, he said, is that people crave information at these moments to make informed choices and protect themselves.

“Panic is a myth,” said Seeger. “People do not panic. They generally respond in rational and logical ways.”

» RELATED: Outbreak apparently taking a heavier toll on blacks

» MORE: Georgia’s COVID-19 deaths surge, and a rural county coroner reels

He said many state and local leaders across the country have stepped up to the challenge, but he was critical of others, including Georgia Gov. Brian Kemp, for not effectively communicating during the crisis.

Kemp’s staff has sometimes provided conflicting messages and his briefings have been less frequent than some other governors. However, the governor’s briefing Wednesday —the first in a week — was more robust, as he extended the state’s shelter-in-place order, temporarily banned vacation rentals and tightened safety requirements at nursing homes and assisted living facilities.

Those decisions came after criticism from local officials of his decision to reopen Georgia beaches and news about the growing number of outbreaks in senior care facilities.

Kemp’s office told the AJC that the governor has kept Georgians up to date by holding 10 press conferences and a televised town hall since Feb. 28. He’s also conducted more than 30 individual interviews with media outlets while also leading the state’s response to the pandemic, said Cody Hall, Kemp’s press secretary. Plus, the governor’s office has responded to thousands of media requests, Hall said.  

“Panic is a myth. People do not panic. They generally respond in rational and logical ways.” —Matthew Seeger, a public health communication expert

“I want every single Georgian -- the ones who voted for me and the ones who didn’t -- to know I’m working hard, not to do what’s popular, not to do what’s best for my politics, and not to do what’s easy,” Kemp said at his most recent press conference. “I’m working every single day, as a husband, father, businessman, proud Georgian -- and your Governor -- to do what’s right.”

However, state agencies are holding tight to information about how they are managing the crisis. The AJC had to use the state’s Open Records Act to discover that the Georgia Emergency Management Agency was looking into establishing three large emergency hospitals, including one at Georgia World Congress Center in downtown Atlanta, to handle a potential surge in coronavirus patients. And while Oregon posts information about daily shipments of personal protective equipment to counties, GEMA hasn’t detailed where it is distributing supplies.

Other times, it’s not that state agencies are refusing to release what they know. Instead, Georgia apparently lacks basic information about the coronavirus that other states have on hand. It doesn’t have information on the race of the majority of coronavirus victims or provide information on the nature of pre-existing conditions for those who died.

» RELATED: Just a handful of Georgia counties have no reported coronavirus cases

» MORE: Georgia could turn convention centers into emergency hospitals

It only provides the number of cases in each county, not by city or zip code, a breakdown that could better pinpoint where the virus is spread.

After health systems and patients complained of waits of a week or more to learn test results, the AJC asked DPH for the backlog of test kits awaiting processing. The agency did not provide that information.

“There seems to be a black box and a lack of transparency about what’s going on,” said Dr. Harry J. Heiman, a clinical associate professor at the Georgia State University School of Public Health.

Public health officials said they had to adapt a disease reporting system that had handled only a few hundred cases a year to one that could quickly handle tens of thousands. Data coming into the system is often not complete, they said, and epidemiologists and medical students are now backtracking to try to fill in the blanks.

Anxious and in the dark

With statewide information gaps, a dramatic headline last Tuesday seemed to fall from the sky without warning: Ten residents with coronavirus dead at an Athens nursing home.

The case, first reported by Channel 2 Action News, marked the deadliest known outbreak at a Georgia nursing home and an escalation of the crisis across the state’s long-term care system. It jolted Georgians cut off for weeks from visiting loved ones in senior care facilities.

It also surprised the state’s leading long-term care industry organization, which had been closely monitoring state reporting. Local elected leaders in Athens also knew nothing of the death toll until the news report.

» RELATED: Kemp allies defend reopening Georgia beaches despite coastal criticism

» MORE: Kemp faces backlash to aide’s criticism of local coronavirus response

That’s emblematic of the information gap from the state to local leaders, compounding their challenge to support their community and address the pandemic, said Russell Edwards, mayor pro-tem of the Athens-Clarke County Commission.

“I struggle to find an adjective to describe how frustrating this is for us as elected officials,” Edwards said. “Why is this information being withheld?”

Until recently, the state had not been releasing how many senior care facilities had outbreaks and which ones. Then, on April 3, DPH released a two-day old list of 47 homes they were investigating with positive cases, but provided no information about the extent of the outbreak at each. Finally, on Friday, DPH released a list showing the number of confirmed cases for most homes and known deaths. But it also was outdated, showing no deaths at the Athens home, PruittHealth-Grandview.

National Guard members wearing protective suits are disinfecting PruittHealth — Grandview nursing home, where 10 patients who had COVID-19 have died as of Monday. The facility continues to operate despite the deaths. Special photo by John Bradley
Photo: The Atlanta Journal-Constitution

Even the state’s long-term care advocates have struggled to know what’s going on. Melanie McNeil, the state’s long-term care ombudsman, said that representatives of her office are having to call nursing homes and assisted living centers to try to find out.

Some respond and provide updates, she said, but others don’t even return calls. Meanwhile, without complete information coming from the state and families shut out of homes, McNeil said it’s been impossible for her office to track conditions that vulnerable residents are facing.

“We absolutely are in the dark,” she said.

Officials of PruittHealth-Grandview said they were hiding nothing. They said they had been in contact with state officials for weeks about what was happening, and a DPH spokeswoman said the agency had epidemiologists and communicable disease specialists at the home investigating.

But the AJC learned the state’s internal reporting on the Athens nursing home as of last Monday showed just two positive cases in the facility, illustrating a statewide gap in local information making its way to the Capitol. “It’s critical we have the best possible data be made available to help coordinate resources,” said Tony Marshall, CEO of the Georgia Health Care Association, which represents most of the state’s nursing homes and dozens of assisted living facilities.

“I struggle to find an adjective to describe how frustrating this is for us as elected officials. Why is this information being withheld?” —Russell Edwards, mayor pro-tem of the Athens-Clarke County Commission

After the AJC asked PruittHealth why more information on outbreaks at its facilities was not known, Neil L. Pruitt jr., chairman and CEO, said it would begin next week posting more detailed information about cases.

“We want our family members to feel like they have all the information that we have,” he said. “Transparency is better than fear and panic.”

Families across Georgia are craving information about outbreaks and conditions at senior care facilities.

Jacqueline Smith has had many sleepless nights worrying about her 94-year-old mother. After the Cobb nursing home where she has lived for years had a positive test a couple weeks ago, the home has provided limited updates, but Smith wishes someone in an oversight role was providing information.

“It’s just horrible,” Smith said. “I don’t know how many have gone to the hospital, if anyone’s died….I would rather know so I can prepare myself instead of the unknown fear that I would know there’s a possibility my mom was infected because there’s an outbreak in the facility.”

Hospitals clamp down

Some Georgia hospital systems are frank about what’s happening, revealing how many coronavirus patients they are treating and whether workers have been sickened by the disease.

For example, Augusta University Health System, whose medical center is the teaching institution affiliated with the state’s medical college, said last week that eight faculty or residents and two medical center employees had tested positive, with all having now recovered, while 226 staff tested negative. It said three patients being treated for coronavirus had died.

“In a time when there’s a lot of misinformation, which in turn generates a lot of fear, we believe it’s our responsibility as the state’s public academic medical center to lead with integrity and openness for our state and the communities we serve,” said spokesperson Christen Engel.

Grady Memorial Hospital CEO John Haupert talked openly earlier this month about how many coronavirus cases and deaths his hospital had handled and also said a handful of workers had tested positive.

But all of the massive hospital systems in Atlanta — Wellstar, Emory, Piedmont and Northside — have remained secretive about their coronavirus caseloads, deaths and employees. They don’t like to share much about their supply of masks and gowns either, even as workers fret on social media about the risks that come with the short supplies.

On the line and dying

When soldiers die in battle or police officers are killed in the line of duty, their names and pictures are released, and their comrades and community honor them with parades and solemn services.

But for healthcare workers fighting the pandemic in Georgia, their illnesses and deaths often remain hidden.

At a press conference Wednesday, state Public Health Commissioner Kathleen Toomey said Georgia doesn’t have data on how many health care workers have become infected.

Pastor Bill Gilbert, who worked part-time as a respiratory therapist as Wellstar Paulding, died after being infected with the conronavirus. He was 78.
Photo: The Atlanta Journal-Constitution

Word of illnesses and deaths is coming primarily from unofficial channels. The Georgia Nurses Association early this month announced the first known coronavirus death of a nurse, without releasing a name or details, and asked the state to pause and recognize the loss.

“GNA believes it is critical to recognize our fallen heroes during this crisis,” said Matt Caseman, the association’s CEO.

Word started tricking out on social media that a well-loved respiratory therapist also had lost his life to COVID-19.

It turned out to be Bill Gilbert, who worked at Wellstar Paulding Hospital. His family announced his death on the website of his church, where he served as pastor.

When the AJC asked Wellstar if a respiratory therapist had died, the 11-hospital health system said only that it was saddened by the news of the death of a “team member.” It provided no other information about the death. When the AJC asked Wellstar this week how many of its employees had tested positive for the virus and how many had died, it declined to say.

Gilbert’s widow, Brenda, said Bill was 78 and had decided that due to his age, it was too risky to keep working in the hospital during the pandemic. Within days of his last shift, she said, he fell ill and was diagnosed with the virus. She became infected, too. While she returned home, he went to intensive care. She couldn’t be with him when he died.

“He put his life on the line for them,” Brenda Gilbert said, “and they should acknowledge him.”

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