As coronavirus continues to spread throughout the United States, causing a surge in the number of new cases in the newly opened states, older people may need to prepare for the next quarantine step.
States such as Arizona, Florida, and Texas have reported record spikes in recent weeks as they continue their plans for opening while scaling up testing. Arizona state health officials reported 3,056 new confirmed cases on Thursday. According to CNBC University of Johns Hopkins, around 1968 people are hospitalized on average for seven days, up 37% from a week ago.
Arizona was one of the first states to reopen, allowing most restaurants and businesses to resume work with disabilities and health measures in early May. It also has one of the largest elderly populations in the country.
“When we first started blocking in Arizona, our long-term care facilities were hit hardest,” said Dana Marie Kennedy, Arizona State Director at AARP.
“At some point, 82% to 84% of deaths occurred in long-term care facilities. Today, this number has dropped to 55% in long-term care. ”
According to the US Census Bureau, in the United States, people 65 years of age or older make up 16% of the population. In arizona 17.5% of the population at the age of 65 years and older. State Department of Health says 75% of deaths from Covid-19 is from this age group.
There are currently over 140 nursing facilities in the state of Arizona, and the state’s most vulnerable population remains at high risk of infection and a possible outbreak.
“In Arizona, we have not reached its peak, and I do not know when we will reach it. This is really important because last week we didn’t even reach thousands, and this week we were in thousands every day, and four times we broke new business records, ”Kennedy told CNBC on June 19.
While older people and immunocompromised people are most prone to die from coronavirus, national data on nursing homes are scarce.
To better understand the impact of the epidemic on older people, Medicare and Medicaid Services Centers, or CMS, Began to require all nurses in the US to report Covid-19 in May. On June 4, she published her first set of numbers, including the total number of confirmed cases, deaths, and other indicators regarding residents and employees of nursing homes. The federal agency said it would update its numbers weekly, as more agencies would publish their data in the coming weeks.
As of June 14, according to the latest available data, the CMS reported that there were 792 residents in nursing homes in Arizona who tested positive for Covid-19 and at least 215 deaths. in national 111,508 deaths of Covid-19 and 30,794 people were confirmed in nursing homes.
Outbreak in nursing homes
CMS data showed two nursing homes in Arizona that had the largest outbreaks of coronavirus: Tucson’s Sapphire, Care and Rehabilitation Center, and Providence Place at the Glencroft Modern Aging Center in Glendale.
Sapphire reported 107 residents who tested positive for Covid-19 and 30 residents who died from the virus. Among full-time workers, there were 38 confirmed cases and zero deaths.
Sapphire did not respond to requests for comment from CNBC.
To Glencroft82 people tested positive for Covid-19 and 20 residents died. There were 81 confirmed cases among full-time employees and zero deaths.
“From April 15 to May 25, we had an outbreak of Covid, a little in our lives with help and a significant outbreak in our skilled care center [Providence Place]”Said Scott McClintock, director of strategy at Glencroft.” At one point, we had about 40 or 50 people who tested positive for Covid in our nursing center out of about 150, so 30% to 40% were Covid positive “.
McClintock said Glencroft stopped accepting new residents in March and closed all amenities and public areas, such as dining rooms and event rooms. Instead, he began offering food delivery services and coordinated programs to help residents stay at home and remain in quarantine.
According to McClintock, Glencroft also checks and measures the temperature of everyone on his campus every day, and any employee who develops symptoms or has a fever is immediately sent home. Mcclintock said Glencroft deployed perimeter guards to track independent residents who enter and leave the campus.
Another nursing home, Solstice Senior Living, said they also strictly follow CDC recommendations and inspect their employees daily. They also closed their communal premises and instead delivered food to residents.
“We asked people not to leave the community. It is an independent life [facility]“So they could leave, but if they leave, they will have to quarantine on their own for 14 days,” said Christie Ballard, senior vice president of sales and marketing at Solstice Senior Living.
Personnel testing is key
As the number of new cases of coronavirus in Arizona continues to increase, nursing homes emphasize the need for frequent testing.
McClintock told CNBC that Glencroft did not have access to coronavirus testing until the institution identified and reported an outbreak in the county in April.
“If we are going to fight this again in the future, we should be able to test with quick results, because we should be able to separate people who are positive right away,” he said. “And we need PPE” or personal protective equipment.
“If we had fast test results, we could stop half the infections,” he said.
According to McClintock, CMS now requires a weekly coronavirus test for all qualified nurses.
Kennedy agrees that routine testing is necessary to minimize infection and control the spread of the virus.
“If you do not continue testing, then the virus can penetrate. Therefore, knowing that it is contagious in these institutions, you want to conduct regular testing and also make sure that they have adequate personal protective equipment. ” ,” she said.
“We checked only qualified nursing facilities, and in Arizona there are 147. Our auxiliary housing is more than 2000, and they have not been tested. Therefore, there is no basic test for auxiliary living quarters, ”she added.
Kennedy emphasized the importance of testing full-time workers in nursing homes and providing them with adequate personal protective equipment, as they work closely with residents in skilled nursing facilities and supportive living quarters.
“In the beginning, the only way to get Covid in an institution was from someone working at the facility,” she said.
“In institutions with qualified nursing care, these are people who need the most help in terms of basic everyday activities, such as going to the toilet and bathing, so there is a lot of communication with residents.”
According to Kennedy, most of the labor force in nursing homes works in more than one job in several institutions. This can be a serious danger to other employees and residents who are in close contact with them.
“You deal with employees who usually receive the minimum wage, train very little in PPE, and sometimes English may not be their native language. Suddenly, you have this pandemic, and they can be asymptomatic, ”she said.
Glencroft also suspects that his outbreak could potentially be related to an employee who has qualified medical assistance, since the funds have been closed since March.
“This is probably true for older people anywhere in the country, but it is staff who usually infect residents. This is not news when you have to provide such direct personal assistance. Our employees return home every night to their family, and they have contacts with other people, “said McClintock.
No quarantine return
Long-term care facilities can include three types of communities: independent living quarters, auxiliary living quarters, and skilled health facilities.
Independent living is housing for pensioners who can live independently without daily medical assistance, but want to get access to care, convenience and security services. Livelihoods are licensed providers that offer daily housing, personal care, and medical care. Institutions with skilled nursing care are based on a medical model that works around the clock and seven days a week, which provides care for residents with a higher level of clinical needs.
When the coronavirus epidemic swept the United States, qualified nursing facilities had to follow the strict guidelines set by the Centers for Disease Control and Prevention, or CDC, because the federal government controls them. The CDC recommended that other types of long-term nursing homes follow recommendations as best as possible.
“Accompanied life and skilled care are licensed areas, so we control access to them,” McClintock said. “We closed them very quickly in March. There were no visitors, not even a family, unless we had a patient who was really dying. ”
McClintock said Glencroft cannot force residents of independent apartments to stay at home or wear masks.
“When they rent our housing, this is essentially their house from a legal point of view, and we cannot force them to do anything, and we do not provide them with their care,” he said.
McClintock said that although most residents have complied with community health measures in recent months, he believes they will not accept quarantine returns.
“They are crazy. They were terrified. They really wanted news, and they really wanted to get out, ”he said.
Despite recent spurts of new Covid-19 cases in Arizona, many nursing homes in the state are fulfilling their opening plans. They currently have more personal protective equipment and testing than at the beginning of the epidemic, which makes them feel more prepared for a future outbreak.
After the outbreak, McClintock said he was confident that Glencroft’s qualified care and care sites are under control and protected from Covid-19.
“It seems that in our nursing center we have effectively achieved herd immunity. A sufficient number of people have it and now have antibodies. I don’t think we will have another outbreak at the nursing care center, ”he said.
Many nursing homes have already opened their communal areas and began to conduct group events with a limited number of participants and social distance. Although these nursing homes are still not allowed to visit visitors, they continue to ease some restrictions.
“You have to go in stages,” said Ballard of Solstice Senior Living. “This is a transition. It is not like you can turn it on like a light switch. You have to move slowly. ”