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Nursing homes suffer COVID surge while awaiting the vaccine

Nursing homes and assisted living facilities are getting hit hard by the latest surge of Orange County’s COVID-19 cases, with this month’s infection of residents and workers there accounting for 26% of all such cases during the 10-month-long pandemic.

That’s less than the spike of infection among the county’s general population, where 39% of all cases have come since Dec. 1. But it’s concerning because residents in nursing and assisted living facilities often have other health issues that make them particularly vulnerable to the disease.

While those residents make up just 3.5% of the county’s total infections over the course of the pandemic, they’ve accounted for 45% of the county’s 1,777 COVID deaths reported as of Monday, Dec. 21, according to the county Health Care Agency.

“This is the worst that we’ve seen,” said Deborah Pacyna, spokesperson for the California Association of Health Facilities, which represents skilled nursing home operators. She said similar surges are being seen across the state and country.

“Our residents have been at the epicenter of the pandemic and it’s at its worst just before the vaccine arrives,” she said.

Hospital workers are getting the first batch of vaccine, with nursing home residents and workers in Orange County expected to start getting vaccinated Dec. 28. It should take about two months to get all residents and workers in the county vaccinated “if there are no hiccups,” Pacyna said.

For many facility residents and their families, Christmas holidays are a special time to see one another in person — and that won’t be happening this year because of widespread bans on visitors to nursing homes and assisted living facilities. Advocates for those residents are urging particular vigilance.

“The worst time to fall in a marathon is 100 yards before the finish,” said Michael Dark of California Advocates for Nursing Home Reform. “The vaccine will take us to the other side. If we can white-knuckle it through these last couple months, holidays with family will return.”

Pointing fingers

In response to the surge at residential care facilities, County Health Office Clayton Chau issued a Dec. 15 order halting all communal dining and other indoor communal activities at those operations.

Orange County CEO Frank Kim said the order came after state officials asked the county to help the nursing homes, 35 of which have more than one infection, and assisted living facilities, 36 of which have more than one infection.

“Based on our review, it appeared that in a lot of (the facilities) they were eating together in dining rooms and not taking as many precautions as recommended,” Kim said.

Kim wasn’t the only one pointing fingers at the operators. Dark complained that inadequate staffing, lackluster infection control and the absence of paid sick leave for all facilities workers was exacerbating the problem.

But Pacyna, whose group represents skilled nursing homes but not assisted living facilities, pointed to data that showed dramatic improvements in dealing with COVID at nursing homes. She said weekly tests, tighter infection-control protocols and the use of personal protective equipment have lowered infections and deaths.

Statewide, nursing homes initially accounted for 40% of all COVID deaths, she said. That fell to 22% in August and September, although it has creeped back to 25% currently.

“Facilities are required by law to have enough staff on the floor to provide safe levels of care,” Pacyna said. “If they can’t, they have to stop taking new admissions from the hospital or reduce their census by evacuating residents to other facilities.

“Given the lack of staff resources and the lack of flexibility from the state, we are approaching the point where we will have no choice but to … close facilities to new hospital admissions,” she added. “Otherwise, facilities will face a serious citations and monetary penalties. We have been asking the state to temporarily relax its staffing requirements during this recent surge.”

Pacyna also noted that nursing homes aren’t immune to what’s happening in the world beyond.

“When there’s a surge in the community, there’s a surge in the facilities.”

City News Service contributed to this report.


Source: Orange County Register

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