Coronavirus outbreak in Pa. nursing homes: What we know now
At a time when most Pennsylvanians are venturing out of quarantine, many nursing home residents are in isolation to avoid catching a coronavirus that has proven deadly in elder care.
The virus is still spreading among Pennsylvania's most vulnerable residents, and a new state directive on testing is making it easier to detect sick patients and staff.
Testing increased 30 percent in June throughout nursing homes, according to state health officials, and nursing homes saw a spike in patients who tested positive for COVID-19.
Nursing home residents and staff are being isolated, but facility leaders and state health officials are downplaying the outbreaks.
"As long-term care facilities begin to conduct universal testing, we do expect to see the cases in facilities go up, and also the state’s overall numbers to an extent," said Department of Health spokesman Nate Wardle.
The health department and nursing home administrators are saying universal testing is revealing asymptomatic cases, and that's why numbers are so high.
But an analysis by the USA Today Network's Pennsylvania Capitol Bureau has determined the recent spike is more than just asymptomatic cases. Nursing home residents account for about 70 percent of all coronavirus deaths in Pennsylvania.
As most age groups are now seeing fewer covid-related hospitalizations and deaths, the state's seniors in nursing homes are still dying at high rates.
For example, at just two nursing homes in the state, a combined 14 coronavirus-related deaths were reported in three weeks.
Last week, the Lancaster County coroner reported five nursing home deaths in one week.
Recent outbreaks
About 15 miles northwest of Pittsburgh in Moon Township, Allegheny County, the West Hills Health and Rehabilitation Center is experiencing an outbreak that has claimed six lives and seen 32 residents and 13 staff members infected with COVID-19.
"Each one of these deaths is a loss for the staff and residents of our Center and we offer our sincerest sympathy to the families involved," West Hills spokeswoman Annaliese Impink said. "We know that this is an unsettling and scary time for our residents and their family members. We understand and greatly appreciate family members’ concern for their loved ones and are doing everything in our power to keep our residents safe and protected."
The center is focusing all of its efforts on infection control process and keeping family members updated on any significant changes to their loved ones’ conditions, she said.
West Hills has 150 beds and, according to the state health department, its last daily census was 107 residents. Allegheny County has been in the green phase of reopening since June 5.
The center does not know the source of the infection, “but believes that it may have been the result of a staff member who tested positive and who was asymptomatic," Impink said.
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A decision was made to test the entire center after two residents with symptoms were sent to the hospital and tested positive for COVID-19, she said.
“We have had a number of asymptomatic residents and staff who tested positive after the testing was completed,” Impink said.
West Hills is in “frequent communication” with the state Department of Health, Impink said, and staff are taking “significant measures to protect all our residents,” such as contact tracing, enhanced monitoring, cohorting residents with similar symptoms or who have tested positive, consulting with the center’s medical director and expanded education.
Staff members undergo a health assessment before every shift, which includes screening for respiratory illness and high temperatures. All health-care professionals entering the facility are also screened.
Any employees sent home for treatment or self-isolation must either test negative for COVID-19 or meet CDC return recommendations and be cleared by a physician, Impink said.
West Hills provides a daily update about COVID-19 cases on its website, but does not provide the number of virus-related deaths.
The Allegheny County Health Department is aware of the situation at West Hills and is working with the center, said county spokeswoman Amie Downs.
“When a COVID-19 case is identified among residents or staff at a long-term care facility, the Health Department designates someone to be the main point of contact for that facility. The Health Department and the facility communicate regularly,” Downs said. “The Health Department shares guidance from the state Department of Health, answers any questions and helps the facility interpret and apply the guidance to its operations. The facility shares information about its procedures and the current status of any cases.”
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In southcentral Pennsylvania, nursing homes are also reporting outbreaks and deaths.
An outbreak that started on May 25 at Pleasant Acres Rehabilitation and Nursing Center in York County has infected 72 residents, 20 staff and led to eight deaths, according to Tamath Hetrick, administrator at Pleasant Acres.
ManorCare South in York Township, York County, reported 76 residents with COVID-19, including 40 residents and 36 staff members. One resident has died.
Across the state, health officials are seeing about 100 new nursing home infections per day, Wardle said.
“Certainly, the increase is cause for concern, but the state wanted universal testing to determine the burden of disease among our most vulnerable,” he said. “This will lead to increases, and it is essential that people continue to take steps to protect themselves from COVID-19.”
The increases are not prompting state officials to move green counties with nursing home outbreaks back to yellow at this time, Wardle said.
What's being done to stop the spread
All nursing home residents and workers must be tested at least once this summer, according to recent orders from the State Department of Health on June 8 and 26. Testing in nursing homes has to be completed by July 24, while assisted-living residences, personal care homes and intermediate care facilities have until Aug. 31.
Results from universal testing are "so important as we work to determine the burden of COVID-19 among our most vulnerable, and also as we work to protect them from future waves of COVID-19," Wardle said. "This information is also useful to help prevent further spread in long-term care facilities."
"Any nursing home that needs assistance, whether with help conducting testing, supplies to test, etc., the department is ready to assist," he added.
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In a joint statement, Secretary of Health Dr. Rachel Levine and Secretary of Human Services Teresa Miller said their departments have deployed these mitigation efforts as of June 19:
- Distributed over 2,300 shipments of personal protective equipment, which includes 306,944 gowns, 336,559 face shields, 1,023,800 gloves, 2,807,570 N95s masks and 1,175,200 surgical masks.
- Deployed 69 Pennsylvania National Guard Strike Teams to 34 different long-term care facilities. Work includes 32 site assessments, 10 personal protective equipment trainings, 13 COVID-19 mass testing missions and 14 facility staffing missions.
- Responded to 100 percent of outbreaks, defined as one or more confirmed positive case among staff or residents, in long-term care facilities.
- Provided advice and consultation on infection control and outbreak response to facilities
- Collaborated, partnered and received reports from local, state and federal resources, along with contracted support from ECRI, a healthcare nonprofit
At Pleasant Acres, "the comprehensive testing is working because it allows us to identify asymptomatic staff and residents and take appropriate action," Hetrick said.
The state on Wednesday announced a partnership with CVS Health to offer COVID-19 testing services to skilled nursing facilities, free of charge.
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Omnicare, a CVS Health company, will administer up to 50,000 tests for skilled nursing residents and staff members beginning June 29.
Testing will be done on a three-tiered priority list, starting with facilities that have new or ongoing outbreaks, then to facilities with a history of a resolved outbreak and finishing with facilities with no outbreaks.
As of Friday, Pennsylvania had more than 84,000 positive cases of COVID-19. More than 20,000 cases were at nursing homes. Some 6,500 state residents have died since March, and more than 4,500 lived in nursing homes.
Those numbers are stark reminders that while nursing home residents make up about one-fourth of the state's positive cases, they account for about three-fourths of the deaths.
Candy Woodall and J.D. Prose report for the USA Today Network's Capitol Bureau in Harrisburg. Reach Woodall at cwoodall@gannett.com. Reach Prose at jprose@timesonline.com.