COVID spread like wildfire throughout long-term care facilities caught off-guard by the illness at the onset of the pandemic. But healthcare administrators have learned a lot of lessons since the darker days of March and April, and the Benton County Health Department implemented specific guidance to protect assisted-living communities.
“Those are really high on the priority list for Oregon public health,” Benton County Health Department deputy director Charlie Fautin said. “Some of the earliest cases and deaths in Oregon were in long term-care facilities, including in the VA facility in Lebanon.”
There haven’t been any large outbreaks among residents and patients in Benton County long-term care facilities, although there have been a few confirmed cases since March. By-and-large, Oregon’s facilities haven’t taken the same toll as did their counterparts in New York, Washington or Louisiana, among other places.
There weren’t any active outbreaks among residents of long-term care facilities in Benton County as of Friday, but three such facilities in Linn County reported ongoing outbreaks — Bridgecreek Memory Care Center, which reported 35 cases and a death; Regency Albany; and The Mennonite Home, which reported a COVID death.
Fautin said credit is due to the staff, residents and families of Oregon long-term care facilities for keeping cases down and protecting their communities. The prevalence of or exposure to COVID among staff and residents is tracked closely by the state public health system and facilities are required to follow specific guidance.
“They have mandates around regular screening and testing of residents and especially of the staff,” Fautin said. “Staff safety and staff PPE — training and testing.”
Families should be cautious but not dread these facilities, Fautin said, noting that for every tragedy that occurred throughout the pandemic there are also 20, 30, or even 50 similar such cases of public health triumph, wherein individuals were and remain safe.
“There’s some really heroic work being done,” he said.
Continuity among COVID restrictions by community is complicated — even confusing — because of the patchwork nature of their implementation. The state mandates restrictions, but each individual facility also may employ additional restrictions. In some cases facilities enforce restrictions that other facilities may not. Long-term care facilities are licensed and inspected by a branch of the Oregon Public Service, not county health departments.
State restrictions are essentially based upon the recommendations handed-down by administrators at the Centers for Disease Control and Prevention. That guidance suggests that long-term care facilities should not relax visitation policies and other restrictions until the prevalence of COVID in the surrounding community is diminished; no standing or new cases among facility residents or staff exist; no staffing shortages persist; a concrete plan is developed to consistently test staff and residents at these facilities; universal control of the environment is possible by limiting who can or cannot enter a facility, limiting the possible number of sources of a COVID outbreak; adequate access to personal protective equipment for staff members at such facilities is provided and local hospitals have excess capacity to handle a surge in severely-ill patients.
“Early in the pandemic, there were bans on visitation,” Fautin said. “That’s no longer the case as a blanket, statewide. But there are still some facilities employing very limited visitation.”
Strict lockdowns take their emotional toll on residents of long-term care facilities, too.
“These are family members and loved ones — we’re all suffering from isolation,” Fautin said. “Overall, the facilities are really trying to minimize and control in-person visitation and to encourage outdoor visitation as much as possible.”
And some facilities are trying creative approaches to bring additional capabilities to residents through the internet. Now, some residents are able to use video calling applications to keep in touch with their loved ones.
“There are facilities that have beefed-up their WIFI to provide some added capabilities for residents,” Fautin said. “To do more remote visiting with families.”
He noted that long-term care facilities are well-versed in the control of infectious airborne illnesses, especially throughout the colder months of the year.
“Because it’s winter, long-term care facilities have issues this time of year anyway,” he said. “They’re always on guard against the flu in the winter and they’ve got lots of experience.”
There usually are warning signs posted regarding respiratory illness on the entrances of medical clinics and long-term care facilities in the winter, but this year that aspect of precaution is kicked-up an order of magnitude.
By Gabriel Perry