While just 11% of US cases have occurred in long term care facilities, this setting accounts for greater than one third of the country’s COVID-19 deaths. Over 28,000 residents (and workers) at nursing homes and other places of congregate living for older adults have succumbed to the disease. In North Carolina, alone, nursing home residents account for 2320 cases (14% of the state’s total) and 318 (52%) of deaths. This week four of our skilled nursing staff members were diagnosed with COVID-19. They are beloved members of our Deerfield family, and we are heartbroken to know that they are being impacted by this disease.
We know that nursing homes are disproportionately vulnerable to COVID-19 outbreaks, as are any settings of congregate living. Additionally, we know that older, medically comorbid adults, the population that inhabits most nursing homes, tend to suffer more severe syndromes of COVID-19 when infected. And, lastly, we know that SARS-CoV2, the novel coronavirus that causes COVID-19, is highly contagious and fueled by a propensity for stealth transmission through asymptomatic or vaguely symptomatic hosts. With these facts in mind, Deerfield has never presumed that we would be capable of completely averting cases or small outbreaks on campus. Unfortunately, given the nature of this virus and the context at Deerfield, that sort of goal would be improbable, if not impossible, to achieve. Instead, we have worked incredibly hard, both individually and collectively, to put systems in place to shield residents and staff from on-campus exposures to the extent practical and to create a culture of awareness, prevention, and mitigation.
Deerfield has incorporated a method of widespread testing, called a “point prevalence survey”, which is an appropriate response to an outbreak in this setting. The purpose of a point prevalence survey is to expeditiously identify asymptomatic or presymptomatic cases to facilitate early isolation and, ideally, contagion containment. We plan to repeat point prevalence surveillance of Skilled Nursing residents and healthcare personnel in the coming days and weeks, and we will expand testing if warranted by the results.
Widespread testing efforts build upon measures we have already been practicing, including, but not limited to: campus-wide visitor restriction, point-of-access temperature checks and screening for risk factors, mandatory masking by employees for source control, elimination of group dining and activities, facilitation of social distancing and hand hygiene, frequent disinfection of high-touch surfaces, and continued outreach education to residents and staff.
This has been a difficult week. The news of an outbreak right here at home, in our very own healthcare facility, is distressing. All are concerned. Many are frightened. Our team will continue in our tireless efforts to ensure the safety and wellness of our staff and residents to the absolute extent of our collective ability.
In honest acknowledgement, while we wished that our campus would never endure even a small outbreak, we have expected that this moment would come. This is not a failure. Months of research, teamwork, assiduous effort, and creative problem solving have prepared us to meet this challenge. We will get through this together, led by love and compassion. And we will remain steadfast in our practice of those now-ubiquitous infection control measures that help to protect our community.
Stay Home. Wear. Wait. Wash. Send prayers and positive energy to those who are sick, those who continue to come to work in spite of fear, and to those who stay at home to keep themselves and others safe.
Taryn Tindall, RN, on behalf of the Deerfield Leadership Team