After major outbreaks in nursing homes in Walnut Creek and Concord, long-term care facilities now account for a staggering 70% of COVID-19 deaths in Contra Costa County, according to the county health department.
Twelve patients have died of COVID-19 at the ManorCare Health Services-Tice Valley nursing home in Walnut Creek, according to information from the state health department. In total, 92 patients and 38 healthcare workers were infected, and 25 patients are still ill.
At the San Miguel Villa nursing center in Concord, 20 patients and at least one health worker have died, according to state information; Although 65 patients and 17 workers were infected at the center, no one currently has COVID-19.
According to Contra Costa Health Services, 71 of the 102 COVID-19 deaths in the county involved long-term care facilities.
The 70% rate in Contra Costa is significantly higher than the COVID-19 death rate for nursing homes and assisted living facilities in the state total: 46%.
San Mateo County data shows a rate almost as high as that of Contra Costa. In San Mateo County, 78 of the 114 people who died from COVID-19 were associated with long-term care facilities, about 68%
In that county, an outbreak at Millbrae Skilled Care resulted in the deaths of 17 patients and at least one health care worker, according to the state’s information portal. 103 patients and 32 staff members were infected at the center.
In Santa Clara County, 81 of the 181 COVID-19 deaths have been located in long-term care facilities, or about 45%. That’s the same percentage as in Alameda County, where nursing facilities accounted for 77 of 173 COVID-19 deaths.
According to the state, the death toll in California skilled nursing facilities has reached 3,013 patients and 113 health workers. So far, at least 17,162 patients and 12,202 healthcare workers at those facilities have tested positive for COVID-19. Among residential care facilities for the elderly, commonly called assisted living centers, another 5,215 residents and staff have hired COVID-19, and at least 553 of them have died.
Months after the coronavirus pandemic, long after health officials instructed nursing facilities in March to ban visits and stop all group activities, many residents of nursing homes and assisted living facilities continue to get sick.
This is because as COVID-19 spreads in the general population, healthcare workers are more likely to carry the coronavirus, often asymptomatically, to the nursing facilities where they work, experts say.
“The moment I saw further community spread, I knew it would result in the deaths of more older adults, particularly in (nursing homes),” said Dr. Michael Wasserman, geriatrician and president of the California Association. for Long Term Care Medicine.
He noted that, in addition to more COVID-19 cases, the number of nursing homes in California with large outbreaks has also increased.
“If the nursing homes are not doing enough tests and often enough, they will not pick up asymptomatic people,” said Charlene Harrington, a professor and researcher at the UCSF School of Nursing. “So the key question is, how many of the nursing homes are actually testing?”
A ManorCare Health Services spokeswoman said everyone at the Tice Valley facility was evaluated and steps were taken to counter the outbreak, including increased disinfection procedures and symptom and temperature controls, among other protocols suggested by officials at Health.
Contra Costa County issued a health order in late May that required referral tests from all residents and staff of a nursing home or other residential care facility. For those with positive cases, staff should be evaluated weekly until there are no new cases, but after that, a facility “can resume its regular surveillance testing program.” It is unclear how many facilities have their own regular testing schedules, if any.
Statewide, the California Department of Public Health has issued a guide to testing, but has finally left testing to facilities to coordinate with local health departments. There is also the problem of maintaining enough protective equipment, such as masks, gloves, and other equipment for health workers, that nursing facilities and assisted living communities struggled to acquire in the early days of the pandemic.
Harrington said there is still very little transparency and accountability about whether the facility has adequate supplies, personnel or evidence.
“There is no penalty for not reporting, for the shortage of personnel, for not doing the tests,” he explained. While many nursing homes are being “extremely careful,” it is entirely up to the ownership and management of a facility to protect staff and residents.
It has not helped the facility exclude family visitors and patient advocates in March to curb the spread of the coronavirus, he added.
As cases continue to rise in communities, nursing facilities or assisted living facilities are unlikely to start opening doors again.
“As long as we have outreach in the community,” nursing home patients will be affected, Harrington said.
