Nursing homes take steps to prevent COVID-19 spread

Cynthia McCormick

Cape Cod Times

As nursing home officials across the state anticipate phase one of the state vaccination campaign announced last week, they are hoping new infection control procedures prevent the massive loss of life that occurred in the pandemic surge last spring.

Residents of long-term care facilities represent about 52% of total COVID-19 deaths on Cape Cod since the pandemic began. In the spring and summer, however, that number reached more than 60%.

The virus “appears to be even more infectious today compared to the early months of the pandemic,” said Tara Gregorio, president of the Massachusetts Senior Care Association.

But nursing homes have more access to personal protective equipment now compared to when the pandemic started in March, and have ramped up regular COVID-19 testing of staff.

MassHealth started requiring at least 90% of a facility’s staff to be tested for coronavirus weekly as of Nov. 26.

“If one staff member has a positive result then the facility shifts to so-called ‘outbreak’ testing at least every three days of both residents and staff who have previously tested negative,” Gregorio said.

“Under our infection control protocols, residents who test positive are separated from (other) residents until they recover and are no longer infectious,” Gregorio said.

“This is a state mandate,” Tim Brown, spokesman for Athena Health Care Systems, said. Athena operates Cape Regency Rehabilitation and Health Care Center in Centerville and Cape Heritage Rehabilitation and Health Care Center in Sandwich.

"Every center in Massachusetts is required to have a unit available in case they need (to) accept patients or have any existing patients or residents that test positive for COVID-19,” Brown said.

The state Department of Public Health said that Cape Regency lost 17 residents to the coronavirus during the spring surge of the pandemic.

As of the state's most recent weekly report Thursday, just over half of the Cape residents with coronavirus who have died since the pandemic began —  approximately 105 out of 202 — have been residents of area nursing and rest homes. 

The death count was highest at Wingate at Harwich, which lost 21 residents to coronavirus. Royal Cape Cod Nursing and Rehabilitation Center in Buzzards Bay lost 20 residents, and at Pleasant Bay of Brewster, 19 residents with coronavirus died.

The late autumn surge brought a tsunami of new COVID-19 cases to Cape Cod and all of Massachusetts.

The DPH said in its Thursday weekly report that new cases on Cape Cod have risen by more than 800 over the prior two-week period. Since the pandemic began there been 3,821 confirmed cases on the peninsula.

“Regionally cases are leaping everywhere,” said Vaira Harik, deputy director of the Barnstable County Department of Human Services. 

Much of the increase is driven by expanded testing and includes younger people who tend to get less ill. The average age of a person with coronavirus who dies is 82, according to DPH statistics.

But the numbers are concerning just the same, Gregorio said.

“The strongest predictor of a nursing facility outbreak is the infection rate in the community in which the facility is located and where staff live,” Gregorio said in an email.

State Sen. Julian Cyr said the Cape’s legislative delegation would like to see one of two “step-down” facilities for COVID-19 patients open like the ones established last spring by Cape Cod Healthcare in two vacant nursing homes.

The move would free up hospital beds for those no longer needing intensive or acute care but who are too sick to safely return home, Cyr said during the Cape Cod Reopening Task Force press call Thursday.

It would also prevent COVID-19 patients from being discharged to occupied skilled nursing facilities or nursing homes, Cyr said.

“I would really like to see the step-down facility in Falmouth reopened,” he said. 

Cape Cod Healthcare worked with other organizations to open step-down units in Harwich and Falmouth in April.

One step-down facility was located at the empty Wingate at Brewster nursing home and the other in a building that had been recently vacated by Royal Falmouth Nursing and Rehabilitation Center.

Cape Cod Healthcare spokeswoman Christina Peaslee said in an email Friday that the health care organization has no plans at this time to reopen step-down facilities.

Brown said he thinks such facilities are a great idea.

“Athena managed four such locations in Connecticut, under an agreement for the Connecticut Department of Public Health through June 30. They were very successful,” he said.

“Two of them have been re-opened (Nov. 13 and Dec. 8) to meet the growing demand/resurgence for nursing homes, assisted living (centers), and hospitals,” Brown said in a Friday email.

As of Thursday neither Cape Heritage nor Cape Regency had a staff person or resident with COVID-19, Brown said.

Long-term care staff and residents are near the top of the vaccine priority list, coming right after health care employees who care for or are exposed to COVID-19 patients.

Nursing home vaccinations will be conducted on Cape Cod by CVS.

But even with the state expected to receive 300,000 vaccine doses by the end of the month, it will take weeks to fully vaccinate long-term care residents and staff.

Both the Pfizer vaccine that the FDA authorized for emergency use on Friday and the Moderna vaccine, which the FDA will consider this week, require two shots, spaced 21 days for the Pfizer vaccine and 28 days for Moderna.

“It is critical for us all to remain vigilant by wearing face masks, maintaining social distance, practicing good hand hygiene and adopting other necessary strategies to mitigate the risk of spreading COVID-19 into our nursing facilities,” Gregorio said.