As coronavirus case counts and hospitalizations swelled in recent weeks, nursing homes and assisted-living facilities are bracing for how the surge could impact their staff and residents.
Some have already seen outbreaks. As of Wednesday in Dallas County, 95 long-term care facilities were reporting active outbreaks — the highest number since the start of the pandemic.
In the last 30 days, long term-care facilities reported 798 COVID-19 cases, including more than 300 infections of staff members, according to Dallas County.
Of those cases, 27 people died, including two staff members, and 44 people have been hospitalized.
Since the beginning of the pandemic, 281 residents of long-term care facilities have died of COVID-19, making up about 23% of the county’s 1,221 confirmed coronavirus deaths.
Residents of long-term care facilities — both nursing homes and assisted living facilities — are some of the most vulnerable patients and have been “a high-priority population to really try to protect,” said Dr. Philip Huang, Dallas County’s health director.
Because of the vulnerable populations they serve, a Texas health department panel recommended that staff who work at long-term care facilities should be among the first state residents to get COVID-19 vaccines. A CDC advisory committee also recommended Tuesday that nursing home residents should also be in the first groups to receive access to the vaccine.
Huang said that the record number of outbreaks in Dallas County long-term care settings is “really concerning.”
Higher levels of the virus in the community can translate increased spread in the individual facilities, he said.
Greg Loudermilk, owner of the Midlothian Healthcare Center in Ellis County, said the facility went for months without a positive COVID-19 case. But in late November, the facility saw a large outbreak.
“When the numbers in the community started to rise like they have — we’re in the same situation El Paso and Lubbock were in a few weeks ago now here in North Texas,” Loudermilk said in an interview. “Whenever that happens, that’s when we start to see positive tests come up.”
On Nov. 20, Loudermilk wrote in a message to people with loved ones at the nursing home that they were experiencing a “major crisis” — a coronavirus outbreak. At that point, there were 41 residents and 25 staff members with positive tests for the virus.
By Monday, things were starting to improve, Loudermilk said. Still, 30 residents at the facility were positive for the virus, and seven staff members were infected, he said. A week earlier, nearly half of his staff was out sick with the virus.
He offered Walmart gift cards to staff members who were well and able to pick up extra shifts, and people in administrative roles started working on the floor, Loudermilk said — himself included.
Last week, Loudermilk was in charge of maintenance, housekeeping and central supply — definitely a departure from his normal duties, he said.
The surging COVID-19 cases make him nervous, he said, because then it’s difficult to ensure staff aren’t exposed to the virus out in the community — and inadvertently bring it back to work.
“They can do it and not even know. Then the next thing you know, they’re here, and they’re exposing our residents,” he said. “So even though we have a lot of safeguards in place, and we give them the tools to try to prevent spreading the virus, it still can happen. It’s just very, very contagious.”
Some long-term care facilities halted visitations because of rising cases and test positivity rates in the broader community, said Diana Martinez, president and CEO of the Texas Assisted Living Association.
“Every person that walks into a community is a potential vector of this thing,” Martinez said. “So they’re trying to clamp down and trying to protect the residents as best they can.”
They’re also watching hospital capacity levels, she said.
“If someone gets sick and you’re unable to care for them there, are they going to be able to transfer them to a hospital? Or if it’s a community that doesn’t have the resources — could they transform to a nursing facility?” Martinez said.
Monticello West, a Dallas long-term care facility, was hit hard by the virus early on in the pandemic, recording 21 deaths. But since June, there has not been a positive case, said Marjorie Silberman, the interim executive director of Monticello West.
“We are just following the rules to the letter as best we can,” she said. “It’s education, its vigilance — a little bit of luck doesn’t hurt either.”
She said staff has stayed tuned to guidance from public health authorities, and they’ve worked diligently alongside residents to protect themselves and each other during the pandemic.
“Doesn’t mean things couldn’t change tomorrow, but everybody has been working hard to keep the place clean, to screen residents, to screen visitors — limited though they are — and just do whatever we can to impact the pandemic,” Silberman said.
Martinez, of the Texas Assisted Living Association, urged people to stick to taking precautions against the spread of the virus, especially during the holiday season. That means staying home as much as possible, and if you do go out, making sure to practice social distancing, wearing a mask and washing your hands regularly.
“We ask you to please take this seriously,” she said, “and help protect all of our Texas seniors.”
The Associated Press contributed to this report.