As families long to visit for holidays, even more nursing homes experience COVID-19 outbreaks
EDITOR'S NOTE: This story has been updated to correct the spelling of Cindy Peden's last name.
Delaware now has more COVID-19 outbreaks at long-term care facilities, as identified by the Division of Public Health, than at any point during the fall.
It’s affecting families like Cindy Peden's. Her mother and father have recently tested positive for COVID-19 while living at Regal Heights Healthcare and Rehabilitation Center in Hockessin.
Peden says she hasn’t seen her father since he moved into the facility in August, and her mother moved in with him shortly after Thanksgiving after quarantining for two weeks. The first week out of quarantine, she tested positive and is in quarantine again. Her father also tested positive soon after the holiday.
They live on the interior side of the building looking out over a courtyard, making it impossible for Peden to wave to them through a window, she says. They occasionally schedule video chats to replace a part of their in-person visits.
On Wednesday, she dropped off Christmas presents for them.
"I was fighting off tears," she said.
As the outbreaks are unfolding, officials have dedicated their public COVID-19 briefings to warning against gathering with family members around the holidays. They fear a "surge upon a surge" in cases and hospitalizations that could threaten the state’s capacity to provide care to COVID-19 patients.
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But the residents of the state’s 88 long-term care facilities and their families largely don’t have that option. Visitation is heavily restricted throughout the state, and the Division of Health Care Quality has advised against residents leaving facilities because of the heightened risk of exposure.
The limited visitation that opened in September has been closed in many cases. If a facility has had a positive case in the last two weeks, it reverts to the first stage of the state’s reopening guidance, which allows no routine indoor visitors and outdoor visitors by appointment only. Since the end of September, at least 20 facilities have experienced multiple cases among staff and residents.
Even facilities that haven’t had any cases have been affected. At Rockland Place, a retirement community in Wilmington, no one is allowed inside. Families could schedule a time to visit with residents at a window to watch them open gifts and pose for a photo.
Catherine LaPenta described her mother, Camille Thomas, a resident at Rockland Place, as very "family-oriented," saying she’d typically be at the center of her family’s large gatherings. She said it’s sad the facility is locked down but she's grateful to be able to visit through the window.
"My mother is a very optimistic and resilient person, and we’re all trying to take that lesson from her during this time," LaPenta said.
Older people – and particularly residents of long-term care facilities – have suffered the most severe effects of COVID-19. More than half of Delaware’s COVID-19 deaths – 480 of 888 as of Wednesday – have been among residents of long-term care facilities. According to a New York Times database, Delaware ranked 10th among all states in terms of the share of deaths linked to long-term care facilities as of Dec. 4.
The situation has seemingly worsened in recent weeks, in Delaware and elsewhere in the country, as overall case counts and hospitalizations continue to increase. According to an AARP analysis of federal data, about 1 in 65 long-term care facility residents died per month from the virus in the weeks around Thanksgiving.
The Division of Public Health provides a weekly update on its investigations into outbreaks at long-term care facilities throughout Delaware. The state adds facilities to its weekly update when they have had a cumulative total of more than 10 residents and 10 staff each.
In the week ending Dec. 18, the state added 13 facilities to its list of outbreaks, tripling it in size.
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According to Hockessin’s Regal Heights spokesman Brian Dries, 69 of that facility’s residents have tested positive for COVID-19 since Nov. 5. A Thursday afternoon press release from DPH listed nine total COVID-19 deaths at that facility.
"We offer our deepest condolences to their loved ones," reads an emailed statement from the facility, where Peden's parents live. "Unfortunately, many facilities are impacted by surges in positive cases occurring in their surrounding communities."
The statement also said Regal Heights is screening staff before they start their shift and is regularly disinfecting all surfaces. No visits are allowed.
For each facility, the state provides the number of residents and staff that have tested positive since Sept. 25. At Regal Heights, where Peden's parents live, the state reported 72 cases in residents and 31 cases in staff – the fourth-most combined cases of any facility on this list.
Regency Healthcare and Rehabilitation Center in Wilmington, which has appeared on the list since Oct. 23, has had the most cases, with 74 cases in residents and 47 cases in staff.
Cheryl Heiks, executive director of the Delaware Health Care Facilities Association that represents the majority of assisted living, skilled nursing and continuing care retirement facilities in the state, warned that Delaware residents need to be mindful this Christmas about who they gather with because it could have an impact on cases rising.
"We understand everyone wants to see their family and friends during the holidays, but we really need to consider our parents and grandparents who are living in our nation’s long term care facilities,” Heiks wrote in an email. "Our residents — seniors with underlying health conditions — are the most vulnerable when it comes to this virus, and this level of COVID in the community makes it virtually impossible to stop."
Because long-term care residents are considered by public health officials to be the most susceptible to COVID-19 spread and the disease’s most dire effects, they will be among the first groups to receive the COVID-19 vaccine starting Monday.
Long-term care residents will receive the vaccine through a federal partnership with pharmacy chains CVS and Walgreens. Vaccines have been shipped directly to the pharmacies, which will have pharmacists and technicians travel to long-term care and assisted living facilities across the state to administer the vaccine.
The companies have agreed to return two times. The second trip will come three weeks after the first to give the second dose of the Pfizer vaccine. Pharmacists will make a third trip to cover anyone who may still need or want the vaccine.
CVS expects its long-term care vaccination program to last about 12 weeks.
The operation could be a precursor to the spring or early summer, when officials expect the general public will be able to access the vaccine at pharmacies in a fashion similar to the flu shot. Bullock said the process will likely involve more COVID-specific clinics operated by CVS, so pharmacies can also continue to serve their regular customers.
"We are definitely thinking about what this looks like at a larger scale," said Jeffrey Bullock, a CVS regional manager.
As of 8 a.m. on Dec. 24, the state has administered 6,569 doses of the COVID-19 vaccine. Most of the initial vaccines went to health care systems, which decided for themselves who among their staff should receive the early limited doses.
Emergency medical services personnel in Kent County began receiving the vaccine on Wednesday, and some staff and administrators from one long-term care system were vaccinated Dec. 17.
As of Dec. 24, the state has received 11,700 doses of the Pfizer vaccine and 16,700 doses of the Moderna vaccine.
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