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Northam reverses position, orders release of nursing home outbreak data

Credit: WHSV
Credit: WHSV(WHSV)
Published: Jun. 19, 2020 at 3:53 PM EDT
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After months and nearly 57,000 COVID-19 cases in Virginia, the commonwealth has begun making details about outbreaks at long-term care facilities available to the public.

On Friday, Governor Ralph Northam announced the new move in a statement about money going from the CARES Act to support response at similar facilities around Virginia.

According to Gov. Northam, his administration is directing $246 million, mainly from federal CARES Act funding, to assist long-term care facilities fighting the virus.

Facility-specific data now available to the public

But he also directed the Virginia Department of Health to make facility-specific data about cases and deaths in long-term care facilities public.

Up until now, State Health Commissioner Dr. Norm Oliver had said multiple times in past press conferences that such information couldn't be made public due to the Virginia code treating facilities as "persons" and prohibiting the sharing of medical information for "persons" to protect their anonymity.

So, thus far, information about outbreaks had only been released to the public if a facility granted permission for that, and many did not.

But now, a public spreadsheet is available on the Virginia Department of Health website here to track the status of cases and deaths from outbreaks at nursing homes, assisted living, and multi-care facilities.

“The lockdowns of long-term care facilities to protect residents and staff from the spread of COVID-19 have been hard on residents and their families,” said Governor Northam. “These actions will help support long-term care facilities as they ease those restrictions, while keeping their residents safe and ensuring that the public gets accurate information on the spread of this virus in these facilities.”

Northam said in a statement that he was directing the health department to "release the names of individual long-term care facilities (nursing facilities and assisted living facilities) that have experienced a COVID-19 outbreak."

The health department had previously released aggregate data about long-term care facility outbreaks across the state, but not facility-specific data out of what they said was their responsibility to protect patient anonymity, but they say, "due to the widespread nature of this pandemic, it is now unlikely that releasing facility information would compromise anonymity or discourage facilities from participating in a public health investigation."

VDH also placed some blame on data from the federal Centers for Medicare and Medicaid Services (CMS) , which they called "inconsistent, creating public confusion."

However, Republicans questioned why Northam had the ability to release the data now, but not before.

“I cannot fathom the reasoning behind the Governor’s announcement today," said House Republican Leader Todd Gilbert in a statement. "Families have sought this information — information they could use to protect their loved ones from a lethal threat — for months. Now, after the body count in nursing homes reaches 1,000, the Governor has reversed course. If it is legal to release the information now, it was legal to release it when it was first requested. Perhaps, had the Governor not been distracted by his political rehabilitation, he could have realized this earlier and lives could have been saved. Incompetence kills, and there is a great deal of incompetence from this Governor. Inexplicable decisions like this will force us to look at executive authority in the upcoming special session."

A month ago, on May 18, the Centers for Medicare and Medicaid Services (CMS) laid out reopening criteria for nursing facilities, including a recommendation that all facilities conduct a baseline testing survey, and that facilities with outbreaks test residents and staff weekly.

State-specific guidelines from VDH require licensed nursing homes, certified skilled nursing facilities (SNFs), and certified nursing facilities (NFs) to conduct baseline and ongoing testing of all facility staff and residents while those facilities are in the first phase of the reopening process.

Testing recommendations for latter phases of the reopening process are under development.

The data on facilities themselves

You can find the list breaking down facilities with outbreaks by county and city in Virginia here, alongside a whole list of resources from the Virginia COVID-19 Long-Term Care Task Force, including reopening guidelines, point prevalence testing plans, and more.

Our local long-term care facility outbreaks

According to the newly released data, there are several outbreaks in progress around the Shenandoah Valley, multiple outbreaks that have closed, and outbreaks pending closure.

Here's our local breakdown:

Augusta County

Outbreak pending closure: Golden gardens Residential Living - Count suppressed to preserve anonymity

Harrisonburg

Outbreak in progress: Harrisonburg Health and Rehabilitation Center - 32 cases and 0 deaths

Outbreak pending closure: Accordius Health at Harrisonburg - 112 cases and 21 deaths

Page County

Outbreak in progress: Skyview Springs Nursing Home - 150 cases and 22 deaths

Rockingham County

Outbreak in progress: Sunnyside Retirement Community - 6 cases and deaths suppressed to preserve anonymity

Shenandoah County

Outbreak in progress: Consulate Health Care of Woodstock - 82 cases and 10 deaths

Outbreak pending closure: Dutch Haven Assisted Living - 43 cases and 11 deaths

Outbreak closed: Pine Meadow - 5 cases and 0 deaths

Outbreak closed: Skyline Terrace - Count suppressed to preserve anonymity

Staunton

Outbreak pending closure: Ritenour Rest Home - 24 cases and 0 deaths

More funding for long-term care facilities

According to the governor, Virginia will also spend $246 million in new funding to support nursing homes and assisted living facilities in addressing staffing shortages, increasing infection control measures, and purchasing personal protective equipment (PPE), as well as complying with the new testing requirements.

The majority will go to to nursing facilities that receive Medicaid payments.

More than $56 million will be provided for periodic testing of nursing home residents and staff.

It also includes another $152 million from the Provider Relief Fund that long-term care facilities have received for COVID-related expenses. Assisted living facilities have been unable to benefit from that fund, but will now receive $20 million in support, nearly doubling state funding.

Point prevalence testing

Because a majority of the outbreaks in Virginia have occurred in long-term care facilities, VDH, in partnership with the Virginia National Guard, has supported long-term care facilities in conducting “baseline” or point prevalence surveys (testing all residents and staff in the same time period). VDH has a goal to complete these baseline surveys of all Virginia nursing homes by July 15, 2020.

The full long-term care facility list

Outbreaks we knew about before

As numbers have climbed in parts of the Shenandoah Valley, much of the increase has been attributable to outbreaks within particular facilities. By June 19, the Central Shenandoah Health District had identified 18 outbreaks and the Lord Fairfax Health District had 22.

Health department officials have not specified the majority of the locations of our outbreaks, because the Virginia Department of Health has interpreted Virginia code as treating facilities the same as "persons," meaning their anonymity has to be protected. So information about outbreaks is only released to the public if a facility grants permission for that to be released, and that has not been often.

Of the outbreaks in our area, several have been confirmed at long-term care centers, including at Accordius Health Harrisonburg, where 22 patients died of COVID-19; Skyview Springs, where there have been 16 confirmed deaths; Ritenour Rest Home in Staunton, where Augusta Health has confirmed a “COVID situation” but no exact numbers have been provided; Sunnyside Communities, with at least 5 cases among residents and staff as of June 3; and three outbreaks in Shenandoah County, including one at an unnamed nursing home and two at unnamed assisted living facilities.

The largest of those outbreaks was the one at Accordius Health Harrisonburg, where 81 residents and 12 staff members tested positive for COVID-19 in April. By Tuesday, May 5, the facility confirmed 22 deaths due to coronavirus. By a little later in May, the large majority of patients had recovered from the virus.

In Page County, the outbreak at Skyview Springs Rehab resulted in 59 residents and 23 staff members testing positive for the virus. By May 13, 16 people there had died of COVID-19-related causes. The facility has 115 residents total.

Dr. Colin Greene, with the Lord Fairfax Health District, told WHSV in May that the Skyview Springs outbreak was the only major outbreak in the Page County area.

However, he said they were monitoring five active outbreaks in Shenandoah County. Due to Virginia code preventing the identification of facilities with outbreaks, he could not identify the exact locations, but said two were at businesses, two at assisted living facilities, and one at a nursing home.

Outbreaks have also been confirmed at New Market Poultry, the Harrisonburg Men’s Diversion Center, with at least 25 positive cases, and LSC Communications, which had at least six cases by the end of April but then stopped providing updates on their employee hotline so that media outlets would not have access to the information, which was not publicly provided.

On May 26, RSW Regional Jail confirmed at least 15 people at the facility had tested positive for COVID-19, as the outbreak identified inside a correctional facility in the Lord Fairfax Health District. A day later, that number was up to 18 positive tests.

New Market Poultry Products, which has more than 100 employees working on a daily basis, confirmed near the end of April that they had multiple employees test positive– though an exact number was not provided and no update has come since then.

None of the other Shenandoah Valley poultry plants have released any information about COVID-19 cases to the public, but 18 workers tested positive at the Pilgrim’s Pride in Moorefield, W.Va. and Cargill in Dayton has confirmed the death of one employee due to COVID-19 – though never any information on the number of cases at the facility.

Poultry plants and other meat processing facilities have been hotspots for the virus across the country and a focus of Gov. Northam's in Virginia. State health commissioner Dr. Norm Oliver has also referenced the situation at poultry plants in Harrisonburg leading to a disproportionate number of cases among the Latino community in the Shenandoah Valley, though, again the facilities themselves have released no information publicly.

The only exact number for poultry workers that has been provided is that as of May 20, at least 317 poultry plant workers living in the Central Shenandoah Health District had tested positive.

Many of the local outbreaks that do not have confirmed locations have been identified in congregate settings, which could include workplaces, apartment complexes, churches, gyms, or any setting with a group of people in one place. While WHSV has received reports from viewers about specific stores, for instance, if the business does not provide consent for their information to be shared, the health department cannot confirm any information about cases there.

Where are our local cases overall?

Overall, according to the Virginia Department of Health's June 19 breakdown, 567,162 tests have been run for the virus in Virginia, with 56,793 positive results.

The department’s breakdown and location map, available to the public here, shows the number of cases confirmed each day, number of people tested, total hospitalizations, total deaths, demographic breakdowns, and testing numbers, as well as breakdowns by health district.

Here's a breakdown of cases for our region as of 9 a.m. on June 19. You can find the breakdown for the entire state in the chart at the bottom of this article.

Numbers sometimes decrease day to day when the health department determines that a test initially reported in one locality was actually for a resident of another city, county, or state.

Central Shenandoah : 1,853 total cases

• Augusta County - 166 (+2 from Thursday)

• Buena Vista - 12

• Harrisonburg - 874 (+4 from Thursday)

• Highland County - 3

• Lexington - 8

• Rockbridge County - 18

• Rockingham County - 646 (+5 from Thursday)

• Staunton - 62

• Waynesboro - 61

Outbreaks: 18, with 7 in long-term care facilities, 1 in a healthcare setting, 8 in congregate settings, 1 in a correctional facility, and 1 in an educational setting | 568 cases associated with outbreaks

Total tests: 14,321

Local percent positive: 12.9%

Lord Fairfax: 1,787 total cases

• Clarke County - 44 (+1 from Thursday)

• Frederick County - 446 (+2 from Thursday)

• Page County - 261 (+2 from Thursday)

• Shenandoah County - 534 (+4 from Thursday)

• Warren County - 235 (+1 from Thursday)

• Winchester - 278 (+2 from Thursday)

Outbreaks: 22, with 8 in long-term care facilities, 5 in healthcare settings, 8 in congregate settings, and 1 in a correctional facility | 579 cases associated with outbreaks

Total tests:

17,159

Local percent positive:

10.4%

Thomas Jefferson

: 730 total cases

• Albemarle County - 304 (+2 from Thursday)

• Charlottesville - 164

• Fluvanna County - 103

• Greene County - 48

• Louisa County - 102

• Nelson County - 18

Outbreaks:

13, with 4 in long-term care facilities, 2 in correctional facilities, 6 in congregate settings, and 1 in an educational setting | 176 cases associated with outbreaks

Total tests:

16,462

Local percent positive:

4.4%

Rappahannock Rapidan

: 1,387 total cases

• Culpeper County - 792 (+2 from Thursday)

• Fauquier County - 401 (+2 from Thursday)

• Madison County - 42

• Orange County - 136

• Rappahannock County - 16

Outbreaks:

8, with 3 in long-term care facilities, 1 in a healthcare setting, and 4 in congregate settings | 118 cases associated with outbreaks

Total tests:

11,718

Local percent positive:

11.8%

Recovery

Wondering about the number of people who have recovered from COVID-19 in Virginia? Recovery information is not required to be sent to the Department of Health, so there is no accurate way to track that data for every single confirmed case. Individual health districts may track cases as "active" and "non-active," but that data is not published anywhere in aggregate.

But there is a way to track the number of patients who were hospitalized due to COVID-19 and have since been discharged – effectively tracking how many people have recovered from the most severe cases.

The Virginia Hospital & Healthcare Association updates their own dashboard of data each day on hospital-specific statistics, including bed availability, ventilator usage, and more. Their

indicates that, as of June 19, at least 7,563 COVID-19 patients have been discharged from the hospital.

Unlike the VDH data that reports cumulative hospitalizations, their data on hospitalizations reflects people currently hospitalized for COVID-19 (whether with confirmed or pending cases), and that number is at 862, which is one of the lowest points since the start of the pandemic.

The data used by the VDH to report

cumulative

hospitalizations is based on information reported in hospital claims. On the other hand, the numbers reported by the Virginia Hospital & Healthcare Association are based on a current census from hospitals, which provides a separate data set.

What to know about preventing the virus

Most people don't suffer much from COVID-19, but it can cause severe illness in the elderly and people with existing health problems.

It spreads primarily through respiratory droplets produced when an infected person coughs or sneezes. Those droplets may land on objects and surfaces. Other people may contract the virus by touching those objects or surfaces and then touching their eyes, nose, or mouth.

The coronavirus that causes COVID-19 can cause mild to more severe respiratory illness. In a small proportion of patients, COVID-19 can cause death, particularly among those who are older or who have chronic medical conditions. Symptoms include fever, cough, and difficulty breathing. Symptoms appear within 14 days of being exposed to an infectious person.

To lower the risk of respiratory germ spread, including COVID-19, the Virginia Department of Health encourages the following effective behaviors:

• Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer only if soap and water are not available.

• Avoid touching your eyes, nose, and mouth.

• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.

• Clean and disinfect frequently touched objects and surfaces.

• Stay home when you are sick.

• Avoid contact with sick people.

• Avoid non-essential travel.

There is currently no vaccine to prevent or antiviral medication to treat COVID-19. The best way to avoid illness is preventing exposure, which is why governments around the world have implemented Stay at Home orders.

For the latest factual information on COVID-19, you're encouraged to check both the

and the

.

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