COVID spreads past nursing home staff

ELIZABETHTOWN| Spread of COVID-19 at Essex Center continued apace this week. And, sadly, a fifth elder resident at the nursing home died on Friday. Ongoing testing Wednesday found 12 new positive cases among residents and one staff person. And six close contacts of nursing home workers had tested COVID positive as of Thursday. No new COVID infections were found on Friday. 81 CASES There have been a total of 81 cases in the Essex Center cluster, 62 have recovered or been released from isolation, according to county health officials; 36 are residents. Five residents of the nursing home have died, and three remain in hospital. Essex County Public Health Department on Wednesday provided free COVID drive-thru testing to all close-contacts of personnel at Essex Center. "Out of the about 60 individuals, we offered the test to, 22 accepted and were screened," Public Health Senior Health Educator Andrea Whitmarsh said. Of the 22, six "close contacts" were positive, she said. Countywide COVID cases added three in Elizabethtown; four in Moriah and one in Willsboro. Wary of the uptick, area organizations are taking precautions. Vermont placed Essex County in it's "Red" travel advisory category, which limits visits to essential travel between Vermont and the county for work, business services, medical or parental visits. Any vacationers going back to Vermont from Essex County could have to quarantine for two weeks. Banks, including Champlain National and TrailNorth Federal have moved to Drive-Thru only service, providing appointments for banking matters. And another school moved to a remote start of the school year. AUSABLE VALLEY RESETS START AVCS Superintendent Paul Savage announced Thursday evening that they will delay in-person opening this fall. All students will take remote classes until Oct. 5. "The school year via remote will start on Sept. 8 for students and you will receive important updated remote schedule information from your individual building principal very soon," Savage announced to families. And the Oct. 5 date will be reviewed continuously, he said. "We learned a lot about remote instruction from last year's short notice change to remote learning. We will be better and expect to have a much smoother transition for all by having the proper time to plan." Savage said the delay "was an excruciating decision to make and we are truly thinking of the overall safety of your children, our faculty and staff, and our communities. As an educator of 30 years, this is a heartbreaking decision, but one that I feel is necessary based on many important factors." Reasons, he said, include the district's need for more time to receive appropriate Personal Protective Equipment. "And we need time to see if there are any further (COVID) spikes around our local communities like there have been over the past week. "We need to be methodical in our reopening process and we need to be patient!. "Today it was shared that COVID cases involving children were up to 70,000 cases just in the month of August (nationwide) and 9,000 in Florida since reopening (school)," Savage said. "We want to learn from their experience and it tells me that we need to pause. We need to be confident when it comes to the overall safety of your children and employees and that's what we will always do. We have over 1,200 students and 300 staff members in our district which is a large number of individuals who contact many others in their daily lives, and it is a risk not worth taking." Savage said the recent COVID outbreak in local communities demonstrates how quickly this infection spreads. "We are close communities in the North Country and it has directly impacted some of our very own local families at AVCS. That is a fact that can't be ignored or dismissed. "I know many of you either agree with the decision or will be angry about the decision. I understand both sides of that stance for sure and understand that as a parent myself," he said. "In the end, if the delay of in-person for a number of weeks can best ensure the safety of your children and our communities - I can live with that, even if it is overcautious. No matter what, I hope you will at least respect the fact that the well-being of your children, the faculty and staff, and our communities is at the core of this tough decision. That decision is on me," Savage said. Boquet Valley announced it is also delaying in-person attendance until Oct. 5, which is essentially the first half-way point in the first marking period. PUBLIC HEALTH Q & A Public Health officials held a question-and-answer session with media on Thursday, bringing in county leaders, hospital medical staff and a spokeswoman from Essex Center, Grace Pfordresher, the company's regional administrator. Pfordresher said the facility currently has 85 residents, 37 are COVID positive. She did not know how many people work at the nursing home. DOH confirmed 30 employees have tested COVID positive, 22 cases are current, five have recovered and 3 are not residents of Essex County. The Sun asked Pfordresher if traveling employees brought in to fill vacant jobs at the Elizabethtown center are tested first in their home county or in Essex County? The Sun also asked if incoming staff are tested again once they arrive at Essex Center? Neither Pfordresher nor county Public Health officials answered the questions. But Public Health Director Linda Beers has said incoming staff is quarantined before they begin work. Pfordresher said that, prior to Monday, Aug. 17, Essex Centers had no idea they had COVID-19 infection in the facility. The information contradicts county Public Health comments made Monday in the daily report, which said: "four positive cases of COVID that are Essex Center employees were related cases identified from a test in July." Pfordresher said the only time that nursing home residents in Elizabethtown were tested prior to this outbreak was in June, "when we had an employee test positive." Essex Center worked with public health at that time, she said, and all residents tested negative. Public Health Director Beers said that all nursing home residents in Essex County were tested after the first case at Essex Center on June 9. And every nursing home resident tested negative. COVID INFECTION It is not clear how COVID was unleashed in the nursing home in Elizabethtown. But on Aug. 17, a Monday, Pfordresher said, they "first identified a positive resident. We had a patient who coded and passed away (and) the patient's roommate was sick and exhibiting symptoms." The roommate was sent to an Emergency Room where a rapid test for COVID occurred, Pfordresher said. That same Monday, Aug. 17, Essex Center received staff test results back. "And we had three employees who were positive," Pfordresher said. "From the facility's standpoint, we're rather shocked at how many employees have it. I'm not a Public Health person ... but we have been wearing proper Personal Protective Equipment in that facility. We've been practicing social distancing ... we don't really know." COVID in nursing home staff has occurred throughout the pandemic, Beers said, reporting that every nursing home in Essex County has had one staff member test positive for COVID positive at some point in time. Case management has not proved an increased burden to residents or staff of nursing homes, Beers said. Each was managed per Public Health protocol, and disease did not spread. Asked why Essex Center's outbreak was not contained, Beers suggested contact exposure may have derived from ordinary social settings between co-workers. Asked if the Essex County Board of Supervisors, which manages the county Board of Health, is going to investigate, Board Chairman Shaun Gillilland said county Public Health staff have worked closely with the supervisors, providing all information they have asked for in efforts to control the outbreak. That, he said, is an ongoing and constant review. Gillilland is a member of the North Country Region Reopening Control Room, tasked with monitoring COVID outbreak. "This outbreak has been discussed at length in the Control Room," he said. Any requests for resources are met with a quick response from the state. "It's been working pretty well." And the county does not regulate the nursing home. "That is done by the state's Department of Health," Gillilland said. "Maybe we're a victim of our own success," he added. The region has managed safely through the pandemic to maintain low infection rates. "We have a low population. We live further apart from everybody else. and our people are and have been very compliant with following the protective protocols," Gillilland said. "It is a virus's job is to infect its host. And it only takes one person -- no malice or forethought -- in spread of disease. This doubles the need for everybody to protect themselves," Gillilland said. "I don't like hearing the blame game. Let's turn all that energy into fixing and controlling this." Beers agreed, suggesting control of COVID is a community effort. "Every one of us has a job to do. It's not a hard job. It's your job to wear a mask, maintain social distance. It's your job not to gather. It's your responsibility." Elizabethtown Community Hospital Medical Director of Emergency Medicine and Chief Medical Officer Dr. David Clauss said in the short and intense months of the COVID-19 pandemic, they have learned -- no matter how far down you drive the disease -- it seeks out vulnerable groups. ECH has maintained its ability to ramp upsurge capacity, Clauss said, though surge requirements have formally been deactivated by state DOH. He assured media that they are working closely with Essex Center to coordinate efforts, communicate and be transparent. "We remain, we think, ready to respond should the situation require it," Dr. Clauss said. There are no COVID patients at ECH, which has no intensive care wing. COVID TESTING: SCHOOLS Asked how Public Health would manage outbreak in any school, given the long wait in test results, Beers admitted the labs nationwide are backed up. "As far as testing capacity, the lab response with quick turnaround is a challenge," she said. But county Public Health received a small grant from the state's Wadsworth Laboratory, courtesy of the U.S. Centers for Disease Control, to facilitate "Closed Pod" testing using ECH and DOH personnel here. Testing could be ramped-up rapidly for "a small group at high risk." But primary care doctors, Beers said, will be responsible for turnaround time in diagnosing a sick child. "Students (exposed or exhibiting illness) will need a negative COVID test through their primary care provider in order to return to school," Beers said. If there was a problem, the rapid POD (Point of Distribution) testing is available. "The health department is ready to do that," Beers said. State data on deaths in nursing homes is updated regularly and available online.

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COVID spreads past nursing home staff

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