With LTC virus cases growing, IDPH avoids mandatory testing

Testing of nursing home staffs recommended, not required

"We haven't mandated that long-term care facility staff be tested," IDPH Deputy Director Sarah Reisetter said Thursday.

Maureen Cahill, administrator of the Spurgeon Manor in Dallas Center, described Thursday the anti-virus efforts at her facility and the community’s support for Spurgeon Manor’s residents and staff, including the Thursday parades. “We’re so happy to see everyone that sometimes we cry,” Cahill said.

Although the number of positive cases of COVID-19 continues to creep upward at long-term care (LTC) facilities across Iowa — including at two of Dallas County’s LTC outbreak sites — the Iowa Department of Public Health (IDPH) has not required compulsory testing for workers in the infected nursing homes.

According to records of the Iowa Department of Public Health, 22 positive cases of COVID-19 were reported among the residents and staff at the Granger Nursing and Rehabilitation Center April 28. That number grew to 44 cases by May 9 and to 50 by May 14. The Rowley Masonic Community in Perry reported on May 11 six cases among its residents and staff. By May 14, the number had climbed to 11.

To date, 35 LTC facilities in 14 Iowa counties have reported 1,249 positive cases of COVID-19, representing about 9% of the state’s total of 13,675 positive cases.

“Sadly,” Iowa Gov. Kim Reynolds said Thursday at her daily press briefing, “about 57% of all Iowans who have lost their life to COVID-19 are residents of long-term care facilities,” that is, 180 out of the 318 COVID-19 deaths in Iowa occurred among LTC residents.

To date, 244 residents of LTCs have recovered from the COVID-19 infection.

Since April 28, the number of LTC outbreaks in Iowa has jumped more than 50%, from 23 to 35 facilities, and the number of positive cases among the vulnerable elderly population of the nursing homes has also increased more than 50%, from 657 to 1,249 cases.

“I want to reassure Iowans who have family members in long-term care facilities that every step is being taken to protect your loved ones,” Reynolds said Thursday. She said all Iowans have been challenged by the novel coronavirus pandemic, “but nothing has been more difficult than its impact on older Iowans, especially those who live in our long-term care facilities.”

One step that has not been taken is compulsory testing for workers in the state’s 444 LTCs.

“To date, we haven’t mandated that long-term care facility staff be tested,” IDPH Deputy Director Sarah Reisetter said Thursday, “but it is strongly recommended, and we’re doing everything we can to make those opportunities available so facilities can take advantage of those testing opportunities.”

Reisetter said when the IDPH saw the “devastating consequences in other states” that COVID-19 infections were causing in “congregate living situations,” her department acted proactively at Iowa’s LTCs to restrict visitation, suspend communal dining and activities, impose staff health screenings and temperature checks and require proper use of personal protective equipment (PPE).

“And yet, unfortunately, we have still seen circumstances where even the best efforts to prevent the virus from entering the facility have not been enough,” Reisetter said.

Once an outbreak in an LTC occurred, she said, the IDPH recommended isolating the ill person in a single room and using “cohort staff, so that dedicated staff are working with ill residents and not with healthy residents.”

The IDPH also recommended that LTC employees use PPE at all times, even when not providing patient care, but the state did not require it because the supply of PPE was not adequate to the task. The same circumstance appears to be the case with recommended but non-mandatory testing.

According to Reynolds, “Right now we have tested 95% of all of our long-term care facilities,” or some 420 of the state’s 444 LTCs. She said the tests are variously given.

“They can be sent directly to the facility and administered by their own nurses for staff and residents,” she said. “We can also coordinate through local public health departments, so they can also do that. Or we have conducted countywide long-term care strike teams to provide testing as well. Testing of the long-term care facility staff can also be facilitated through TestIowa sites that are in the area. Since May 1, more than 9,000 tests have been sent to 94 facilities to test staff and residents. Strike teams have been deployed to five counties to test more than 1,300 long-term care employees across 40 facilities, and long-term care facilities within a county where a TestIowa site is located have been offered the opportunity to be tested at the site, for a total of 286 more facilities and more than 16,000 staff, so in total that’s more than 26,000 tests for 420 long-term care facilities. That’s 95% of our long-term care facilities in Iowa have really been proactive in taking advantage of the testing that we’ve been able to provide so that they can really understand if the virus is active in their facilities, if it’s active within their staff or residents.”

All employees of LTCs in Dallas County were “offered” virus tests May 8-9 at the Dallas County Fairgrounds in Adel. About 1,000 workers from the county’s nine LTCs were eligible for the tests, according to the Dallas County Public Health Department. The IDPH has not replied to repeated inquiries about the turnout for the free tests, which were paid for by the individual LTCs.

Testing is not mandatory but is “provided to any long-term care facilities that request it,” Reynolds said Thursday.

“The offer has been made to facilities,” Reisetter said.


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