As coronavirus cases across Colorado rose dramatically in recent weeks, so did deaths in nursing homes. Of the 624 confirmed fatalities in nursing homes since the pandemic first hit the state in March, about a fifth were in facilities that have active outbreaks, according to state data analyzed by KUNC.
“As we see community level rates go up, we see, I think, more opportunities for the virus to be potentially introduced into settings like nursing homes and other long-term care facilities or residential facilities,” said Dr. Rachel Herlihy, the state’s epidemiologist.
Families can visit nursing homes only under extraordinary circumstances, like end-of-life scenarios. Dining and group interactions inside are restricted. Workers are screened before their shifts and must wear prescribed PPE, like masks. Such protocols and procedures were put in place to reduce the transmission of the virus not only at nursing homes but other facilities, including assisted living and combined care centers.
“Some of those key changes include strategies around infection prevention and cohorting to make sure that seniors living in facilities are protected,” Herlihy said. “We also have really robust testing programs that have been established in these facilities.”
Yet coronavirus is still getting into the facilities. There are 116 of them with active outbreaks. More than a quarter of those involve 20 or more residents. Four have 70 or more infected residents and seven have tallied 10 or more deaths.
The virus’ entry point into the facilities can be through its workers.
“On multiple occasions we have seen the index case — the first case associated with an outbreak — be staff members who work in a facility,” Herlihy said.
Doug Farmer, the president and CEO of the Colorado Health Care Association, which represents nursing and assisted care facilities, agreed that workers can bring the virus in.
“Our employees have to come and go from those facilities,” Farmer said.
When they do, they stop to get gas, pick up groceries and travel in an environment where one in 41 Coloradans are struck by the virus — the highest rate measured yet by state officials and a figure that is rising by the week. Those who care for the frail are simply more exposed to the virus and some of them are asymptomatic, meaning they can unwittingly carry the virus into a facility, even past the screening process.
Two national organizations that represent nursing homes and assisted living centers — the American Health Care Association and the National Center for Assisted Living — have tracked the undulations of infections in the community since June. They found the ups and downs of infections closely mirrored the pattern of infections at nursing homes.
In an effort to reduce infections, state officials have repeatedly implored residents to reduce their interactions, to follow state rules and to wear masks in public. As health officials declared many counties across the Front Range and other parts of the state Level Red — or severe risk — on its COVID-19 dial, indoor dining was closed.
But pockets of dissent and resistance have arisen. For instance, Weld County Commissioners in Northern Colorado said the county would not enforce any restrictions, but instead would “promote and encourage residents and business owners to take individual responsibility and make decisions to protect themselves, their families, their community and their businesses.” The statement gave recommendations like handwashing and physical distancing, but made no reference to masks, advising people instead to “cover your cough” and stay home if sick.
Farmer said while masks and other precautions aren’t 100% effective, he cited federal and state health officials who agree that they reduce the virus’ spread. He said people who decide to go out in public without masks only increase the likelihood a health worker will get infected.
“When people make that decision that they think is really only impacting them, it impacts the entire community,” he said. “If, because of their choices they become a spreader and they spread the virus to another person who doesn’t share that point of view, well now they’ve gotten other people sick. And, in fact, that’s what’s found its way through the doors of nursing homes.”
Forty-four percent of the 2,355 deaths in Colorado due to COVID have been residents of nursing homes or assisted living or combined care centers, according to KUNC’s analysis.
Amid rising cases, Gov. Jared Polis warned Tuesday that Colorado’s death toll could double by the end of the year.
