The novel coronavirus outbreak at Life Care Center nursing home
in Kirkland, Washington, which has killed 13 residents and left others
seriously ill as of Sunday, highlights the risk that such facilities
face from the virus.
As of Saturday, 70 of the 180 staff members at Life Care Center
were reportedly out sick with symptoms resembling COVID-19, the disease
caused by the coronavirus.
The nursing home-focused outbreak of the coronavirus comes as
nursing homes and assisted living facilities are already struggling with
infections. Such places are sometimes poorly staffed and don’t control
infections properly, leading to resident hospitalization or death, The
New York Times reports.
“We have to prepare for the inevitability that there are going to
be facilities like the one in Washington where you’re going to have the
virus … move rapidly through nursing homes and assisted living
facilities,” Brown University geriatrician David Dosa told the NYT.
A large majority of U.S. nursing homes — 75% — have been cited for
not controlling (or monitoring) infections during the last three years,
USA Today reports, citing federal inspection data. Not all of the
citations were serious, but many were, including ones for facilities
trying to cover up infection outbreaks.
Inspection reports show that many errors are fairly simple, and
thus theoretically easy to correct, such as workers not washing their
hands between patients, or not bothering with masks, gloves or gowns in
situations where they are called for, such as visiting a patient in
isolation, Kaiser Health News.
Even though it is a top-rated nursing home by the government — five
stars — Life Care Center had previously been cited for a lapse in
infection control.
The potential damage from infections in nursing homes is quite
large. Over 4 million Americans reside in nursing homes or skilled
nursing facilities each year, according to the U.S. Centers for Disease
Control and Prevention, and almost 1 million live in assisted living
facilities.
The problem of serious infection in these facilities isn’t
precisely known, though it is estimated to be extensive. Between 1
million and 3 million serious infections occur annually in the
facilities, the CDC says, including antibiotic-resistant staph
infection, urinary tract infections and diseases marked by diarrhea.
Since the coronavirus outbreak in the United States is still
evolving, its impact on nursing homes or any other kind of congregate
care is unknown.
The problem is compounded by the fact that the elderly are proving
to be particularly vulnerable to COVID-19. In China (as of Feb. 11), the
fatality rate for the disease for people over 80 is 14.8%, and for
those 70 to 79 years old it is 8%, compared with a 2.3% fatality rate
overall, the Chinese CDC reports.
Another consideration for senior housing, especially skilled
nursing facilities that employ a significant number of healthcare
workers, is protecting those workers from the disease.
Healthcare–associated transmission is a major problem, the U.S. CDC
reports. To deal with that problem, the U.S. CDC further recommends
that healthcare workers use personal protective equipment such as gowns,
gloves and either an N95 respirator plus a face shield, goggles or a
powered, air-purifying respirator. How practical that would be for
skilled nursing facilities, the agency does not address.
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