Bacon's Rebellion

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2/3 of COVID-19 Deaths Yesterday Traceable to Long-Term Care Settings

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by

James A. Bacon
in

According to the latest Virginia Department of Health data:

  • 33 COVID-19-related deaths were reported May 19 and published today.
  • 22 new deaths were reported for long-term care facilities.

That’s just one day’s results. But it’s consistent with yesterday’s data. Can we agree that the COVID-19 epidemic in Virginia is, at this point in time, primarily a nursing home epidemic?

Meanwhile, according to the latest Virginia Hospital and Healthcare Association data, 10 of 262 Virginia’s nursing homes reported having difficulty obtaining N95 masks, 4 had trouble getting surgical masks, 7 finding face shields, and 21 obtaining isolation gowns. Is there a correlation between PPE shortages in nursing homes and the spread of the virus (and resulting deaths) at those same nursing homes? It would be nice if the VDH would make the data public so citizens could find out for themselves.

— JAB

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17 responses to “2/3 of COVID-19 Deaths Yesterday Traceable to Long-Term Care Settings”

  1. Steve Haner Avatar
    Steve Haner

    The real question is, are COVID patients who no longer need hospital care being sent to Virginia nursing homes or rehab centers next? That’s what happened in New York and New Jersey that caused that explosion – state orders that the non-hospitals could not deny admissions to COVID-positive patients.

    1. Nancy_Naive Avatar
      Nancy_Naive

      That’ll bump the numbers.

      Things looked soooo much better back in the days when hospitals just dumped indigent patients in the park.

    2. MAdams Avatar
      MAdams

      Very good question considering VA discharges lead hospitalizations by a 4 to 1 ratio.

    3. cjbova Avatar
      cjbova

      The one person officially VDH-recognized as hospitalized from Mathews, did go to a long term care facility and is still there according to the latest word on the street. She took sick March 24th. A second Mathews person was hospitalized more recently, but not on VDH for here, and might be listed under another county.

      1. LarrytheG Avatar
        LarrytheG

        Looking around the country – it’s apparent there is no uniform standard and each state is sorta doing it’s own thing….and it’s not
        really vetted or validated.. it’s just what they decided.

        States Accused of Fudging or Bungling COVID-19 Testing Data
        Public health officials in some states are being accused of bungling infection statistics or even deliberately using a little sleight of hand to make things look better than they are.

        I know in the Fredericksburg Area – VDH is saying that they do not identify the business that has a hotspot.

  2. Ichabob Avatar
    Ichabob

    No, can’t agree yet as the data (other than deaths) is incomplete:

    https://www.theatlantic.com/health/archive/2020/05/covid-19-tests-combine-virginia/611620

    https://www.roanoke.com/news/local/roanoke-ranks-lowest-in-state-for-covid-19-testing/article_a5fd0e2e-fa63-533f-960d-06d5fc155730.html

    https://www.wsls.com/news/local/2020/05/17/galax-has-third-highest-number-of-coronavirus-cases-in-our-region/

  3. Acbar Avatar
    Acbar

    Steve, I keep hearing that — “blame the State order” — but also have read that it was covid infection brought into nursing homes by staff who also work in hospitals and private homes (multiple jobs). Could the story be more nuanced?

    1. Nancy_Naive Avatar
      Nancy_Naive

      I don’t think he’s blaming the State Order. He’s merely pointing out that the “I’m not dead yet” patients are being transferred to facilities where when they die, they bump the number on the receiving facility as opposed to the treating hospital.

      They’ll probably never be able to cull them out unless they look at the date of admission.

  4. S. E. Warwick Avatar
    S. E. Warwick

    We have no idea what happens with people who test positive with symptoms who may not be sick enough to hospitalize and recover after alleged self quarantine for at least 14 days. Surely, since testing began in early March, there are a considerable number of cases like this. We also seem to have lost sight of the fact that the number of cases reported is cumulative since early March.

    1. cjbova Avatar
      cjbova

      S.E. Warwick: You’re right. VDH does not track recoveries in Virginia.

      Their cumulative number of hospitalizations since the beginning of March is 3,979, but VHHA shows 4,523 discharged and 1536 currently still hospitalized.

  5. Nancy_Naive Avatar
    Nancy_Naive

    The dashboard has a number (4,523) as “hospitalized + discharged”. The question is “discharged to where?”

  6. djrippert Avatar
    djrippert

    A bit whiny / partisan but otherwise a good description of how a state should have managed the crisis, at least so far ….

    https://www.nationalreview.com/2020/05/coronavirus-crisis-ron-desantis-florida-covid-19-strategy/

  7. LarrytheG Avatar
    LarrytheG

    Checked at the dentist this morning about PPE and was told that they got no help in getting it, though they could ask for help from the state if they could not get it. The staff spent their down time finding sources for the PPE and by the time they opened, they had enough.

    The dental personnel were completely wrapped in PPE including full face masks and visor shields. Was told that dental hygienists were considered the most vulnerable even more so than the dentist.

    The hygienists has almost cut in half the number of clients she sees and each room is cleaned and left unoccupied for 2-3 hours after each client.

    Their protocol is from the ADA, they said they got no guidance from the CDC nor OSHA – and that there are competing and contradictory guidance from various groups in the dental industry.

    Was told (informally) that the safest time to visit a dentist is first thing in the morning and worst is the last appointment for the day.

  8. cjbova Avatar
    cjbova

    Maybe CDC didn’t contact them, but CDC has a webpage about COVID-19 for dental settings you might want to share with them:
    https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

    On that page under: PPE use during clinical care, it refers and links to OSHA standards.

    Employers should select appropriate PPE and provide it to DHCP in accordance with OSHA PPE standards (29 CFR 1910 Subpart I)

    1. LarrytheG Avatar
      LarrytheG

      is this the latest? it does not seem to address how to re-opem.

      ” Key Concepts
      Dental settings have unique characteristics that warrant additional infection control considerations.
      Postpone elective procedures, surgeries, and non-urgent dental visits.
      Proactively communicate to both staff and patients the need for them to stay at home if sick.
      Know steps to take if a patient with COVID-19 symptoms enters your facility.

      What’s New
      Revisions were made on April 27, 2020

      Recommendations
      Postpone Elective Procedures, Surgeries, and Non-urgent Dental Visits”

      wouldn’t you consider dental cleanings as “elective”

      I was told that other dentist office were doing different things – there was no real govt-specified “guideline” for re-opening.

      They seemed to be doing their own stuff…

      and though I did ask quite a few questions – I did not ask them if they totally cleaned all their equipment in between clients… as it was obvious that while they did wipe -that a lot of the equipment could not be really cleaned by “wiping”… lots of different “connectors” for swing-arms and things… if someone sneezed – I’d not want to be in that room unless I was convinced they had cleared it.

      1. cjbova Avatar
        cjbova

        Larry, you’ve got to learn to slow down and read the references people share with you. CDC didn’t address reopening because they’re not recommending it yet. I don’t know how much more they could say. Just look at all the links they give which should cover every contingency.
        As to being the latest, it says:
        Revisions were made on April 27, 2020
        To address asymptomatic and pre-symptomatic transmission, implement source control (require facemasks or cloth face coverings) for everyone entering the dental setting (dental healthcare personnel [DHCP][ 1 ] and patients), regardless of whether they have COVID-19 symptoms.
        Actively screen everyone on the spot for fever and symptoms of COVID-19 before they enter the dental setting.
        Actively screen DHCP on the spot for fever and symptoms before every shift.
        —-
        The section right after that says:
        During the COVID-19 pandemic, dental emergencies[ 2 ] will arise and may require treatment by DHCP. DHCP should regularly consult their state dental boards or other regulating agencies for requirements specific to their jurisdictions, as information is changing rapidly.

        1. LarrytheG Avatar
          LarrytheG

          Well, then I’ve clearly missed the bubble. I THOUGHT they were “cleared” to re-open and that’s why they called ….

          I thought the Feds were pushing to re-open ,no?

          yes.. they gave specifics but basically were they not advocating that dental offices essentially not operate at all except for emergency cases?

          So… did Virginia approve the Dental offices to re-open – but no guidelines for doing so? And the Feds, even though Trump and others want the company to re-open, the CDC is NOT recommending that and thus has no guidelines for it?

          (The funny thing – and this NOT sexist – the two dental people (and one was THE Dentist/prosthodontist) – both female were wondering since the Dental was approved to re-open if hair salons were… I offered than I thought haircuts were by appointment. They countered that Dental has separate rooms while salons and barbers did not… funny.. I woulda thought that Dental was one of those places were infection was a real issue.

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