State Requires Long-Term Care Facilities To Limit Visitors To Prevent Deadly Coronavirus Outbreak
Oregon health and human services officials have imposed mandatory restrictions on residential care facilities, telling them to limit visitors and restrict social activities to try to prevent a fatal coronavirus outbreak like the one in Washington state.
The restrictions require managers of nursing homes, assisted living, memory care and other long-term care facilities to only allow “essential individuals” to visit and to limit visitors to each resident to two at a time. State officials also asked managers to screen all visitors and staff for respiratory symptoms, travel to an affected country or exposure to a patient with COVID-19 and to document the findings. They want anyone who’s potentially infected to self-isolate.
So far, 15 Oregon residents have been found to be infected with coronavirus among 295 tested. Results for 67 tests are pending. The state can process a maximum of 80 tests a day.
Dr. Dean Sidelinger, Oregon’s state epidemiologist, said some testing has been done in residential care facilities, though he didn’t give specifics. He said that so far no one who lives in a facility or has been in contact with someone in a long-term care center has tested positive for the virus.
“We know that these measures will limit the introduction of people who potentially may be sick with COVID-19 or other infections like influenza into the facilities,” Sidelinger said.
The virus has infected nearly 119,000 people worldwide, mainly in China, according to a tracking map by Johns Hopkins University in Baltimore, Maryland. Nearly 4,300 people have died, most of them elderly or with other underlying illnesses. They include 22 deaths in King County, Washington where the virus swept through a nursing home, killing at least five residents. Two others have also died in Washington state and two people have died in California.
The virus causes respiratory symptoms similar to influenza, including a fever, dry cough and pneumonia. Elderly people, especially those with chronic conditions like heart disease and cancer, are especially susceptible. Every year, long-term care residents are hit with flu outbreaks, many of them deadly. The latest flu report in Oregon shows that last week, among eight new flu outbreaks statewide, four were in long-term care facilities.
Oregon has 670 licensed residential care facilities across the state, with about 30,000 residents. Fariborz Pakseresht, director of the state Department of Humans Services, said the coronavirus visiting restrictions apply to everyone but facility employees, vendors, the state ombudsman and staff, relatives and friends visiting someone who is dying and visitors deemed essential to the emotional well-being and care of residents.
State officials said they realize the restrictions pose a hardship on elderly people who already have a limited social life.
“We know that companionship, emotional connections, social connections are very important to people, particularly people in long-term care,” Sidelinger said. “We don’t take these (restrictions) lightly.”
DHS staff members have visited 200 of the 670 care facilities and plan to visit the rest to inspect their preventive and emergency plans, which are required in order to receive a state license. Pakseresht said facilities appear to be following the restrictions.
“They’re taking it very seriously,” Pakseresht said. “They’re taking appropriate steps to limit exposure.”
The department is taking a cooperative -- not a punitive -- approach with facilities.
"The intent with the visitation guidance is to work in partnership with facilities with the end goal of ensuring residents’ needs are met," the department said in a statement on Wednesday. "If we determine that there has been willful disregard for the guidelines, the department will use existing regulatory tools to respond."
The department can fine facilities, prevent new admissions and even close them in extreme cases.
It will be up to managers and family members to determine who is “essential” to a resident’s well-being, Pakseresht said.
“It’s not something we can define centrally," Pakseresht said. “It’s really individual circumstances. Some family members are caretakers.”
Pakseresht said DHS case managers have contacted the 1,700 adult foster care homes in the state, asking them to enact the same restrictions as other long-term care centers and to review their emergency plans. These homes have up to five residents and are not under the same scrutiny as residential care facilities.
The care centers are subject to regular inspections by state employees. Some facilities house two people in a room; others offer private rooms. But long-term care centers don’t have negative pressure isolation rooms like those in hospitals for patients with infectious diseases. These rooms allow air to flow in but prevent viral particles from reaching adjacent rooms or other parts of the hospital either by filtration or by directing the air outside the building. It’s also not clear how well-stocked long-term care facilities are for protective gear.
Sidelinger said they usually have gowns, face masks, protective eye equipment and gloves.
“The facilities do stock these, and they can access additional supplies if they’re running low,” Sidelinger said.
Pakseresht said the state won’t lift the visiting restrictions until it’s clear the virus is waning.
“We hope to minimize the impact and time frame but it all depends on what transpires from here on,” Pakseresht said.