New report shows 80 long-term care facilities in Georgia have at least 1 staff member or patient who has tested positive for COVID-19, 47.5 percent of those facilities have reported only one case, and 76.25 percent report fewer than five.
Yesterday, Georgia Governor Brian Kemp released news of a new reporting effort by the Georgia Department of Public Health to address the impact of COVID-19 on long-term care facilities in Georgia.
The advent of this report followed closely on the heels of Kemp’s Executive Order on April 8 that put all long-term care facilities, as well as many other age-related living facilities, as well as Department of Behavioral Health and Developmental Disabilities Community Integration Homes, under the control of the GDPH and issued a set of 18 protocols every facility must follow, including closing to visitors and operating as a “non-essential business.”
On the evening of April 8, ConnectLocal received confirmation from PruittHealth – Toccoa that a resident at their facility had tested positive for COVID-19 and had been transferred to the local hospital for treatment. A PruittHealth corporation media liaison advised ConnectLocal that they “were actively working with the Georgia Department of Public Health and other public health officials,” and would provide answers to further questions posed by ConnectLocal as soon as the information was verified by GDPH.
Despite this indication that the Toccoa facility was in direct communication with the GDPH regarding the COVID-19 confirmed case, the report released by the GDPH on April 10 did not include any listing for Stephens County.
The report released yesterday, April 10, advises that data may be incomplete. “The data in this report is contingent on what information has been provided to, and verified by, the Department of Public Heath. It is possible that a facility is reporting different numbers to different entities, but unless it has been verified by the DPH, it will not be included in the weekly report,” the report documentation states.
The first confirmed case in a long-term care facility in Georgia was reported on March 16 by the GDPH. On April 1, according to GDPH figures, 47 long-term care facilities had reported a staff member or patient with COVID-19.
By Friday, April 3, the number had risen to 60. According to an April 3 report in the Atlanta Journal Constitution, “The (GDPH) release did not contain information about how many residents at each facility were infected. Some facilities have reported that information publicly. Rome Health and Rehabilitation said it has 15 infected residents. Pelham Parkway Nursing Home reported 19 residents have tested positive, with test results pending on 29 others. The facility with the largest known outbreak is PruittHealth-Palmyra in Albany, which reported 35 cases as of Wednesday with 38 results pending. Seven of its patients died from the virus.”
According to a US News and World Report study, there are 360 licensed nursing homes in Georgia, and a Dibbern & Dibbern, Ltd. study of Georgia nursing homes lists 357 nursing homes in Georgia, with a total of 26,506 nursing home beds.
The April 10 report that was released following Kemp’s Executive Order placing long-term care and other facilities under GDPH control, indicates that, as of April 10, 80 long-term care facilities in Georgia currently have, or have had, one or more staff members or patients/residents who have tested positive for COVID-19 – an increase of 20 facilities over the intervening week.
The April 10 report shows that the cumulative number of confirmed COVID cases among staff or residents of long-term care facilities in Georgia is 407; of those 80 facilities,
38 had 1 confirmed case
23 had 2-5 confirmed cases,
11 had 6-10 confirmed cases,
4 had 11-20 confirmed cases
2 had 21-25 confirmed cases
1 facility accounted for 47 cases
1 facility accounted for 62 cases
The total number of deaths listed is the report is 22, all of which occurred in 11 facilities, with two facilities accounting for 10 of the 22 deaths.
Rome Health and Rehabilitation, which was identified on April 3 as having 15 infected residents, is identified in the April 10 report as still having 15 confirmed cases.
On April 3, Pelham Parkway Nursing Home reported 19 residents have tested positive, with test results pending on 29 others. The April 10 report shows this facility with 24 confirmed cases.
On April 3, PruittHealth-Palmyra in Albany self-reported 35 cases with 38 results pending and seven deaths. The April 10 report lists the facility with 62 confirmed cases and five deaths.
The following guidelines for long-term care facilities have been published by the GDPH
COVID-19: Long-Term Care Facilities
The following measures should be implemented in ALL long-term care facilities throughout Georgia, regardless of whether there are increased respiratory illness or confirmed cases of COVID-19 in the facility, and regardless of the number of persons diagnosed with COVID-19 in the immediate area. These precautions are critical for the protection of residents of these facilities.
Restrict all visitors and non-essential health care personnel, except for certain compassionate care situations, including end of life.
Cancel communal dining and all group activities, both internal and external.
Establish appropriate social distancing infrastructure for residents and staff, and promote frequent hand hygiene
Implement active screening of residents for fever and respiratory symptoms (shortness of breath, new or change in cough, etc.)
Screen all staff at the beginning of their shift for fever and respiratory symptoms
Establish a mechanism so that staff who work in multiple locations are required to report their exposure to a COVID-19 case in other facilities and then follow guidelines for 14-day quarantine before returning to work.
Reinforce adherence to infection prevention and control measures, including hand hygiene and selection of personal protective equipment (PPE)
Consider implementing universal use of face masks for HCP while in the facility. Although this is ideal, availability of masks must be considered.
Use Standard, Contact, and Droplet Precautions with eye protection when caring for residents with undiagnosed respiratory infection, unless the suspected diagnosis requires Airborne Precautions (e.g., tuberculosis).
Make sure that EPA-registered, hospital-grade disinfectants are available to allow for frequent cleaning of high-touch surfaces and shared resident-care equipment (https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2)
Create a plan to cohort residents with symptoms of respiratory infection, including dedicating healthcare personnel to work only on affected units.
Facilities without persons diagnosed need to be prepared for an outbreak of COVID-19 in their facility. Critical planning elements include:
Rapid identification and management of ill residents
Considerations for visitors and consultant staff
Supplies and resources
Sick leave policies and other occupational health considerations
Education and training
Surge capacity for staffing, equipment and supplies, and postmortem care
Place residents in isolation if possible.
If they leave their room, residents should wear a face mask, perform hand hygiene, limit their movement in the facility, and perform social distancing (stay at least 6 feet away from others).
Implement universal use of face mask for HCP while in the facility.
HCP should wear all recommended PPE (gown, gloves, eye protection, N95 respirator or, if not available, a face mask) for the care of all residents, regardless of presence of symptoms. Implement protocols for extended use of eye protection and face masks. o If PPE supplies are limited, strategies for extended PPE use and limited reuse should be employed (https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html)
Notify the health department immediately of the following in residents or in staff:
any case of unexplained severe respiratory illness
clusters of 2 people or more with respiratory symptoms
a positive COVID-19 test
It is critical to identify any potential COVID-19 infections in long-term care facilities early, before it has a chance to spread. In these urgent situations, DPH and District Health Department staff can support facilities in evaluating risk among residents and staff, facilitating COVID-19 testing, and making recommendations to prevent spread (call Health Department or 866-PUB-HLTH).