Josh Bergeron: Lesson for public in Citadel’s story
Published 12:01 am Sunday, May 3, 2020
To hear Sherri Stoltzfus tell it was hard.
When she learned that a majority of the 138 residents of the Citadel and dozens of staff tested positive for COVID-19, she was in disbelief.
Stoltzfus, a seasoned nursing home professional and the Citadel’s administrator, said the nursing home had done its best to prepare. Its preparations, though, were clearly no match for COVID-19, which infected many people who tested positive while asymptomatic and made the facility a hotspot for the virus and the disease it causes.
Stoltzfus in an interview with the Post last week, poured out her heart about the facility’s shortcomings and that she wasn’t done fighting the virus. But while she is the leader of the facility, she is also just one of a number of people who work there. And she alone cannot ensure all people who work there follow proper protocols.
There are other festering problems that have not helped, including a shortage of nursing home workers that started before the outbreak and won’t be solved while a global pandemic is devastating nursing homes.
Maybe there’s a lesson in the Citadel’s story for our state and county.
Early last week, the Citadel appeared to be the worst nursing home outbreak in the state. No facility had as many cases and deaths, according to data from the N.C. Department of Health and Human Services. Since then, though, a more recent update shows an outbreak in the western N.C. town of Franklin with a higher case fatality rate. And rather than ranking the worst nursing home outbreaks at this point, it’s better to acknowledge that all congregate living facility in the state are at risk of similar outbreaks. That includes jails and prisons, too.
Because the virus is known to be able to spread from people who have no symptoms, all it takes is one asymptomatic person for an outbreak (two or more cases). The problem is that a relative shortage of tests persists. Everyone who wants a test still cannot get one, as the president claimed nearly two months ago. Injecting disinfectant will only result in more health problems rather than cure any.
The Rowan County Health Department is unable test at congregate living facilities unless there are people who are symptomatic. So, by the time there are one or two people with COVID-19 symptoms — fever, chills, muscle pain, headache, sore throat and loss of taste or smell — it’s possible the number of positive cases will be many more than staff initially thought, as was the case at the Citadel.
At present, there are four outbreaks at local nursing homes — Liberty Commons, the N.C. State Veterans Home, the Citadel and the Laurels.
Rowan County’s number of active cases has remained relatively steady, with new cases making up for any increase in the number of people who recover.
In a worrying trend, it seems that local folks are taking longer to recover than a county like Cabarrus. Here, there were 379 COVID-19 cases on Saturday, with less than a third of those (109) being people who have recovered. Cabarrus County, though, says more than half of people who have tested positive have since recovered — 185 of 315. Roughly 65% of people in Davidson County have recovered. A similar story is true in Iredell County, where 67 of 117 people are “assumed or estimated recovered.”
In another worrying trend, there’s a number of people who seem to believe that outbreaks at nursing homes are not a problem for the community at large. Workers at nursing home facilities live here, too, and are just as likely to get infected by a careless person who is contagious as anyone else.
Sure, it’s possible to “reopen” the state’s economy while protecting the vulnerable, but it’s irresponsible now to return to what life looked like in February. The country needs more widespread testing, strict adherence to social distancing recommendations and a reduction in restaurant capacity. In a few words, our governor’s plan is good.
The entire American public, scientists and health care professionals included, is learning about a new, global virus at the same time. And if we’re to believe that Stoltzfus and the Citadel took the virus seriously from the start, the story is that even the best-laid plans fail. If it’s something less than that, the story is that well-intentioned plans fail when implementation doesn’t meet the mark.
Gov. Roy Cooper’s stay-at-home order ends in less than a week. His plan is both well-intentioned and well-planned.
It’s better to cautiously move toward a new normal rather than rapidly embrace an old life that could overwhelm our health care system.
But Cooper, the advisors who crafted the plan and health care professionals across the state cannot alone ensure all people follow proper protocols.
If the state’s reopening plan fails because the general public does follow its guidelines, it won’t mean nursing homes making headlines for deaths of its residents. It could mean an overwhelmed health care system.
Here, that means more than 56 people in need of ventilators and 104 in need of hospital beds, according to Rowan County Health Department data.
Josh Bergeron is editor of the Salisbury Post.