Earlier this month, Ripon resident Robin Wolzenburg received an email from a Wisconsin assisted living provider that broke her heart.
“Hi Robin, I want to let you know we have a COVID outbreak in our facility. I have 13 residents, two have already tested positive earlier this week, with eight more today. Two of them have already died. I have three staff members who are positive and I have no one to staff my building.”
Over the last month, the director of housing and clinical services for the senior living advocacy group LeadingAge Wisconsin said emails like that are “becoming the norm” as senior living facilities struggle to contain COVID-19, despite the array of safeguards in place meant to prevent its spread.
Wolzenburg explained that community spread of coronavirus in Wisconsin has gotten so bad that employees are contracting the virus outside of work because much of the public still refuses to take the virus seriously.
“There are over 63,000 people working in long-term care and healthcare throughout the state, so how can we have contact with them on a daily basis and think that we're not going to bring that into a nursing home,” she said.
Locally, the Wisconsin Department of Health Services (DHS) reported public health investigations at eight nursing homes in Fond du Lac County and two in Green Lake County, including at Whispering Pines Nursing & Rehab in Ripon, Juliette Manor in Berlin and Markesan Resident Home.
Wolzenburg noted any nursing home with a case among residents remains on the DHS website for 28 days as an active investigation.
While she couldn’t speak to the specifics of the situation at Markesan Resident Home, it is where Wolzenburg worked for 20 years prior to LeadingAge Wisconsin.
In her current position, Wolzenburg helps senior living facilities stay up to date with rapidly changing public health guidelines from DHS, the Centers for Medicare & Medicaid Services (CMS), the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention.
Through her job, she’s talking to administrators at nursing homes and assisted-living facilities all day, trying to assist them as they navigate a pandemic.
“I'm hearing desperation and a lot of really defeated feelings in a lot of ways, going into the fall surge,” Wolzenburg said. “It didn't feel as close to home until the last 10 weeks, when we just started seeing this awful increase with the community spread.”
For an example of how community spread infected the facility in the aforementioned email to Wolzenburg, look no further than the source:
A church retreat.
From the outside, a church retreat may look harmless, but Wolzenburg said all it takes is one person acting irresponsibly for coronavirus to move from an ordinary event to a senior-living facility.
She explained that the husband of one of the facility’s employees attended a church retreat, but someone else at the retreat had taken a COVID-19 test days earlier, telling no one at the event.
When the results came back positive, it was too late. The damage was done.
“That one person in the community who made a really poor choice and didn't think about the fact that his wife was maybe working with vulnerable people caused a chain reaction, resulting in the death of two people so far, not to mention a staffing crisis,” Wolzenburg said.
To prevent coronavirus outbreaks, she noted CMS is requiring all staff members to be tested in nursing homes twice a week because the COVID-19 positivity rate is so high in Wisconsin. Residents are tested if they become symptomatic or if there is an outbreak.
Additionally, DHS is requiring nursing homes to test staff for COVID-19 every other week, regardless of positivity rate.
If a staff member tests positive, Wolzenburg explained that they are immediately sent home. The facility then begins contact tracing to locate people who were in close proximity to the positive case and then immediately test those close contacts.
Testing presents another problem as most of the tests being used take three days for results because most nursing homes do not have access to rapid testing, she noted.
Wolzenburg added that facilities have “some access” to COVID-19 tests that produce tests within hours, but those tests are not as accurate on asymptomatic carriers.
Even before the pandemic, she said there was a shortage of workers in senior-living facilities, which combined with staff contracting the virus has created the perfect storm of staffing shortages.
“There's not enough caregivers to cover this,” Wolzenburg said. “Even hospitals are trying to think about how they can help nursing homes with staffing because nursing homes could take more of their residents and free up some of those hospital beds for COVID.”
However, nursing homes are not allowed to accept new residents until 14 days after their last positive case.
“The problem is most facilities in Wisconsin right now are in some kind of constant outbreak,” Wolzenburg said. “They’re having at least one staff member test positive every time they test, especially in nursing homes, because they're doing the regular testing.”
As a result, nursing homes have been unable to help relieve the burden on hospitals, she noted.
Beyond staffing concerns, the acquisition of personal protective equipment (PPE) remains an issue for many senior-living facilities.
While PPE is more readily available than it was in March and April, Wolzenburg noted the cost also has increased.
“If you had an outbreak, you might not have enough PPE to last very long if you can't keep purchasing a quantity at a time, nor can you afford it,” she said.
Wolzenburg added that the pandemic has taken an emotional toll on the staff in senior-living facilities, who are “working tirelessly” to care for our most vulnerable population.
“They have to meet their own needs to homeschool their children too,” she said. “They're also meeting the emotional, spiritual and psychosocial needs of all these residents in absence of having contact with their families.”
Going forward, Wolzenburg hopes people can start acting more selflessly in taking the pandemic seriously.
“We all have grandparents — we all have great aunts and uncles — think about them getting sick,” she said. “We need to really think about our actions, especially going into the holidays.”