Area nursing homes taking same precautions for the coronavirus as they do for flu season

  • Home care nurse Denise Livingston wipes down her equipment before and after her examination at Havenwood Heritage Heights on Thursday, March 5, 2020. GEOFF FORESTER—Monitor staff

  • Home care nurse Denise Livingston wipes down with hand sanitizer before examining Earl Raymond in her room at Havenwood Heritage Heights on Thursday, March 5, 2020. GEOFF FORESTER—Monitor staff

  • Left: Home care nurse Denise Livingston talks with Earl Raymond in her room at Havenwood Heritage Heights on Thursday.

  • Above: An informational poster regarding the COVID-19 virus has been placed on the walls of Havenwood Heritage Heights. GEOFF FORESTER photos / Monitor staff

  • Home care nurse Denise Livingston listens to Earl Raymond’s breathing during an examination Thursday at Havenwood Heritage Heights. GEOFF FORESTER / Monitor staff

Monitor staff
Published: 3/7/2020 10:55:28 PM

Earl Raymond would rather talk to her friends about politics than the deadly virus spreading around the world.

Raymond, 95, said there isn’t a lot of concern about the virus from fellow residents at Havenwood, the retirement community and long-term care facility in Concord she’s lived in for almost 30 years. She said dinner room conversation still usually centers around the latest news from the primary elections going on around the country, or the president.

“Nothing’s changed. We’re all really careful,” she said, sitting in a blue armchair in her apartment while a nurse wrapped an inflatable cuff around her arm to check blood pressure. “Even when I come back from the dining room, I wash my hands.”

There’s still a lot unknown about COVID-19, a new form of coronavirus that has claimed the lives of more than 3,000 worldwide, most of them living in China.

Most of the people who died in Washington, the state most affected by the virus with 14 deaths so far, were residents of Life Care Center, a nursing facility in Kirkland. All but three of the victims in Washington were over age 70. Other people in the U.S. killed by the virus were either elderly or had “underlying medical conditions,” according to health officials.

In New Hampshire, two people have tested positive for the virus. Both are currently quarantined. One man, from Grafton County, tested positive for the disease after traveling to Italy, and passed it on to another person in the area.

Health care facilities have been mobilizing to prevent potential spread of the disease, taking different approaches to make sure the vulnerable people in their care stay safe. All say they are monitoring residents, patients and employees who have traveled to areas of concern, like Italy, where the virus has been more prevalent, or have plans to travel to one of those areas. They are emphasizing to staff not to come to work if they are feeling ill. They are passing along the latest guidance from the CDC as it is released.

“We want our staff and patients to be prepared, but not alarmed,” said Andrea Patrick-Baudet, chief clinical officer at the Concord Regional Visiting Nurses Association.

Some are taking a more drastic approach than others.

Manchester VA Community Living Center, a nursing home tied to the veteran’s hospital, is not allowing visitors into the facility. It’s open only to “essential employees,” according to its website.

At the Manchester VA Medical Center, everyone who enters the facility is being screened for the virus. Before arriving at the hospital, patients are asked to take a prescreening survey via phone. The Manchester VA has suspended “non-essential” healthcare groups, events and gatherings through March 23.

Most care providers, however, say the efforts are not too different than what they would do for flu season. It has long been recognized that people over 65 are at greater risk of developing severe complications from seasonal influenza. The CDC says that in recent years, between 70% and 85% of seasonal flu deaths have occurred in people age 65 and above.

“It is absolutely the same approach you take as influenza,” Patrick-Baudet said, of preventative measures taken for the new coronavirus. “When you think about the patients we serve, many of them are at risk.”

They are elderly, they may have multiple pre-existing conditions and they live in close quarters, she said.

Denise Livingston, a home care nurse with the Concord Regional VNA, visits patients every day at Havenwood. She said it’s business as usual – she uses hand sanitizer before touching instruments and uses a sanitizing wipe on the equipment before moving on to the next patient.

Around flu season, many assisted living facilities will put up signs warning potential visitors not to expose loved ones to infection of visitors who are feeling under the weather. Now, they have signs up warning about COVID-19, too.

“There’s nothing I’m doing any different than I would do normally: Good hand-washing, using the Purell, teaching our patients not to go out if they’re not feeling well,” Livingston said. “We were talking today, if you go to the grocery store, using the wipes on your grocery cart to help reduce the risk for infection. That would be all the time, even in the summertime.”

“We just want to keep everything clean between patients,” she added.

Public health officials are taking most of their guidance on COVID-19 from China, the country where the outbreak originated. More than 80,000 people in China have tested positive for the virus.

CDC experts have said data coming out of China now suggests that older people and people with underlying health conditions are about twice as likely to develop serious outcomes versus otherwise younger, healthier people.

Studies in China have shown that younger people – even vulnerable populations, like babies – are not severely affected by the virus. Moreover, four out of five confirmed cases of the illnesses (80.9 %) were considered mild.

New Hampshire has one of the oldest nursing home populations in the state, making fear of an outbreak natural, said Brendan Williams, President and CEO of the New Hampshire Health Care Association.

The state also has a lot of experience with this population. New Hampshire ranked first in the number of facilities in “substantial compliance” with federal regulations, according to federal CASPER (Certification And Survey Provider Enhanced Reports) records evaluating nursing care facilities in 50 states from January.

“I feel proud of what we have here, and I do think we provide quality care,” Williams said. “Facilities are underfunded, and that doesn’t help to deal with crises because that’s its own crisis.”

“Generally, speaking as a society we need to do a much better job of caring for the health of the elderly – it shouldn’t take this kind of pandemic to make people say there are nursing homes out there, and maybe we should do something to support them,” he added.

Right now, one concern is ensuring health care providers have access to cleaning supplies and protective equipment.

Since the news of the virus has spread, people have cleaned out department stores of basic supplies like hand sanitizer and protective masks. On Amazon, an 8-ounce bottle of Purell is going for $65. Many are out of stock.

In a survey that went out to all New Hampshire Health Care Association members, one third said they were experiencing some sort of supply shortage, Williams said.

“If there’s one thing I am worried about, it’s that if there is a situation in any health care faculty in the state, is there enough personal protective equipment out there? At the moment, there may be enough for day-to-day operations. You just worry about if a situation escalated,” Williams said. “If you have people just panic-buying all of the stuff, it’s not helpful to health care providers who are really needing the equipment.”

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