Front Line at a Nursing Home - Covid update

 

 Sometimes data is simply not enough to grasp what is happening. So here is a direct witness on the Covid Front-line... 

Front Line at a Nursing Home– an in Person Report

Guest Post by Javelin

I work jointly at a hospital and it’s adjoining Skilled Nursing Facility. The SNF has long term patients occupying 2/3rds of the building and a short term wing which acts as transitional care for hip/knee replacements, falls, cardiac rehab and various NeuroMuscular pathologies ( strokes, Parkinson’s, MS, brain injuries etc.) The building has 132 beds with an average census of 110-120 residents at any given time.

The population of long term residents runs the gamut of post-stroke pts, COPD, CHF, dementia etc to general issues with aging. The average age at this bldg is 80+ with the oldest resident at 101 years of age. The rehab/transitional wing of 30 pts or less are generally younger with many of them ending up their post-rehab as long term residents pending outcomes, family support and functional status/independence.

Our SNF in March issued protocols different than the death-dealer Cuomo. Although we were not allowed to block Covid patients from entering the building, we transformed the wings so that the locked wing for dementia patients with elopement risks was changed into an isolation Covid unit and the dementia patients were moved into the semi-lockdown East wing with “slightly confused” and higher skilled patients reside. From March until the final week of October we had ZERO covid positive patients and just 3 staff ( none caregivers.)

Even without Covid positives our administrator issued an in-room lockdown for all patients. The building is locked down from vendors, visitors and only employees and emergency teams allowed. So for 6+ months these elderly patient’s days consist of 24 hours in rooms 10×20 with 2 patients per room. They transfer from bed in the morning to sit at a table in-room while in their wheelchairs, they watch TV, eat, read, puzzle books, color and then back to bed for 12-16 hours. This has been their “life.”

Our SNF averages 15-20 fatalities per year. This includes palliative care, hospice, care and comfort patients -the general population of long term are in the building to live until they pass. This year from March until October there were 41 deaths of patients, NONE from Covid. It is a vision of human sadness. Alone, bored, increase in bed sores, functional decline, no visitors, no music groups, no families, no weekly services/sermons. Sunday, Tuesday, Friday.. it doesn’t matter or change the routine of isolated drudgery.

The final week of October we had a Patient Zero. Initially sent to the hospital for a suspected UTI secondary to “altered mental status” the patient returned to the SNF two days later and tested positive from her weekly testing. To cut to the chase, she was moved to the Covid wing but her roomate and another patient were positive the following week ( as were two GNA’s.) The 3 positives became 9 the following week. The following week the 9 became 32 and now there are 39. Wings had to be changed because of the Dementia Unit only having 12 beds–now there are 2 Covid wings.

This past week we had our first “covid death.” A 90+ year old patient who was already on hospice passed while also positive with Covid. Now we have had 6 more in the past 3 days with 10 additional patients in very severe condition. Remember, these are VERY old people with 40% of the entire population on continuous O2 through nasal cannula or concentrators. There can be no doubt that Covid ( like flu or a viral pneumonia outbreak) is a very serious multiplier to the co-morbidities that ALL of these people suffer from.

It is worth noting that 12 staff have had positive tests to date and NONE of them were sick beyond headache complaints or reduced taste– most have already returned to work and the post-Covid staff are perfect to treat in the Covid units.

My final observation is this. Covid is a multiplier, especially for serious medical issues. Covid x COPD/CHF = a fight for life. Covid x ZERO co-morbidities = 0 issues. Yes it is real and appears to be quite contagious. However there is no full-proof way to prevent contact; masks, distancing are a joke unless someone is sneezing or coughing covid in your face. We touch door handles, cans and produce, countertops in Walmart, target and grocery stores. Hands are still the #1 spreader of viral agents. If you are young and healthy it appears to be almost better to contract the virus and allow your body’s leukocytes/T cells to build a template to recognize and fight any future strains.

I work in a Covid positive environment. I gown, glove, goggle and mask all day. I wash my hands and change clothes after work before I go anywhere. I have ZERO fear of catching Covid and if I test positive I will enjoy my two weeks of time off to catch up on leaf raking, felling and chopping dead trees and finish turning the vegetable garden– but I guarantee that I won’t be bedridden or incapacitated. I am over 50, no health issue history ( never even had the common cold) I sleep from 11-6 every night and I eat fruit and veggies and take Vitamin C and B complex suppliments.

However as healthy as I am and with virtually no risk of succumbing to Covid, my government has restricted my life and may threaten to restrict my movement, travel, my job in healthcare and even my ability to buy/sell unless I am injected with their RNA altering vaccine when it arrives. I won’t be getting the vaccine so I am already preparing for some major life changes–We have to draw the line somewhere.