Surge may be linked to nursing home

Published 1:03 pm Thursday, April 23, 2020



An outbreak of COVID-19 at a long-term care facility in Windsor may be part of the reason Isle of Wight County saw a sudden spike in confirmed cases, which nearly tripled from 31 on Monday, April 13, to 86 as of this Monday.

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Consulate Health Care of Windsor, a 114-bed facility, notified residents and their family members of the outbreak on April 2 via a letter from its executive director, Gary James, which stated — without specifying the number of cases at Consulate — that some residents and staff members had tested positive for the virus. The Smithfield Times obtained the letter from a family member of a resident.

The Virginia Department of Health is investigating a total of six outbreaks — five of which are at long-term care facilities — in its Western Tidewater Health District, which includes Isle of Wight County, Southampton County and the cities of Franklin and Suffolk. The sixth is at a correctional facility, according to the VDH’s website.

“Outbreak,” when applied to long-term care facilities, typically means two or more confirmed cases among residents or staff members, according to WTHD Director Dr. Todd Wagner. Wagner, however, said he was “not at liberty to discuss specific numbers of cases at any particular facility.”

“Doing so would greatly erode the necessary trust between those facilities and the local health departments to allow for them to confidently and securely report any issue or situation,” he said.

James, when asked for details regarding the outbreak at Consulate, deferred to Jennifer L. Trapp, vice president of corporate communications for Consulate’s Florida headquarters. She, like Wagner, cited privacy concerns when responding to questions about the company’s Windsor facility.

“Out of respect for the privacy of all involved, we will not comment publicly on COVID-19 cases,” Trapp stated in an email. “We will continue to communicate timely with the proper health care agencies, families, staff and residents as necessary and appropriate.”

A Portsmouth woman, who asked that her name not be used, said a staff member at Consulate — where her mother is a long-term resident — had told her in late March that as of that date, six residents had tested positive for COVID-19 and that three had been placed on ventilators.

“I received a call last Friday from my mother’s unit nurse to let me know that the health department was there testing all residents with results coming back within three to five days,” the woman told the Times. “I received another nurse call Tuesday to say that the health department was back and having to retest all the residents on my mother’s wing with no explanation, but said results would be back in two to three days.”

On Thursday, she received a third call from the facility, informing her that her mother, who has Alzheimer’s and COPD, had tested positive for COVID-19, but so far had no symptoms.

“She has no clue what’s going on and can’t understand why we can’t come and see her,” she said.

Many nursing homes have eliminated visitation since the pandemic began, whether or not they have positive cases.

A Windsor woman, who likewise requested anonymity, said she also received a phone call from Consulate recently informing her that the VDH would be testing all residents, including her mother, for COVID-19. Last week, she received the results: Her mother was also positive but asymptomatic. She added that as of her most recent communication with Consulate, there had been no deaths.

“They took Mom … to the section of the facility that they’re keeping the COVID-19 patients,” she said. “Mom is not showing any signs, no fever, no cough, she’s eating and sleeping well.”

In his April 2 letter to residents and their families, James assured all that those residents who had tested positive for COVID-19 had been isolated and were being cared for individually. Staff members who had tested positive, he said, were not working and had been quarantined for 14 days.

“We are staying in very close communication with local and state health officials to ensure that we are taking all the appropriate steps,” James wrote. “We understand that you are concerned about your loved ones, but it is crucial that we continue to restrict visitation in order to reduce the potential spread of this virus … Family members are encouraged to call our center with any concerns or to obtain information about a loved one.”

In a press conference on Friday, Gov. Ralph Northam assured citizens that measures were being taken with regards to outbreaks in long-term care facilities — 66 of them across the state. Testing criteria have been expanded to include people who are about to be admitted into congregate settings like long-term care facilities, he said.

“This is an important safety measure to help prevent the virus from being brought into these facilities,” Northam said.

He also acknowledged that facilitywide testing is being done in facilities experiencing outbreaks, as resources allow.

“All of these steps will help support our nursing homes and long-term care facilities, which are struggling to keep their residents and staff safe,” Northam said.

In the same press conference, Dr. Norman Oliver, state health commissioner, said the requirement to keep facility names confidential is a statutory one.

“It says I cannot release data on individuals or people who make reports on individuals,” he said of the state code. “So I couldn’t release information from a doctor or a facility.”

Northam followed up on a question from a reporter about whether he could issue an executive order overriding that, saying he would leave it to the General Assembly.

Isle of Wight’s 86-case total is out of an estimated 37,649 county residents, which equates to 228 cases per 100,000 people, making it the seventh-highest among more than 120 localities in Virginia in terms of COVID-19 cases per capita. The city of Suffolk, by comparison, which has nearly three times Isle of Wight’s population, had 92 cases as of Monday morning.

During Thursday’s Board of Supervisors meeting, County Administrator Randy Keaton suggested that Isle of Wight’s seemingly disproportionate caseload was tied to increased testing.

Wagner, however, rejected the notion that tests were more available in some areas of the health district than others. He then explained that tests performed in a variety of settings such as hospitals, clinics and urgent care centers, are all sent either to the state’s Division of Consolidated Laboratory Services in Richmond, a commercial lab such as LabCorp, or a hospital reference lab such as the one at Sentara Obici Hospital in Suffolk. Wagner then added that there was insufficient evidence to suggest a link between the county’s high caseload and the number of county residents who commute to larger localities for work, such as the Peninsula, which has seen one of the worst outbreaks of community spread in the state.

“There has not been any current analysis performed within the district to look at this, as we have simply been putting all of our efforts … toward looking at cases and contacts at this juncture,” Wagner said.

He then acknowledged that the Virginia Department of Health’s website, which tracks outbreaks in each health district by facility type (long-term care facility, congregate setting, health care setting, correctional facility or educational setting), lists only two sources for Western Tidewater: long-term care and correctional, with five long-term care and one correctional. However, he discouraged making any causal connection beyond that.

“The breakdown of outbreaks reflected just provides a sense of the type of settings in which those outbreaks are occurring, broken down by district,” he said.

Town and county officials added that they have not received any official confirmation or denial of COVID-19 cases at Consulate from the Western Tidewater Health District or the facility itself.

“The county is pretty much relying on the health department to communicate with, and direct, any long-term care facilities like Consulate that may have positive cases, but we don’t have any detailed information,” said Assistant County Administrator Don Robertson.

Don G. Rosie II, who represents the Carrsville District on Isle of Wight’s Board of Supervisors, said the VDH had notified board members of a possible outbreak at Consulate a while back, but could not recall when he and the other board members had first been told. He added that he and his fellow board members were given no details at the time, and still have not been provided details, such as the number of COVID-19-positive residents and employees at Consulate.

“They’ve pretty much told us because of HIPAA (the federal Health Insurance Portability and Accountability Act) we weren’t in a position to be releasing information anyway,” Rosie said. “It really is the responsibility of those facilities to give information, but they’re also guided by HIPAA rules.”

Lt. Tommy Potter, spokesman for the Isle of Wight County Sheriff’s Office, added that his department had not been approached for anything with regard to alleged COVID-19 cases at Consulate.

Windsor Mayor Glyn Willis added he had also heard rumors of COVID-19 cases in Windsor, but said he hadn’t been officially contacted or provided any information.


TRACY AGNEW, editor of the Suffolk News-Herald, contributed to this story.