Coronavirus transmission slows at some Sonoma County nursing homes, although more deaths occur

Even as coronavirus deaths among Sonoma County senior care home residents continue to mount, there are signs monthslong efforts to slow the spread of the virus at skilled nursing centers are working.

For example, Broadway Villa Post Acute, the Sonoma skilled nursing home that has experienced the largest outbreak, has sharply reduced the number of residents infected by COVID-19, its top administrator has told their family members.

Meanwhile, a state public health strike team of infection control experts that a week ago came here to start helping nursing facilities reported finding substantial improvements in senior living sites’ management of the virus and infection control measures, said county Health Officer Dr. Sundari Mase.

“I think since the beginning of ... the outbreaks, absolutely, they have improved their infection control practices, no doubt about that,” Mase said Friday, during a press briefing.

Because the California Department of Public Health publishes cumulative data on new infections and deaths at senior care homes and the administrators of those sites declined to be interviewed for this story, it’s difficult to independently verify if purported infection control improvements are translating to fewer new infections of residents and staff.

Mase said the skilled nursing centers, however, continue to struggle trying to isolate residents diagnosed with COVID-19 or those exposed to it, because residents often live three and four in a room.

Tony Chicotel, a staff attorney with California Advocates for Nursing Home Reform, agreed infection control efforts at nursing homes “probably have never been better. The question is, is it enough?”

Chicotel, whose organization has been tracking nursing home cases and deaths across the state, said the virus continues to spread and claim the lives of California’s most vulnerable residents.

To be sure, nursing homes and residential care facilities for the elderly remain the deadly coronavirus epicenter in Sonoma County. County health officials confirmed Saturday another skilled nursing center resident has died. Of the 47 county residents who died as of Friday from virus complications since the pandemic started in March, 38 had been residents of senior care homes. Of those 38 people, 26 had lived in nursing homes and the others were in senior residential care facilities.

What’s more, last week a fourth county skilled nursing center reported at least one fatality, according to state public health data.

While senior care home residents comprise more than 80% of all coronavirus-related deaths in the county, containment of the infectious disease appears to be improving among this vulnerable elderly population, according to Mase and nursing home administrators.

Out of the ’red zone’

Teresa Fallon’s 90-year-old mother-in-law, Donabel Carley, on Tuesday made it out of Broadway Villa Post Acute’s “red zone.” That’s what the skilled nursing center calls the area where COVID-19-infected residents are isolated. The facility also has a “green zone” for residents who have tested negative and a “graduate zone” for those who have recovered from virus.

Fallon, 60, of Santa Rosa said Carley tested positive July 5 and was in isolation for about a month, when her subsequent virus test came back negative.

“I had no words, all I could say was thank you and hang up,” Fallon said, recounting the call from Broadway Villa about Carley’s improvement. “I did a FaceTime phone call with her Wednesday. I could see her, she could see me. She’s very weak but she gave me a thumbs-up.”

Fallon said despite her mother-in-law’s progress, she continues to receive hospice services.

“To me, knowing that she’s in a room out of isolation with a garden view is just heartwarming,” Fallon said, adding nursing home staff now can spend more time with her.

As of Friday, Broadway Villa has reported to the state a total of 47 COVID-19 cases among its residents and 23 infections among its staff since the pandemic began in March. At least two residents who died in June and as many as eight residents stricken with COVID-19 at the skilled nursing center have been casualties of the virus. Broadway Villa’s administrator Mike Empey told a Press Democrat reporter on June 30 there were two resident deaths related to the virus. In late July, based on an examination of county and state public health records, the newspaper reported the deaths of up to eight Broadway Villa residents were linked to COVID-19.

Senior care homes are required to report new infections and deaths to the state public health department, but exact numbers of deaths and cases at each nursing home are shielded by the state for patient privacy until the tallies of deaths or infections reach 11 or more.

Broadway Villa’s Empey did not respond to a reporter’s email and phone requests last week for information about the facility’s ongoing battle against the coronavirus. But in recent communications with relatives of residents at the nursing home, he described improvements.

On Thursday, Empey reported in a mass email to “family members” that state public health representatives visited the skilled nursing center in the morning and reviewed its infection control program.

“We received very high marks, and they were happy to see the progress our residents and staff have made in recovery from this recent outbreak,” Empey said, adding Broadway Villa was given approval to “further return our facility to a normal operating status by removing more of the residents from isolation areas.”

Empey also said the “red zone” section had two “graduations” among residents who no longer tested positive for COVID-19, “leaving only 7 residents recovering there now.”

While it appears conditions are improving or at least stabilizing at some nursing homes that have been hit hard by the virus, the number of infections is increasing at others and deaths are still occurring.

Another senior home with virus-related fatality

Sonoma Post Acute, a skilled nursing home in Sonoma, on Monday reported to state public health officials at least one of its residents had died from the coronavirus. At the time, Sonoma Post Acute reported that it had 23 residents afflicted with the virus. On Friday, the latest data available, it reported 26 infections.

Sonoma Post Acute leaders did not respond to requests for an interview. Dan Kramer, president of KPA Strategies public relations firm and a spokesman for the nursing home, responded to a reporter’s questions with an emailed statement.

Kramer said in response to the pandemic, the facility has bolstered its infection control efforts, followed procedures established by the federal Centers for Disease Control and Prevention and the Centers for Medicaid & Medicare.

The nursing center is restricting nonmedically necessary visits, screening employees and residents for virus symptoms and isolating residents who show symptoms.

“We are in regular communication with local and state health authorities,” Kramer said in the statement. “We will continue to follow the guidance they have provided us for infection control to limit risk to residents and staff.

Dodging transmission

The first case of COVID-19 in a Sonoma County skilled nursing home was discovered in April, when county public health surveillance testing led to early identification of two staff members infected at Apple Valley Post-Acute Rehab in Sebastopol who had yet to show symptoms.

Staff, led by the nursing home’s infection preventionist Kelly Phillips, responded quickly by immediately removing employees and isolating them at home. A battery of testing of all staff and residents was quickly conducted and followed up with more testing.

Phillips, a licensed vocational nurse, said there’s been constant communication with local public health officials. The results: None of the nursing home residents have contracted the pandemic disease and no additional cases among staff have surfaced.

Phillips ensures everyone in Apple Valley uses personal protective equipment properly and that staff is ready to effectively isolate and quarantine and adheres in the strictest possible way to public health guidelines at work and at home.

“Everybody is just as informed, so we’re all on the same page. It’s an entire facility effort,” she said. “What our staff does at home, it all affects what we do at work.”

State help with infection control

Mase said staff members at local nursing homes have accumulated more knowledge through the pandemic that has led to the infection control improvements at many sites. And she said the state’s COVID-19 strike team has visited all the county’s skilled nursing and senior care homes currently experiencing large viral outbreaks.

State public health officials declined to provide a Press Democrat reporter an interview with strike team members for this story and only would respond to questions through an emailed statement.

State officials said in the statement that the team of infection control experts were deployed to Sonoma County senior care facilities to assess operations, patient safety and infection control measures, and to provide guidance to staff members for curtailing any further spread of the virus.

“CDPH (California Department of Public Health) remains committed to assisting and supporting all skilled nursing facilities in Sonoma County as they continue to manage, prevent, or recover from outbreaks,” according to the statement.

During her Friday press briefing, Mase said one of the strike team’s main observations was confirming it’s difficult to stop the virus from spreading in nursing homes when three or four residents share a single room.

Still, as more residents recover from viral symptoms, she said further transmission of the virus at some nursing homes seems to be waning.

“There is now a group of recovered patients that have pretty much been through their infectious period and have recovered,” Mase said. “That's really positive.”

’Don’t think we’re winning yet’

Chicotel, the attorney with California Advocates for Nursing Home Reform, acknowledged the infection control diligence at nursing homes, but made clear that work has not yet reversed the statewide negative trends of more COVID-19 infections and deaths.

“The numbers of nursing home residents infected and dying have been steady,” he said. “Every day, we see twenty-something die. It’s been pretty consistent, and dozens of new infections.

“I guess it could be worse, but from my perspective, I don’t think we’re winning yet,” Chicotel said. “I think most residents are still losing against COVID-19. ... Infection control is really about good habits, and good habits are hard to develop in a short period of time.”

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.