Sonoma County’s residential care homes for elderly sustaining spike of coronavirus cases

The spread of the coronavirus in Sonoma County senior care homes has shifted, with fewer new cases reported by skilled nursing homes and a spike of infections at residential care facilities for the elderly, according to newly released local public health data.

Public health officials said the decrease in fresh infections during the past two weeks compared with the previous two-week period was led by a decline in cases among staff members at skilled nursing centers — a significant development because officials have said for months nursing home outbreaks were caused by workers who contract the virus in the community and pass it to elderly residents inside these facilities.

The shift in virus transmission among the county’s most vulnerable elderly residents to residential care sites comes even as deaths at skilled nursing homes keep mounting. Indeed, nursing home residents represent 41 of the 51 virus-related fatalities countywide as of Friday night. And late last week a Petaluma nursing home became the sixth of the county’s 20 skilled nursing centers to report a death due to complications of the coronavirus.

At the same time, the virus’s spread in Sonoma County rose sharply last week. Another 136 cases announced Saturday put the county at 737 for the week, meaning roughly 17% of all cases since the pandemic began were confirmed in the past seven days.

The county disclosed three more deaths Saturday night related COVID-19, bringing the total to 54, though details about those deaths were not immediately available.

Still, Sonoma County health officials say they are cautiously optimistic about the overall decline in new virus cases at nursing centers, which have the capacity to treat a combined 1,500 patients. Despite that progress, they recognize the need to ramp up efforts to slow the spread of COVID-19 in residential care homes.

Mase said the spike of cases at residential care homes is concerning, because many of these them are smaller, have few caretakers and are not patient-care settings like skilled nursing centers. She said, however, many residents at care homes have underlying health conditions, putting them at high risk if they contract the virus.

“Now, we need to focus on the residential care facilities,” said Dr. Sundari Mase, the county’s health officer, adding that county public health staff members have been in contact with the California Department of Social Services that licenses these care homes to discuss ways to improve infection control at these sites.

Since there are nearly 180 of these nonmedical assisted living and board and care homes with the capacity for about 4,000 elderly residents in Sonoma County, virus transmission could prove difficult to contain among this group.

“It’s a good sign for the skilled nursing facilities,” Mase said. “Since the beginning of this, they’re actually really shoring up their infection control practices, and are doing really much, much better with a very new disease, of course, that no one knew how to approach before.”

During a press briefing Friday, Mase said one idea under consideration is collaborating with other counties to establish a regional facility to house assisted living and board and care residents when they get infected by the coronavirus.

According to the latest Sonoma County public health data, between Aug. 7 and Aug. 13, there were 67 new coronavirus infections at local residential care homes, with 41 cases among residents and 26 among staff. That’s 70% of the 96 new cases overall at senior care sites during that period. The other 30% were infections in skilled nursing homes.

That virus transmission shows a reversal from the period, between July 29 and Aug. 4, when there were 17 new COVID-19 infections at residential care homes, only 16% of the 100 fresh cases at senior care sites. During that stretch, residents of skilled nursing centers represented 84% of new virus cases at senior care facilities, with 83 people infected.

County health officials say the 67 new virus infections at residential care homes are all concentrated at eight such homes. On Friday, Mase declined to disclose names of the particular residential care homes that have reported new cases or deaths attributed to COVID-19, citing privacy reasons.

Sanford Horowitz, a Santa Rosa attorney who specializes in litigating elder abuse cases involving long-term care facilities, said he’s glad to hear new infections among area skilled nursing centers are declining.

But Horowitz said he’s troubled by the increase in coronavirus cases at residential care homes for the elderly. Horowitz said many of them are small, with half a dozen beds, and are staffed by workers who have little if any medical training.

State investigations of these care homes are conducted by social workers not health care workers, he said, referring to this group of homes as “the wild West.”

“They’re less regulated and less apt to accurately report information,” Horowitz said, noting he’s not surprised by the spike of COVID-19 infections at these sites.

The state social services department produces an ongoing list of residential care homes that have reported coronavirus cases and deaths among residents and staff. But the agency withholds that information for residential care homes with fewer than seven beds. The state agency says it does so to protect people’s privacy in residential care facilities, often private residential homes.

As a result, the only Sonoma County care home now listed on the state social services department’s latest COVID-19 report is Mirabel Lodge, a Forestville care home that has capacity for 34 people. Mirabel Lodge has reported 14 residents have tested positive for the coronavirus and at least one resident death from the infectious disease.

The state agency’s list, like that of the California Department of Public Health for skilled nursing centers, does not specify the exact number of COVID-19 cases or deaths until they reach 11 or greater at individual sites.

Mirabel Lodge’s co-owner, Alain Serkissian, on Wednesday, at the entrance to the home, refused to answer a reporter’s questions about the outbreak, including precisely how many residents had died from COVID-19 complications.

“I’m not going to tell you,” Serkissian said of total virus-related deaths at Mirabel, standing outside the property. “We’re all clear. We’re just back to normal.”

While fresh infections overall are finally declining at county skilled nursing centers, there are nursing homes still struggling with the highly contagious virus.

For example, Vineyard Post Acute, a nursing home in Petaluma, reported on Thursday to the state public health department that at least one of its residents had died as a result of COVID-19, and 31 residents are infected with the virus.

Overall, the 99-bed skilled nursing center reported 27 staff and 55 residents have contracted the virus during pandemic that began in March.

Kevan Bills, Vineyard Post Acute’s administrator, did not respond to a reporter’s phone calls seeking comment about the outbreak there.

Sonoma County public health epidemiologist Jenny Mercado said the recent decrease in new COVID-19 cases at skilled nursing centers is encouraging but it’s too early to call it a trend.

"One big outbreak or two medium-sized outbreaks in a facility in a week can really affect the numbers,“ Mercado wrote in an email.

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