Austin Public Health Promises 'All Necessary Resources' After Nursing Home COVID-19 Cases And Deaths

May 6, 2020

At least 335 positive COVID-19 cases and 30 deaths have been reported among staff and residents of Austin-area nursing homes and long-term care facilities. But testing levels remain low, and health officials say they don't have a good estimate of how many tests would be needed for that entire population.

Austin Public Health Director Stephanie Hayden says the city is committed to providing "all the necessary resources and support to the nursing homes" to try and stop the spread of COVID-19.

She says that assistance can range from testing to contact tracing to providing personal protective equipment such as masks, gloves and gowns.

The city is also working to replace the state's "strike teams," which were dispatched temporarily to provide staffing assistance and other support in elder care facilities.

Hayden says she is confident APH can provide adequate levels of testing in those facilities even though additional tests are still on order. But, she says, the only estimate she has of how many tests would be needed is "not a good estimate."

On March 11, Austin Public Health issued an order for additional hygiene information in nursing homes and long-term care facilities and for symptom and temperature checks for anyone entering those buildings. Listen to the interview with Hayden or read the transcript below to hear why widespread testing was not suggested or implemented then or when that order was subsequently updated despite this population's vulnerability.

This transcript has been edited lightly for clarity.

Austin Public Health Director Stephanie Hayden: [Protecting the older population] is one of our top priorities because it ultimately affects our entire community. And that's why testing is so important. The city will provide all the necessary resources and support to the nursing homes. In addition to that, we will do contact tracing in those facilities, as well, because we do need to be able to determine additional services we need to provide in that facility.

KUT: You said the city would provide all necessary resources and support and that testing is critical. What might some of those resources and supports mechanisms be in addition to contact tracing?  

Hayden: The “strike teams” are a resource. In addition to that, if there are testing kits, we need to provide them. We've also provided technical assistance for them to be able to provide their own tests. We have actually gone in and done some testing and then we have also provided PPE [personal protective equipment]. So, they are able to order PPE from us, and we deliver it to their facilities.  

KUT: PPE being personal protective equipment such as masks and gloves. We've been hearing a lot about that.

You mentioned testing. When we chatted last week, we talked about the testing level in the Austin area is still right at about 2,000 a week. You mentioned more testing in nursing home facilities and long-term care facilities. There are calls to test all residents and staff anywhere there is a cluster. Is there ramped-up testing capacity yet that could actually do all of that testing?  

Hayden: We have placed some additional orders for additional test kits with the state. In addition, we have also made an additional purchase on our own with a private laboratory. We are confident that we will be able to provide the testing that we need in those facilities.  

KUT: Do you have a sense of how many tests that would be if we looked at the facilities you mentioned where there are clusters and calls to test all residents and staff? Do you have a sense overall of how many additional tests would be needed to cover that?  

Hayden: At this time, most facilities – the smaller facilities at least – have 100 residents in them and from the data that we have, it does show the recommended number of staffing, so we are in the process of developing a plan that will determine exactly how many tests we need. At this point, we only have an estimate and it's not a good estimate. So we want to go back and actually do the survey to determine exactly how many tests we will need.

As we look at the facilities and where they have clusters, what we want to be certain of is that have gone in, and we tested the employees and then we've gone back and tested all the residents and have conducted some interviews so we can develop some baseline data. And then we moved on to another facility. This is going to help us as we're moving forward with testing the rest of the facility.

KUT: Knowing that older people are more vulnerable to complications from COVID-19 and seeing what happened in Washington state early on in the pandemic at a long-term care facility there – I know Austin Public Health back in early mid-March started issuing some orders about visitors to long term care facilities. Why not issue that call for widespread testing of those populations earlier on? A couple of months ago when things were really starting to ramp up?

Hayden: We are continually looking at ways to protect our most vulnerable. Our proactive efforts to protect our vulnerable populations within nursing home and long-term care facilities began on March 11 with an initial health authority control order issued by Dr. [Mark] Escott. This order outlined a proactive measure to avoid the spread in facilities, such as displaying hygiene signage, making hand sanitizer readily available, and symptom- and temperature-checking everyone entering the facility.

Since then, we've updated our control orders that have been issued to enhance protection against the spread of COVID- 19 among vulnerable populations in the event of positive cases and clusters. We are adhering to the CDC [Centers for Disease Control and Prevention] recommendation for nursing homes and long-term care facilities. The updated orders stipulate that if there is a confirmed case of COVID-19 in a facility, all patients, staff and next of kin must be notified. And in the event of a cluster, the facility must restrict receiving new or returning patients, and make all staff available for testing, among other provisions.

KUT: It didn't come up, though, back on March 11 to go ahead and start testing then, knowing the vulnerability of the populations involved?

Hayden: On March 11, we moved to do those more proactive efforts. And we were starting to do some testing. At the time, there was not the recommendation to test the entire facility; and everything is evolving and changing. As things move along, and we have more access to testing and more information comes through CDC as well as the availability of PPE, we evolve and improve with those additional supports.

Got a tip? Email Jennifer Stayton at jstayton@kut.org. Follow her on Twitter @jenstayton.

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