Care homes say early action led to success in limiting spread of COVID-19

Legacy Hilo Rehabilitation and Nursing Center in Hilo. (Tribune-Herald/file photo)
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No-visitor policies implemented at Big Island long-term care facilities have so far seemingly done their part to protect residents there from the ongoing COVID-19 pandemic.

“We’re doing just great,” said Tammy H. Silva, nursing home administrator at Legacy Hilo Rehabilitation &Nursing. “All of our precautionary measures came out in February, so I think we were ahead of the curve.”

Adults over 65, individuals who live in a nursing homes or long-term care facilities, and people of all ages with underlying medical conditions are at higher risk from severe illness or death from COVID-19, according to the U.S. Centers for Disease Control and Prevention.

Such facilities had outbreaks of the disease in other parts of the country, and as of Thursday, the CDC said 1,317 COVID-19 deaths were reported in nursing homes and long-term care facilities in the United States.

“I think the fact that we took action early on provided a layer of security for everybody,” said Merilyn Harris, administrator of Ka‘u Hospital and Rural Health Clinic, which also serves long-term care residents.

Allison Griffiths, vice president of marketing for Avalon Health Care Management, which runs Yukio Okutsu State Veteran’s Home, said Yukio Okutsu has been conducting daily health questionnaires and temperature checks for vendors and staff since March 11, while an “infection preventionist” has performed daily observations of residents and staff.

Denise Mackey, administrator at Hale Ho‘ola Hamakua in Honokaa, said the implementation of the no-visitor policy has gone well, and there has been plenty of support from families for the no-visitor policy, which was adopted by all long-term care facilities on the Big Island in March.

At Hale Ho‘ola Hamakua, Mackey said they’ve instituted a schedule for video calls between families and residents, and staff members are working to offer creative activities for residents, like hallway bingo, that also practice social distancing.

“We’re trying to keep things as lively as we can for our residents, given the restrictions,” she said.

Griffiths said staff have gone “above and beyond” to help keep residents engaged, providing events such as room-to-room visits, bingo, poker and tea time while maintaining social distancing requirements.

Harris said staff at Ka‘u Hospital also have been working to keep residents engaged and family members informed of what’s going on with their loved ones.

While residents want the lockdown to end, Harris said they’re handling the changes well because of efforts by the staff to care for them and keep morale up.

“I think, overall, it’s going a lot better than I thought it would.”

Mackey agreed and said especially in smaller facilities, residents often feel like staff are family, and staff members have been able to provide a level of consistency.

That doesn’t mean residents don’t miss their families, she said, but the sense of community within the facility has been helpful.

The facilities also have tightened restrictions beyond a no-visitor policy.

Silva said Legacy Hilo has implemented thorough screenings of prospective incoming residents and regularly screens staff each day. When they leave each day, every staff member’s temperature is taken to ensure they are not feverish, one of the symptoms of the coronavirus.

The facility also is testing employees for fever-reducing drugs, Silva said.

“We want to make sure people coming in have a normal temperature, without needing medication to keep it down.”

The new measures have affected incoming residents, Silva said, estimating that Legacy Hilo has admitted five or 10 new residents since the beginning of March, but some were turned away based on the screening results. Despite this, she said the current residents are grateful for the stringent protective policies in place.

“They’re very appreciative that we’re taking extra steps to keep them safe,” Silva said. “These are very vulnerable people. The last thing we want is a cluster here.”

Meanwhile, everyone entering the facilities in Honokaa and Ka‘u, as well as Hilo Medical Center’s Extended Care Facility, must have their temperatures taken and wear, at minimum, a cloth mask.

Additionally, new COVID-19 testing and quarantine procedures were adopted this week for new admissions at those three facilities.

Mackey said all new admissions must test negative for COVID-19 before entering the building, where they will be quarantined for 14 days.

Seven days after entering quarantine, the prospective residents will be tested again and will stay in quarantine for the remaining week.

If the individual hasn’t tested positive after seven days and shows no symptoms during quarantine, Mackey said it’s “reasonably safe that they’re negative.”

“Like everybody else, we’re in for the long haul, and we’re going to protect our residents to the very best of our ability,” Harris said.

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com. Email Michael Brestovansky at mbrestovansky@hawaiitribune-herald.com.