As COVID-19 burns through the Midwest, the Minnesota Department of Health says 15 of Douglas County’s 29 deaths occurred in elder care facilities, a number that appears to be low, based on interviews with facility managers.
The elderly have been the most at risk of dying from the coronavirus, and the infections and deaths have caused local assisted living facilities, nursing homes and memory care units to keep out visitors except in the most dire circumstances.
“People are starting to get scared,” said Dustin Lee, president of Prairie Senior Cottages, which operates a facility in Alexandria. “The truth is this is worse than war.”
The state's list
Here is the state’s count of infections and deaths among staff and residents in the following Douglas County elder care facilities:
Alex Assisted Living: 2 infections among staff, 5 resident infections, 1 resident death
Bethany on the Lake: 13 infections among staff, 19 resident infections, 5 resident deaths
Galeon in Osakis: 24 infections among staff, 37 resident infections, 5 resident deaths. (Galeon Administrator Angie Reinke told the Echo Press that there had been 7 resident deaths as of Nov. 11)
Diamond Willow Assisted Living: 1 infection among staff, and no resident infections or deaths
Edgewood Assisted Living: 16 infections among staff, 41 resident infections and 3 resident deaths
Evansville Care Center: 6 infections among staff, 7 resident infections and no deaths
Grand Arbor by Knute Nelson: 17 infections among staff, 23 resident infections and no deaths
Knute Nelson Care Center: 18 infections among staff, 6 infections among residents and one resident death. (Chief Development and Strategy Officer Katie Perry said the report was incorrect, and that there were three infections and no deaths at Knute Nelson. However, patients from Alomere have been moved to a special COVID unit at Knute and three of them have died.)
Prairie Senior Cottages: No staff infections, two resident infections and no resident deaths. (Lee told the Echo Press that there was one infection among staff and one resident death.)
Windmill Ponds: Four infections among staff, four among residents and no deaths.
A health department spokesperson advised relying on data from facility managers, as the state’s list might have lag time. The report counts all those considered residents of the facility, no matter where they died, he said.
The COVID crisis is also hurting long-term care facilities financially, as they upgrade their facilities and as families, in some cases, shy away from moving their loved ones there.
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The situation has become so dire across the country that the American Health Care Association and National Center for Assisted Living, which represent more than 14,000 long-term care facilities, have issued public statements asking for more federal funding.
“Our worst fears have come true,” said Mark Parkinson, the organization’s president and CEO. He pleaded with the public to wear masks and follow social distancing guidelines, citing statistics that tie COVID cases in nursing homes to major spikes in community spread.
How COVID got in
Lee said the death at the Prairie Senior Cottages Alexandria facility was linked to a staff member. The worker’s temperature was normal on arrival, but it rose three-tenths of a degree by the time they left. The next morning, when they reported for duty, they had a runny nose and were told to leave and get tested. The test was positive, Lee said. About 48 hours later, a resident got sick and was later hospitalized, then moved to a different facility where they died.
“Behind the numbers was somebody’s child, dad, aunt, mother, cousin,” he said. “Behind every number, there’s a story and a person.”
Lee said they do not have the capacity to conduct regular COVID checks at the 20-bed memory care facility, and they also don’t have the ability to separate sick residents from healthy ones. They have added an ionization system into their duct work and a blue light system, which, together, are supposed to kill bacteria, mold and viruses.
Waiting for a vaccine
Since the surge of COVID in Douglas County, Knute Nelson has ramped up its testing of staff and residents from once a week to twice.
The tests are put in a freezer, and the same day, an Alomere courier picks them up, puts them on dry ice and drives them to the Mayo Clinic in Rochester. Whenever they find a positive case, a lab employee alerts Knute Nelson, no matter what time it is.
Twice, Angie Urman, Knute Nelson’s chief operating officer and senior vice president, has been awakened in the middle of the night to be informed that a resident has tested positive.
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When that happens, she calls the staff on duty, and they move the resident into a special wing for COVID patients. The wing has its own heating, ventilation and air conditioning system, and 12 beds, each in a private room. Nine of the rooms have negative pressure, which traps and keeps airborne viruses from spreading beyond the room. They keep those doors shut as much as possible, and the staff that works there wears full protective gear.
From March to Nov. 15, Knute Nelson said it had 33 cases of COVID infection among staff at its three facilities and 15 cases among residents. Other than isolating the residents testing positive, they have not had to treat them for COVID because few have exhibited serious symptoms, Urman said. In fact, staff has been unable to determine how residents caught the virus.
“It’s been very random,” she said. “Without facility wide testing, we may or might not have caught it early on.”
Precautions include asking staff members to be cautious about where they go during their off hours. Also, any resident who moves into or returns to one of Knute Nelson’s facilities must quarantine in their room for two weeks. After that, they are able to mix with other residents to some extent, but Urman is the first to concede that it’s not ideal. They can sit in the dining room with others, but only one per table, and everyone has to be masked. With hearing a frequent problem with the elderly, it can be difficult for them to catch up with each other.
Like any nursing home, Knute Nelson’s visiting policy is determined by how many COVID cases there are in the facility and in the community. If there hasn’t been a positive case in 14 days in the facility, and if fewer than 10% of community tests are positive, visitors can sit with their loved ones.
However, that hasn’t been the case since early fall. Visitors are still able to wave through the window, but it is now too cold to open the windows. Only allow essential care visits and compassionate care visits are allowed.
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Still, the staff does all it can to keep spirits up, Urman said.
Their pastor, who is musically inclined, travels the halls with a banjo, and residents can listen from their doorways. Certified music practitioner Sara Severson also brings her guitar and sings through a mask.
“Our staff always try to be as positive as they can. We are looking forward to a vaccine so there will be some hope in the future,” Urman said. “Our staff really has to try to be their family.”