https://www.sfchronicle.com/politics/article/Families-left-in-dark-as-coronavirus-races-15191179.php
Politics
Families left in dark as coronavirus races through Bay Area nursing homes
Jason Fagone , Cynthia Dizikes and Trisha Thadani April 9, 2020 Updated: April 9, 2020 5:55 p.m.
Jaime Pati-o, a councilmember for Union City, lowers his head as he visits his 84-year-old grandmother, Emma Pati-o, at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. "When a loved one is in that situation, it comes close to home," Pati-o said. Alameda County public health spokeswoman Neetu Balram confirmed the outbreak Wednesday afternoon.Officials are also monitoring an outbreak at East Bay Post-Acute Rehab in Castro Valley where seven people, including four staffers, have tested positive. Balram cautioned the number of infected persons at each facility could be updates and should be considered a "point-in-time" count. Health officials are tracing suspected and confirmed cases of COVID-19 at long-term care facilities throughout the county, Balram said.
1of4Jaime Pati-o, a councilmember for Union City, lowers his head as he visits his 84-year-old grandmother, Emma Pati-o, at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. "When a loved one is in that situation, it Photo: Yalonda M. James / The Chronicle
Ambulance and fire department bring out equipment from Gateway Care and Rehabilitation Center, 26660 Patrick Ave. on Thursday, April 9, 2020, in Hayward, Calif.
2of4Ambulance and fire department bring out equipment from Gateway Care and Rehabilitation Center, 26660 Patrick Ave. on Thursday, April 9, 2020, in Hayward, Calif.Photo: Liz Hafalia / The Chronicle
Jaime Pati-o, a councilmember for Union City, speaks with members of the press after visiting his 84-year-old grandmother, Emma Pati-o, from outside her window at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. "When a loved one is in that situation, it comes close to home," Pati-o said. Alameda County public health spokeswoman Neetu Balram confirmed the outbreak Wednesday afternoon.Officials are also monitoring an outbreak at East Bay Post-Acute Rehab in Castro Valley where seven people, including four staffers, have tested positive. Balram cautioned the number of infected persons at each facility could be updates and should be considered a "point-in-time" count. Health officials are tracing suspected and confirmed cases of COVID-19 at long-term care facilities throughout the county, Balram said.
3of4Jaime Pati-o, a councilmember for Union City, speaks with members of the press after visiting his 84-year-old grandmother, Emma Pati-o, from outside her window at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. Photo: Yalonda M. James / The Chronicle
Donna Barnett doesn’t know what is happening at Drake Terrace, a large San Rafael nursing home where her 90-year-old father lives, even after two weeks of frantic attempts to find out.
On March 27, she said, the nursing home emailed a letter to family members disclosing that a resident had tested positive for the new coronavirus.
“Learned first (hope last!”) coronavirus positive resident at Drake Terrace,” Barnett wrote in her journal that day. “Took it like a gut punch. I’m sad, scared.”
Over the next few days, the situation grew muddier. The facility, which cares for 115 residents and employs 110, told families that a staff member had tested positive but provided few details. And an official with the nursing home’s parent company, who also spoke to the Chronicle, told Barnett that the facility lacked coronavirus testing kits, she said.
“I don’t know if there’s some secrecy around this?” Barnett told The Chronicle. “I don’t understand. … I’m getting incomplete information.”
Since February, when the coronavirus raced through a senior-care facility in Washington state, killing 37 people, it has been clear that the virus poses a deadly threat to nursing-home residents and their caretakers.
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Still, two months later as outbreaks infect hundreds and kill dozens at Bay Area nursing homes, many senior living centers remain dangerously unprepared and poorly equipped. Many facilities are also leaving families and the public in the dark about the severity of the threat — and so are several Bay Area counties, which either didn’t respond to requests for data about the outbreaks or declined to share the information with The Chronicle.
The lack of transparency has confounded health care experts, legislators, nursing home staff and resident advocates, who say secrecy during a pandemic is harmful to public health and deprives people of crucial information -- particularly families who might want to move their loved ones out of facilities that are experiencing outbreaks.
“It’s not fair to hide this,” said Charlene Harrington, a professor emeritus in the UCSF School of Nursing.
A Chronicle analysis found more than 230 coronavirus cases and more than a dozen deaths linked to nursing homes across the Bay Area, based on news reports and counts from some county officials. Many of those cases came to light over the past 10 days — often without details on how the outbreak started or even when the deaths occurred.
Of the six counties with reported cases in such facilities, only San Francisco and Contra Costa counties disclosed how many they had. Alameda, Marin, San Mateo and Santa Clara refused to share the information.
“Cases have been reported to the media by the facilities themselves, but we are not confirming or commenting on them,” said Preston Merchant, a county health spokesman for San Mateo, where the Chronicle found at least 10 cases and three deaths in long-term care facilities.
Cases at long-term care facilities have ballooned in the last week, driven by large outbreaks at several nursing homes around the Bay Area. At least 87 cases, including six deaths, have been linked to Alameda facilities, while at least 66 cases, including two deaths, have been reported in Contra Costa facilities.
Elsewhere in the state, Los Angeles County said this week that a total of 552 cases and 37 deaths were connected to 121 institutional settings, including nursing homes and other assisted living facilities.
Meanwhile, the federal government has not released tallies of cases within nursing homes and neither has California. Relying on media reports and information from some state health departments, The Associated Press recently counted nearly 2,300 coronavirus infections and at least 450 deaths linked to the nation’s nursing homes and long-term care facilities.
These numbers, however, are likely vastly lower than the true count. Experts say no one really knows how widely the virus has infiltrated nursing homes due to a lack of transparency — and widespread testing.
Faced with a shortage of tests, the Centers for Disease Control and Prevention has issued evolving guidance to stop outbreaks that relies heavily on screening people for symptoms. The recommendations have included restricting visitors, canceling group activities, having staff wear protective gear and, if there are already coronavirus cases in the facility, requiring everyone to wear masks.
But the continued wave of outbreaks suggest that these measures were either implemented too late, or weren’t comprehensive enough to keep the virus from spreading. Health experts, nursing home staff and advocates for residents told The Chronicle that not all nursing homes have been following the CDC guidance, which has been impractical for some facilities that lack protective gear and other resources needed to fully isolate residents. The recommendations have also lagged behind the latest research, showing that people without symptoms are a probable source of transmission within nursing homes and that the safest approach likely involves testing everyone.
“To protect staff and to protect residents, having the availability of widespread testing is absolutely vital,” said Dr. Alison Roxby, an infectious disease expert at the University of Washington who investigated an outbreak at a Seattle-area retirement community and discovered that residents without symptoms were infected.
“Everyone recognizes that we are not going to get a handle on this epidemic until we can get a handle on these facilities, which comes down to testing,” she added.
U.S. Rep. Jared Huffman, who represents Marin County and five others in Congress, said the testing shortfall has frustrated lawmakers and forced nursing homes and health departments to ration their limited tests.
“If you had enough tests, you’d obviously be testing every staffer and every resident in a nursing home,” Huffman said. “But we’ve also got healthcare workers, we’ve got people in hospitals. How can you say they shouldn't also get tests? First responders? The real problem is we’re nowhere where we need to be on testing.”
Jaime Patiño, a Union City Councilman, said his 84-year-old grandmother lives in Gateway Care & Rehab Center in Hayward where at least 59 people have been infected and six people have died. He said he had been given scant information, and only found out about the severity of the outbreak from the news.
“The families need to know because that’s their loved one in there and they need to be reassured,” said Patiño, who has only been able to visit his grandmother through the facility’s window for the past few weeks. “When they can’t even make a phone call, that shows that something is breaking down in the management of that place.”
Back at Drake Terrace in Marin, Donna Barnett said she didn’t consider pulling her father out when positive cases started popping up there. The thought would never occur: Drake Terrace is his home.
Her father, a former administrative law judge for the California Public Utilities Commission, suffers from Parkinson’s Disease, and she said he has received “phenomenal care” throughout his nearly six years at the facility, where he lives in an apartment with his wife. When Donna talked to staff about the virus, she got the sense they were doing their best in a difficult and fluid situation, and she was glad that her father’s apartment had been placed under quarantine.
Still, she worried when she learned that Drake Terrace didn’t have test kits or a plan to test everyone. She had read about the nursing home in Washington where people without symptoms spread the virus, and she kept thinking about her father, who needs daily assistance from staffers — what if one of the people helping him was infected and didn’t know it?
“The big issue has been testing,” Jerry Church, an operations specialist for the home’s parent company Kisco Senior Living, told The Chronicle on Tuesday. “Right? Knowing what we’re dealing with…. Get us the frickin’ tests.”
Church said that after March 27, when the facility confirmed its first coronavirus case, a few other people were tested, but officials were told it would take 14 days to get results. It is unclear where the tests were being performed. A spokeswoman for Marin County said that Drake Terrace never referred anyone to the county to receive testing.
According to figures provided Wednesday by a Kisco spokesperson, there are now seven coronavirus cases at Drake Terrace — more than Donna Barnett was aware of. Five residents and two staffers have tested positive; Barnett said the home had not notified family members of the total.
Also, those seven infected people at the nursing home are the only ones there who have been tested. All seven were showing symptoms of COVID-19, all seven tested positive, and no one else has gotten a test, even though 225 people live and work at Drake Terrace.
On Tuesday, Church said, Marin County officials and physicians from Kaiser Permanente visited the nursing home and offered support and resources. “There’s a good synergy,” Church said. But he did not say how many coronavirus tests the nursing home will now perform — and he insisted that to test everyone at the facility would be “overkill.”
Church did not respond to a subsequent text message and voicemail asking for clarification. In an emailed statement, the executive director of Drake Terrace, John Meyer, said the nursing home has “stringent protocols in place to help prevent the spread of the virus.”
Jason Fagone, Cynthia Dizikes and Trisha Thadani are San Francisco Chronicle staff writers. Emails: [email protected], [email protected] and [email protected] Twitter: @jfagone, @cdizikes @TrishaThadani
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Politics
Families left in dark as coronavirus races through Bay Area nursing homes
Jason Fagone , Cynthia Dizikes and Trisha Thadani April 9, 2020 Updated: April 9, 2020 5:55 p.m.
Jaime Pati-o, a councilmember for Union City, lowers his head as he visits his 84-year-old grandmother, Emma Pati-o, at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. "When a loved one is in that situation, it comes close to home," Pati-o said. Alameda County public health spokeswoman Neetu Balram confirmed the outbreak Wednesday afternoon.Officials are also monitoring an outbreak at East Bay Post-Acute Rehab in Castro Valley where seven people, including four staffers, have tested positive. Balram cautioned the number of infected persons at each facility could be updates and should be considered a "point-in-time" count. Health officials are tracing suspected and confirmed cases of COVID-19 at long-term care facilities throughout the county, Balram said.
1of4Jaime Pati-o, a councilmember for Union City, lowers his head as he visits his 84-year-old grandmother, Emma Pati-o, at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. "When a loved one is in that situation, it Photo: Yalonda M. James / The Chronicle
Ambulance and fire department bring out equipment from Gateway Care and Rehabilitation Center, 26660 Patrick Ave. on Thursday, April 9, 2020, in Hayward, Calif.
2of4Ambulance and fire department bring out equipment from Gateway Care and Rehabilitation Center, 26660 Patrick Ave. on Thursday, April 9, 2020, in Hayward, Calif.Photo: Liz Hafalia / The Chronicle
Jaime Pati-o, a councilmember for Union City, speaks with members of the press after visiting his 84-year-old grandmother, Emma Pati-o, from outside her window at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. "When a loved one is in that situation, it comes close to home," Pati-o said. Alameda County public health spokeswoman Neetu Balram confirmed the outbreak Wednesday afternoon.Officials are also monitoring an outbreak at East Bay Post-Acute Rehab in Castro Valley where seven people, including four staffers, have tested positive. Balram cautioned the number of infected persons at each facility could be updates and should be considered a "point-in-time" count. Health officials are tracing suspected and confirmed cases of COVID-19 at long-term care facilities throughout the county, Balram said.
3of4Jaime Pati-o, a councilmember for Union City, speaks with members of the press after visiting his 84-year-old grandmother, Emma Pati-o, from outside her window at Gateway Care and Rehabilitation, located at 26660 Patrick Ave., on Wednesday, April 8, 2020, in Hayward, Calif. 59 people are confirmed to have COVID-19 at Hayward nursing home. Photo: Yalonda M. James / The Chronicle
Donna Barnett doesn’t know what is happening at Drake Terrace, a large San Rafael nursing home where her 90-year-old father lives, even after two weeks of frantic attempts to find out.
On March 27, she said, the nursing home emailed a letter to family members disclosing that a resident had tested positive for the new coronavirus.
“Learned first (hope last!”) coronavirus positive resident at Drake Terrace,” Barnett wrote in her journal that day. “Took it like a gut punch. I’m sad, scared.”
Over the next few days, the situation grew muddier. The facility, which cares for 115 residents and employs 110, told families that a staff member had tested positive but provided few details. And an official with the nursing home’s parent company, who also spoke to the Chronicle, told Barnett that the facility lacked coronavirus testing kits, she said.
“I don’t know if there’s some secrecy around this?” Barnett told The Chronicle. “I don’t understand. … I’m getting incomplete information.”
Since February, when the coronavirus raced through a senior-care facility in Washington state, killing 37 people, it has been clear that the virus poses a deadly threat to nursing-home residents and their caretakers.
Coronavirus Coverage
Local
By Megan Cassidy and Anna Bauman
Coronavirus outbreak at Hayward nursing home: 6 dead, 53...
Local
By Anna Bauman
Orinda nursing home with coronavirus outbreak had sanitation,...
Local
By Jason Fagone and Trisha Thadani
Coronavirus outbreak at SF’s largest nursing home: Early...
Local
By Anna Bauman, Alejandro Serrano, Kathleen Pender, Tatiana Sanchez, Megan Cassidy and Alexei Koseff
Coronavirus live updates: California's confirmed case count...
Coronavirus Map: Tracking COVID-19 cases across California
Still, two months later as outbreaks infect hundreds and kill dozens at Bay Area nursing homes, many senior living centers remain dangerously unprepared and poorly equipped. Many facilities are also leaving families and the public in the dark about the severity of the threat — and so are several Bay Area counties, which either didn’t respond to requests for data about the outbreaks or declined to share the information with The Chronicle.
The lack of transparency has confounded health care experts, legislators, nursing home staff and resident advocates, who say secrecy during a pandemic is harmful to public health and deprives people of crucial information -- particularly families who might want to move their loved ones out of facilities that are experiencing outbreaks.
“It’s not fair to hide this,” said Charlene Harrington, a professor emeritus in the UCSF School of Nursing.
A Chronicle analysis found more than 230 coronavirus cases and more than a dozen deaths linked to nursing homes across the Bay Area, based on news reports and counts from some county officials. Many of those cases came to light over the past 10 days — often without details on how the outbreak started or even when the deaths occurred.
Of the six counties with reported cases in such facilities, only San Francisco and Contra Costa counties disclosed how many they had. Alameda, Marin, San Mateo and Santa Clara refused to share the information.
“Cases have been reported to the media by the facilities themselves, but we are not confirming or commenting on them,” said Preston Merchant, a county health spokesman for San Mateo, where the Chronicle found at least 10 cases and three deaths in long-term care facilities.
Cases at long-term care facilities have ballooned in the last week, driven by large outbreaks at several nursing homes around the Bay Area. At least 87 cases, including six deaths, have been linked to Alameda facilities, while at least 66 cases, including two deaths, have been reported in Contra Costa facilities.
Elsewhere in the state, Los Angeles County said this week that a total of 552 cases and 37 deaths were connected to 121 institutional settings, including nursing homes and other assisted living facilities.
Meanwhile, the federal government has not released tallies of cases within nursing homes and neither has California. Relying on media reports and information from some state health departments, The Associated Press recently counted nearly 2,300 coronavirus infections and at least 450 deaths linked to the nation’s nursing homes and long-term care facilities.
These numbers, however, are likely vastly lower than the true count. Experts say no one really knows how widely the virus has infiltrated nursing homes due to a lack of transparency — and widespread testing.
Faced with a shortage of tests, the Centers for Disease Control and Prevention has issued evolving guidance to stop outbreaks that relies heavily on screening people for symptoms. The recommendations have included restricting visitors, canceling group activities, having staff wear protective gear and, if there are already coronavirus cases in the facility, requiring everyone to wear masks.
But the continued wave of outbreaks suggest that these measures were either implemented too late, or weren’t comprehensive enough to keep the virus from spreading. Health experts, nursing home staff and advocates for residents told The Chronicle that not all nursing homes have been following the CDC guidance, which has been impractical for some facilities that lack protective gear and other resources needed to fully isolate residents. The recommendations have also lagged behind the latest research, showing that people without symptoms are a probable source of transmission within nursing homes and that the safest approach likely involves testing everyone.
“To protect staff and to protect residents, having the availability of widespread testing is absolutely vital,” said Dr. Alison Roxby, an infectious disease expert at the University of Washington who investigated an outbreak at a Seattle-area retirement community and discovered that residents without symptoms were infected.
“Everyone recognizes that we are not going to get a handle on this epidemic until we can get a handle on these facilities, which comes down to testing,” she added.
U.S. Rep. Jared Huffman, who represents Marin County and five others in Congress, said the testing shortfall has frustrated lawmakers and forced nursing homes and health departments to ration their limited tests.
“If you had enough tests, you’d obviously be testing every staffer and every resident in a nursing home,” Huffman said. “But we’ve also got healthcare workers, we’ve got people in hospitals. How can you say they shouldn't also get tests? First responders? The real problem is we’re nowhere where we need to be on testing.”
Jaime Patiño, a Union City Councilman, said his 84-year-old grandmother lives in Gateway Care & Rehab Center in Hayward where at least 59 people have been infected and six people have died. He said he had been given scant information, and only found out about the severity of the outbreak from the news.
“The families need to know because that’s their loved one in there and they need to be reassured,” said Patiño, who has only been able to visit his grandmother through the facility’s window for the past few weeks. “When they can’t even make a phone call, that shows that something is breaking down in the management of that place.”
Back at Drake Terrace in Marin, Donna Barnett said she didn’t consider pulling her father out when positive cases started popping up there. The thought would never occur: Drake Terrace is his home.
Her father, a former administrative law judge for the California Public Utilities Commission, suffers from Parkinson’s Disease, and she said he has received “phenomenal care” throughout his nearly six years at the facility, where he lives in an apartment with his wife. When Donna talked to staff about the virus, she got the sense they were doing their best in a difficult and fluid situation, and she was glad that her father’s apartment had been placed under quarantine.
Still, she worried when she learned that Drake Terrace didn’t have test kits or a plan to test everyone. She had read about the nursing home in Washington where people without symptoms spread the virus, and she kept thinking about her father, who needs daily assistance from staffers — what if one of the people helping him was infected and didn’t know it?
“The big issue has been testing,” Jerry Church, an operations specialist for the home’s parent company Kisco Senior Living, told The Chronicle on Tuesday. “Right? Knowing what we’re dealing with…. Get us the frickin’ tests.”
Church said that after March 27, when the facility confirmed its first coronavirus case, a few other people were tested, but officials were told it would take 14 days to get results. It is unclear where the tests were being performed. A spokeswoman for Marin County said that Drake Terrace never referred anyone to the county to receive testing.
According to figures provided Wednesday by a Kisco spokesperson, there are now seven coronavirus cases at Drake Terrace — more than Donna Barnett was aware of. Five residents and two staffers have tested positive; Barnett said the home had not notified family members of the total.
Also, those seven infected people at the nursing home are the only ones there who have been tested. All seven were showing symptoms of COVID-19, all seven tested positive, and no one else has gotten a test, even though 225 people live and work at Drake Terrace.
On Tuesday, Church said, Marin County officials and physicians from Kaiser Permanente visited the nursing home and offered support and resources. “There’s a good synergy,” Church said. But he did not say how many coronavirus tests the nursing home will now perform — and he insisted that to test everyone at the facility would be “overkill.”
Church did not respond to a subsequent text message and voicemail asking for clarification. In an emailed statement, the executive director of Drake Terrace, John Meyer, said the nursing home has “stringent protocols in place to help prevent the spread of the virus.”
Jason Fagone, Cynthia Dizikes and Trisha Thadani are San Francisco Chronicle staff writers. Emails: [email protected], [email protected] and [email protected] Twitter: @jfagone, @cdizikes @TrishaThadani
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