Weeks after an employee tested positive, here's how a Wausau nursing home says they have no COVID-19 cases.
“This could have been a totally different situation.”
It’s been almost a month since an employee at one of North Central Health Care’s long term care facilities developed a temperature during their shift on March 22 and later tested positive for COVID-19. At the time, the Marathon County Health Department assumed community spread and NCHC braced for more cases.
So far, those cases haven’t materialized. The New York Times reports more than 7,000 COVID-19 deaths—or about a fifth of total deaths—have occurred in nursing homes around the country.
At Mount View Care Center, fending off an outbreak dates back to almost a week before COVID-19 was declared a pandemic—and perhaps as well, sheer luck.
“We got really fortunate:” The employee had been working night shift and wasn’t coughing or sneezing before they went home, which likely limited the spread, NCHC infection prevention specialist Tim Holzem noted. But the team response also kicked in quickly: the employee’s supervisor sterilized the units the employee had been working in with bleach that same night, and others on the COVID-19 response team tallied a list of every worker or resident in every department that could have had contact. Personal protective equipment was mandatory wear.
Out of the estimated 80 residents or other workers the employee had contact with, according to that list, none have tested positive for COVID-19. The DHS until recently did not recommend prioritized testing for anyone who was not a health care worker, a long term care resident, or hospitalized: As a result, all were put on notice to aggressively monitor symptoms for fourteen days following the positive test. Based on that, nine additional employees would require testing, as would five residents. To date, all have been negative. Working with the Aspirus hotline, Loy said everyone displaying symptoms was able to get one, with testing opening up further for them in the past week.
CEO Michael Loy said employees sent home for symptoms were required to spend a minimum of seven days and 72 hours symptom-free before returning to work. Monitoring of temperatures and vitals for all residents involved was increased to every four hours after the positive test, Holzem said. And while not everyone was tested who had been in contact with the employee, anyone who developed any symptoms related to the viral disease was treated and isolated as if they had it—until a test said otherwise.
Normal rates of hospitalization did not increase, the facility told NewsChannel 7. And while a procedure is in place to test post-mortem deaths for COVID-19 if potential symptoms were present, the facility says they haven’t needed to utilize it.
“There were no individuals who passed at Mount View Care Center who were experiencing symptoms consistent with COVID-19 prior to their death,” a spokesperson noted, and according to Loy, NCHC residents have a higher level of chronic or severe medical conditions than some other nursing homes. The six deaths that have occurred at the facility since March 22 were consistent with ongoing medical conditions in the patients, none of whom had symptoms for COVID-19, according to the facility. In Marathon County, the health department has reported one death from COVID-19 since the pandemic started.
“The most important thing we did was to be very vigilant early,” Loy said.
"NCHC has had the benefit f learning from the experience of others," chief medical officer Dr. Robert Gouthro said. The team had been watching as the pandemic first hit a nursing home in Washington, where
in some way to the outbreak.
"We were watching the case in Washington very closely," Loy said.
On March 11, the day the World Health Organization declared COVID-19 a pandemic and five days after NCHC activated their response team, NCHC implemented symptom screening and restricted visitation. The following day, they cancelled all visitation, according to a timeline of their public messages. March 12 was also the day other nursing homes in the Wausau area started closing their doors to visitors, according to a review of public messaging from other homes. Area hospitals, however, would not implement screening until days or weeks later.
Earlier than the 11th, however, Holzem said their team had started searching for creative ways to bolster their supply of personal protective equipment, attributing their supply team with playing a key role in ensuring their facilities have so far not experienced significant supply issues.
“[They] saved our bacon,” Holzem said with a chuckle.
For Judy Burrows with the Marathon County Health Department, details like learning what shift an employee worked on and what types of symptoms they exhibited are why contact tracing is such a labor-intensive process.
“If this individual had worked a different shift, become symptomatic at a different hour of the day—everything could have been different,” Burrows noted in a phone interview with NewsChannel 7 on Monday.
NCHC chief medical officer Dr. Robert Gouthro says it’s impossible to be sure about a COVID-19 infection—whether currently or in the past—without testing.
“But we can be relatively certain that if we take the proper precautions…and we’re not seeing symptoms among our patients and we’re monitoring their temperatures and vitals and situation, that it is unlikely that we would have anybody in the nursing home at this time with symptoms for COVID-19,” Gouthro said.
Meanwhile, window visits and FaceTime calls for families and loved ones of residents will remain the norm—for now. That’s what’s keeping Melissa Stockwell busy, Mount View’s music therapist and life enrichment supervisor.
“We play music in the hallways," she said with a chuckle. "We do things like snack carts—so passing out cookies and dressing up funny to brighten people’s days. We’ve been leaving inspirational sayings or jokes on our dry erase boards for the staff to see every day.”
Because at the end of the day--
“You do everything you can to keep everybody happy.”