Inside Valley View's Fight With Coronavirus

It has been over two weeks since coronavirus was detected at Valley View Nursing Home on Oct. 5. In that time cases have spread among staff and residents as the home implemented policies, lockdowns and isolation to combat the spread of the virus through the home’s residents.

According to Wes Thompson, the home’s administrator, so far, there have been 11 residents confirmed to be infected with the coronavirus all aged between 63 and 98 years. Of those, none were showing serious symptoms and six were expected to be recovered by next week. Four of the cases were reported late Monday, Oct. 19, and according to Thompson, the cases were spread across the home with no discernible link or contact, despite the home limiting staff to select residents and mitigating staff interactions among each other to prevent the spread of the disease.

Thompson said some of those measures have caused concern among loved ones and family, many of whom have expressed concern about isolation measures and quarantine. The administrator said that one unexpected benefit for quarantined residents is that they are a small group with a dedicated staff. That means those particular residents get more one-on-one care and time spent with nursing staff, which benefits them greatly during isolation.

He credits that time spent with residents for their relative good health despite being infected. Not only because they were able to socialize and do more activities, but because it allowed staff to closely monitor for worsening symptoms and act accordingly. To date none of the residents have needed to be hospitalized for the virus and none of the cases were considered severe at press time.

Asked about this Thompson cautioned that everything could change in a hurry, and in fact when Thompson spoke to the Courier the home had six confirmed cases among residents, but by Monday evening that number had jumped to 10. He used that caution when discussing severity. Asked if any resident was severe, he stated, “No not as we speak. Now, every day is different so please keep that in mind, yes.”

Also of concern to the home, was the number of staff infected by the disease. As of Oct. 19, 11 staff members were confirmed positive and six were suspected to be infected with the disease. Of the 11, six had completed quarantine and returned to work.

Discussing the high number of staff and residents infected, Thompson stated, “Once it gets into one of these facilities, it’s pretty much alive. It jumps like nobody’s business.”

Since first confirming a staff member tested positive in early October, Thompson said the home quickly implemented protocols to combat the spread of the virus among the 50-plus residents. He credited his infectious disease control specialist Taylor Mix and said the staff worked to detect infections, isolate and treat residents as quickly as possible.

“We very quickly did everything according to my protocol,” explained Thompson, in a distinctly military manner. “I have a really, really good infection prevention team, led by my infection preventionist Taylor Mix.”

Thompson said the prevention team had already planned and prepared for the inevitability of a positive case in the home, and they quickly moved to execute that planning to slow the spread. He added that, unfortunately, once the virus enters the facility it is difficult to contain.

“We were able to capture a lot of [cases],” he explained, by screening and detecting staff based on symptoms before they enter the facility and then, with rapid tests, confirming and preventing those cases from entering.

The staff infections have put a strain on nursing, where all but one of the staff infections occurred. As a result, Thompson has had to minimally rotate asymptomatic but positive nursing staff to directly care for patients who were also infected. He said that requires a delicate balance of ensuing staff only treat patients who have similar infection timelines as the nurse or CNA.

Due to a lack of rapid test stock, Thompson said the home has not been able to test every staff member entering the home, and they have relied on symptom and contact tracing to detect cases. He said that, at one point last week, the home had actually run out of tests completely requiring a resupply on Oct. 16 and Oct. 19. Each resupply contains 160 rapid tests, so if Thompson tested all 115 staff and 56 residents, he would run out completely.

“So, we only use rapid testing for those emergent issues,” he said.

Even though the home was able to move quickly on detection and isolation, the same procedures that were in place before the outbreak are not the same ones in place today. The most prominent is the residents’ current status of being isolated almost entirely to their rooms. Everything from activities to meals now occur inside the relative safety of isolation leaving only staff to directly interact with residents.

In response to concerns that staff can transmit the disease into the home and give it to residents, Thompson has changed staffing protocols as well to limit staff interactions. Now nursing staff are limited to specific wings, they do not use break rooms or interact directly with dietary or housekeeping staff. Those measures are on top of personal protective equipment standards like gloves, masks and eye protection, social distancing and hygiene and sanitation.

Despite the current state of the home, Thompson is looking to the future. Recently the Center for Medicaid/Medicare Services issued guidelines allowing in-person visitation and physical contact. That plan calls for a dedicated room, strict sanitation, masking and screening protocols to allow residents to directly interact with loved ones. Thompson plans to implement visitation once COVID-19 has been eliminated in the facility.

Visitors will be allowed in groups of up to three per resident for 45 minutes a visit. The time limit ensures the greatest number of residents can visit with loved ones per day. They will have a dedicated entrance, a dedicated room and will have to follow the procedures in place. They will also be able to physically interact with their loved ones, meaning they can hug, hold hands and be close to the residents, explained Thompson.

Thompson said that even though cases are spiking locally this was something he was going forward with for his residents. “We need to,” he stated. “We have too many amazing community members and too many family members that are dying to see their loved ones and we have to find a way… we need to bring the visitors back to Valley View Home.”

Thompson stressed the need for the community to participate in limiting the spread in Valley County to protect the home’s residents. He said it is impossible to completely isolate staff from the outside world, but that by limiting the spread locally, it would protect staff and ultimately the home from further infections. He pointed to mask wearing and social distancing as key examples of what people can do to help the home recover and stay safe.

“Half of the county care and wear masks,” Thompson said, “and the other half, I’m sure they care too, they just have different ideas, and I wish they would, just for the sake of the average age in Valley County, put a mask on and stay distant.”

Thompson stood up for his staff, especially his nursing staff, explaining they are frustrated with community accusations of reckless behavior when off duty. He pushed back saying, as one of the largest employers in the county, he has had no issues with staff not following COVID-mitigation guidelines since those policies were stressed over the summer. In fact, he stated, only one employee was forced to take a temporary leave of absence due to not following those guidelines.

“The community wanted to point a finger,” Thompson stated. “The community wanted to say, ‘it’s because I couldn’t handle my staff and my staff go out and aren’t doing what they are supposed to be doing.’ I say, ‘no, you’re wrong’. My staff for the most part are.”

Still, Thompson understands community anger surrounding the outbreak, especially since this is the third round of total isolation for residents at the home, and he said the community has a right to get answers to their questions and concerns. He asked that anyone with concerns call him directly to discuss.

“I wish I could sit down with the entire community and explain to them what’s going on, what we’re doing and how to move forward, I do,” said Thompson. “But it’s difficult. It’s difficult to explain every single thing.”

The administrator said it was fair to be angry at the outbreak, but the idea that staff were reckless or, worse, intentionally got infected was unreasonable. “There is no way any of my staff members got out there and got themselves exposed,” he said. “That is not in the cards. Not even in the game. It’s just going to happen and it’s going to happen because we as a community, Valley County, are not taking it seriously.”

Still the community feedback has not all been negative. “Overall, even though the community is angry, and the community is upset, we’re actually getting a ton of community members saying, ‘we’re here to help you too,’” Thompson said.

Asked if everyone wore a mask and socially distanced whether it would make things better for Valley View, Thompson said, without missing a beat, “Overnight.”