The discovery of COVID-19 cases has families and officials with two Chicago-area nursing homes scrambling for testing, supplies and answers to help minimize the impact on elderly residents — those most vulnerable to the disease.
Individuals connected to the homes have appealed to the public for donations, implored state and federal officials for assistance, and sought guidance from an out-of-state nursing home where nearly three dozen residents have perished due to COVID-19.
Last Saturday, a resident of Chateau Nursing and Rehabilitation Center in west suburban Willowbrook tested positive for COVID-19. By Wednesday — after all of the home’s residents and employees had been tested, according to officials — 46 individuals, including 33 residents and 13 staff members, had tested positive.
“We're hopeful that we were able to identify the infection at an early stage and we’re hopeful that we can help these people to get better,” said DuPage County Board Chairman Dan Cronin.
Meanwhile, on Monday, management at Three Crowns Park, a retirement community in north suburban Evanston, notified residents and their family members that a resident there had tested positive for COVID-19. On Tuesday, management shared news of a second COVID-19 case.
However, unlike the Willowbrook nursing home, widespread testing has eluded the Evanston facility despite impassioned pleas for local and state public health officials to provide it.
“We recognize that testing is a vital part of this process but when I inquired about testing residents and staff, [the Evanston Health Department] replied that they do not advise testing for anyone who is asymptomatic,” wrote Three Crowns Park executive director Phil Hemmer, in a letter to residents and their families on Tuesday. “I expressed my frustration that the advice they had been giving us was different from what was happening in Willowbrook.”
On Thursday, state officials echoed the position that testing will be prioritized for individuals exhibiting symptoms.
“Testing will be performed for individuals who are part of a cluster of confirmed cases or possible cases among those who work or live in a residential congregate setting, such as the nursing homes,” said Dr. Ngozi Ezike, director of the Illinois Department of Public Health, during Thursday’s state briefing on COVID-19 in Illinois.
“We will not recommend tests for every single resident or staff of a long-term care facility,” Ezike continued. “Rather, we will take all the precautions necessary and, as soon as any staff or residents develop symptoms, they will be isolated and treated “
In his letter, Hemmer said the Evanston facility has reached out to elected officials for help. Officials with Congresswoman Jan Schakowsky’s office told WBEZ that they will continue to push for broader testing for the facility.
In the meantime, relatives of residents at Three Crowns Park remain on edge.
“They are putting these people in danger, and I think it’s likely they will have some fatalities in the facilities,” said Rick Vines, whose 97-year-old mother is a resident at Three Crowns Park.
Vines said widespread testing would help manage the outbreak.”It would allow them to isolate the people who test positive and, if there are staff who test positive, to make sure that those people don’t come into contact with any residents,” Vines said.
The Evanston facility may also be dealing with a shortage of protective gear for workers. Earlier this week, someone connected to the facility posted a plea on a neighborhood website saying “we are drastically low on Personal Protective Equipment. We are working with the Health Department and Legislators to identify sources — but everyone is hurting for supplies.” The post further asked people to make sanitizer using rubbing alcohol and aloe gel.
Three Crowns Park is a nonprofit retirement community offering different levels of care, including assisted living for about 80 residents and independent living for another 110 residents. The assisted living community is similar to a more traditional nursing home.
While Chateau Nursing and Rehabilitation Center learned of the extent of its outbreak due to widespread testing, it faces its own set of challenges.
Chateau is a for-profit nursing community with 150 beds. The facility offers hospice care, as well. As a traditional nursing home, Chateau is inspected by federal monitors and required to share information about its finances and staffing levels.
The nursing home has received below average ratings — garnering two out of five stars from the U.S. Centers for Medicare & Medicaid Services, based on inspections from last year. In addition, the nursing home had to pay penalties twice in 2017, for poor performance, totaling $31,176, according to federal data.
DuPage County officials are still without answers about how so many residents and staff became infected at the Willowbrook facility. They’ve been in touch with public health officials in Washington state to learn more about the tragic COVID-19 outbreak at Life Care Center in Kirkland, just outside of Seattle.
“They have a viewpoint and a perspective to share,” said Cronin, the DuPage County board chairman. “So there has been some level of communication with them, in an effort to try to come up with best practices here.”
Those lessons could be critical to avert a similar tragedy here.
The first COVID-19 case at Life Care Center was discovered a month ago. To date, 81 residents, 34 staff and 14 visitors have tested positive for COVID-19 — and 34 residents and one visitor have died, according to reports this week from the Seattle Times and the U.S. Centers for Disease Control and Prevention (CDC).
Life Care Center has become one of the country’s largest COVID-19 outbreaks and the largest single-source of fatalities. The Seattle Times outlines the confusion inside the nursing home and among local and state officials during a crucial time.
Staff at the nursing home said they noticed a respiratory outbreak as early as Jan. 29, with a case of a woman in her 80s who was having difficulty breathing. On Feb. 19, the first resident tested positive for COVID-19.
By Feb. 28, county public health officials found out that 20 residents were having unexplained respiratory troubles — all of those residents tested negative for the flu. The state and CDC were contacted when nursing staff started getting sick.
All along, there was confusion among the nursing home, a local hospital, and public health officials at the county and state levels. They also disagreed about the need and availability of testing.
The Seattle Times investigation noted the role of nursing home staff in unknowingly spreading the coronavirus at Life Care Center and remaining questions about whether staff there may have endangered other facilities where they provided care.
The CDC’s report further chronicled challenges with the Life Care Center outbreak and offered strong language about the need for coordination and quick response to COVID-19 — or even the threat of it — in long-term care facilities.
“The findings in this report suggest that once COVID-19 has been introduced into a long-term care facility, it has the potential to result in high attack rates among residents, staff members, and visitors,” the report notes. "The underlying health conditions and advanced age of many long-term care facility residents and the shared location of patients in one facility places these persons at risk for severe morbidity and death."
The CDC recommends that nursing homes implement symptom screening and restriction policies for visitors and nonessential personnel; actively screen health care workers, documenting body temperature and identifying respiratory symptoms; consistently monitoring residents for symptoms; enacting social distancing policies, including the restriction of resident movement and group activities; immediately addressing shortages of personal protective equipment; and training staff to properly use such equipment and on infection control.
“As this pandemic expands, continued implementation of public health measures targeting vulnerable populations such as residents of long-term care facilities and health care personnel will be critical. As public health measures are continually implemented, public information needs will only grow,” the report continues. “To provide information for patients and families as well as communicate more broadly to all stakeholders, public officials and other community leaders need to work together to encourage everyone to understand and adhere to recommended guidelines to manage this outbreak.”
María Ines Zamudio is a reporter for WBEZ’s Race, Class and Communities desk. Follow her @mizamudio.
Monica Eng is a WBEZ reporter. Write to her at firstname.lastname@example.org