After a staff member at Elderwood at Burlington tested positive for Covid-19 on Nov. 23, the virus spread like wildfire.
In the subsequent 10 days, it has nearly engulfed two units of the nursing home and rehab center, with 78 cases. As of Thursday afternoon, three people had died.
An eviscerated workforce is left to care for patients battling infection as the case count continues to rise among staff and residents.
“You just drop from exhaustion,” said one staffer, who asked not to be named for fear of retribution. “That’s what’s heartbreaking is these residents, because they are slowly just dying.”
“This all unraveled very quickly,” said Kayla Donahue, a leader of the Department of Health team that responds to outbreaks at elder care facilities. Within days, “the staffing challenges were amplified to a level that I don’t think many of us have ever seen before.”
The facility, a low-lying building in Burlington’s New North End, has 107 residents in its nursing home and rehabilitation unit, according to spokesperson Charles Hayes. Nearly half of the population, 45 residents, have contracted the virus. Six have been hospitalized.
Outbreaks in elder care homes have become increasingly frequent, as Vermont continues to break records for statewide case counts. As of Tuesday, Vermont had 166 cases in eight facilities. Rutland Health & Rehab was the largest, with 54 cases among patients and staff. A nursing home across the street from Elderwood, Birchwood Terrace Rehab and Healthcare, was the source of the state’s deadliest outbreak earlier this spring, with 21 deaths.
But even compared to other similar facilities, the Elderwood outbreak has spread with alarming rapidity. According to Donahue, case counts started growing on Thanksgiving Day and the holiday weekend, making the initial response more challenging. Poor timing notwithstanding, “we were all surprised at the number of positives,” she said.
‘No red flags’
There’s nothing the facility could have differently, Donahue said.
The state mobilized its rapid response team on Nov. 24 and met daily with Elderwood’s leadership for the first five days, according to Monica White, director of operations at the state’s Department of Disabilities, Aging and Independent Living. The state delivered more masks and protective gear and, expecting a staff shortage, called in volunteers with the Medical Reserve Corps and SerVermont.
Elderwood has set up a “really aggressive testing strategy,” Donahue said, offering PCR tests to staff and residents every three days, and the rapid antigen tests every day in between. It has also moved the patients who have tested positive together and separated them from those who were negative.
Although the staffer claimed that at least one person who was negative was put in a room with someone who tested positive, Donahue disputed that assertion.
“There were no red flags, no evidence of something that could have been prevented or could have done better,” Donahue said.
With the help of the state, the facility has adequate personal protective equipment and sufficient staffing, Hayes said. “Clinical staff have implemented best-practice infection control protocols, including strict isolation measures and the elimination of all communal activities,” he said.
‘Saddest thing ever’
Even so, the situation has overwhelmed the shrinking number of healthy staff.
In some cases, two licensed nursing assistants are taking care of more than two dozen patients, the staffer said. Nurses are trying “to feed two meals, and [respond to] call lights, incontinent care, bedsore care, you name it. It can’t be done,” she said. Even delivering boxed meals, usually a sandwich, to patients takes extra time, as staff members must suit up in the requisite gown, gear and gloves, and sanitize in between each delivery.
Meanwhile, “there’s 30 call lights beeping. People want help; they’re in pain,” the worker said.
She thinks about quitting, she said, knowing she could quickly find a job at a nursing home without Covid cases.
Another staffer, who also spoke with VTDigger and asked not to be identified, described piles of dirty laundry, a shortage of soda for residents, and times when there weren’t enough gowns or scrub hats. The facility has the supplies, but there are too few staff to access them.
Hayes, the facility spokesperson, couldn’t say whether there were supply shortages. “The staff at Elderwood at Burlington, like staff across the state and country are stretched. There’s no doubt about that,” he said. “Do we have concerns about safety and care? No. Are people working harder because of this? Yes they are.”
Workers are also bearing a heavy emotional burden, the second staffer said.
She described holding up a phone in a plastic bag to a Covid-positive resident who was unable to speak, as the woman’s sister encouraged her to keep battling the virus. The staffer described fighting back tears. “It was the most saddest thing ever,” she said.
On Thursday, that staffer learned she had tested positive for Covid.
“Staffing was identified as a critical issue at the onset of this outbreak,” acknowledged White, from the Department of Disabilities, Aging and Independent Living. But she said that, by recruiting outside staffers, “Elderwood has been able to maintain at least minimally adequate staffing levels to assure resident safety throughout this outbreak.”
Hayes praised the staff for doing a “tremendous job” under trying circumstances.
“At the end of a shift, people are tired and exhausted and concerned,” he said. “People are doing the absolute best they can.”
