The first outbreak of coronavirus in the U.S. happened in a nursing home in Washington state, and since then, outbreaks have continued to show up in facilities around the country. Vermont is no different. The state’s largest outbreaks have also been in nursing homes.
The virus poses a high risk to older and chronically ill people, and can spread quickly through facilities and exact a heavy toll. The Associated Press reported earlier this week at least 3,600 people have died in nursing homes across the country.
In Vermont, outbreaks at two nursing homes in Burlington highlight how vulnerable these facilities can be.
"I don't know from one day to the next what's going to happen with her." — Robin Wescott
At the beginning of April, it had been more than a month since Robin Wescott had seen her mom. They could still talk over Skype but Wescott’s mother, Coralyn, has dementia.
“I don’t know from one day to the next what’s going to happen with her,” Wescott said “At this point, she’s not eating, and I was aware of that just before it went into lockdown, but they had her on Ensure, and basically she’s still drinking the Ensure, but she’s not eating.”
Wecott’s 92-year old mother lives at Birchwood Terrace, a nursing home in Burlington. It’s the site of one of the worst COVID-19 outbreaks in Vermont. A total of 69 residents and staff have tested positive, and six residents have died.
“It’s been very stressful for me,” Wescott said. “As far as lying awake and losing sleep, worrying.”
The nursing home restricted visitor access on March 11, two days before Gov. Phil Scott declared a state of emergency and barred visitation at long-term care facilities statewide.
Birchwood also began taking employees’ temperatures prior to their shifts, and was checking residents’ temperatures twice a day, according to a March 16 Facebook post from Birchwood’s executive director.
But the virus still got in. Birchwood confirmed its first case on March 30. Four days later, after discovering 13 more residents were infected, the nursing home announced it would test everyone.
Deputy Health Commissioner Tracy Dolan said Birchwood asked the state to conduct mass testing and even retest people.
“An environment where it’s spreading rapidly within a facility, sometimes it makes sense to test again,” Dolan said. “And a vulnerable population? Yeah, we want to be extra sure.”
"An environment where it's spreading rapidly within a facility sometimes it makes sense to test again. And a vulnerable population? Yeah, we want to be extra sure." — Deputy Health Commissioner Tracy Dolan
In New Hampshire and Massachusetts, about half the deaths associated with COVID-19 are at long-term care facilities. The numbers are similar in Vermont: As of Thursday, about 49% of COVID-19 deaths occurred at facilities housing elderly Vermonters.
As the pandemic has continued the state decided to broaden its testing approach at long-term care facilities.
Secretary of Human Services Mike Smith said at a recent press conference the state would now conduct universal testing at facilities that house vulnerable communities, like nursing homes, once a case of COVID-19 is detected.
Smith also said the state would roll out more guidance about quarantining a patient moved between facilities, and making sure that person is tested before the move.
In addition, the state has ramped up outreach to those facilities to ensure they have proper infection control procedures in place and enough protective gear.
An up-to-date table of COVID-19 cases in Vermont facilities:
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The deadliest outbreak of COVID-19 in the state has been at Burlington Health & Rehab. As of Friday, 10 residents have died, and there have been 68 cases recorded among residents and staff, according to the state health department.
The first case at Burlington Health & Rehab was announced early in the crisis on March 17, just days after the governor declared a state of emergency.
At that time, Genesis Healthcare, a national nursing home conglomerate that owns Burlington Health & Rehab, had restricted visiting across its network, according to its website.
And on a March 17 earnings call, the same day the first Burlington Health & Rehab case was announced, Senior Vice President of Genesis Healthcare Richard Feifer outlined measures the company would use in the event of an outbreak.
“For example, residents are not leaving their room for social gatherings, or meals, any discretionary visitors are not coming in — even discretionary health care workers are not coming in,” Feifer said.
But Seven Days reportsfamilies, residents and even some staff complained that in those early days, the facility did not respond quickly.
"It's just sad to have lost her in this way. She had a lot of life to give." — Holly Barrett-Willard
“She was fine before this, and that’s why I think we’re all in shock,” said Holly Barrett-Willard, the niece of Betty LaBombard — a resident at Burlington Health & Rehab who died.
Barrett-Willard said communication from the facility was confusing and contradictory. At one point, the facility said a man with COVID-19 had been on LaBombard’s floor, according to Barrett-Willard.
“Then it went from, you know, there is no man that was positive on my aunt's floor, to my aunt was under the weather, but she was fine,” she said.
From there, LaBombard’s condition rapidly declined, and she died before her COVID-19 test came back, Barrett-Willard said.
“It's just sad to have lost her in this way," she said. "She had a lot of life to give.”
Genesis Healthcare said in a statement it had “diligently followed” state and federal infection control procedures. Vermont health officials have also repeatedly said Burlington Health & Rehab has followed proper containment and mitigation strategies.
Sean Londergan, the state’s long-term care ombudsman, said he didn’t know specifics on the situation, but he said generally his office is tracking how long-term care facilities are handling this crisis.
“I am concerned that [COVID-19] will happen somewhere else,” he said. “But I also feel as though that facilities and the state are trying to do as best they can to try to make sure it doesn’t get into another facility.”
For nursing homes around Vermont, the outbreaks in Burlington are a stark example of how quickly the virus can spread.
"Does that make you feel like you can let your guard down? I would say no — because again, I think it can happen anywhere." — Ursula Margazano, Administrator at Menig Nursing Home
Ursula Margazano, administrator of the Menig Nursing Home in Randolph, said the 30-bed facility hasn’t had any cases of COVID-19.
Margazano said like most elder care facilities, they’ve adopted strict measures, including delivering meals to residents to limit gatherings in the dining hall.
“Our facility is a smaller, more traditional longer-term care, so those points of exposure are less than a larger facility,” she said. “But does that make you feel like you can let your guard down? I would say no — because again, I think it can happen anywhere.”
Meanwhile, with no end in sight for the current crisis, it's unclear when people like Robin Wescott, who’s mom is at Birchwood, will be allowed to see their relatives.
What are your questions, concerns and experiences with the coronavirus? Share them with VPR, here.
On Friday, Wescott got a call from the nursing home: Her mother had a fever, and her blood-oxygen level was extremely low.
“So they were calling in hospice,” Wecott said. “I’m basically camped out in their parking lot waiting for them to let me go in.”
Wescott doesn't know if her mother has COVID-19; she said her mom's tests had been negative. But at this point, Wescott said she’ll risk getting the virus.
“I figure I’ll battle it," she said. "But I want to see my mother.”
