Focus on nursing homes as county, region appear headed to next phase

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Of the 35 Oneida County residents confirmed to have COVID-19 and sick enough to warrant hospital care, 25 are nursing-home patients, county officials said as the Mohawk Valley region has not seen a prolonged decline in cases requiring hospitalizations and deaths from the disease.

One week after the six-county region joined three other parts of New York state in entering the first of four phases of pandemic re-opening, the Mohawk Valley appears to meet most of the seven criteria for continuing to have some restrictions eased and to enter the second phase of re-opening as early as the end of the coming week.

But the region has not had a prolonged decrease in hospitalizations. According to the state's online regional monitoring dashboard of re-opening criteria, the region had no days of decline in net hospitalizations as of Friday. Under the state's reopening plan, a region must show a sustained decline in the three-day rolling average of total net hospitalizations, which is defined as the total number of people in the hospital on a given day, over a 14-day period.

However, the region does appear to easily meet another way regions can satisfy the hospitalization metric: Having no more than 15 net new hospitalizations for COVID-19 as measured on a three-day rolling average basis. As of Friday, the Mohawk Valley's rolling three-day average was one.

In addition, the region has had only seven consecutive days of decline in daily hospital deaths measured on a three-day rolling average, compared to the target of 14. However, it meets the deaths metric by having only one death every three days, compared to the maximum of five.

Nursing home cases were broken out in the county's daily COVID-19 briefing Friday afternoon. The county reported 17 new lab-confirmed cases. Of the 35 county residents confirmed to have the disease, 24 were being treated at the hospitals of the Mohawk Valley Health System, eight at Rome Memorial Hospital, and three at hospitals in some other county. Of those, 19 of the MVHS patients were from nursing homes, and of the eight at Rome Memorial, five were from nursing homes. One person being treated out of the county is from a nursing home.

In Oneida County, about two-thirds of all cases so far have been linked to facilities -- nursing homes, assisted-living or other congregate-care establishments, hospitals, group homes, a commercial greenhouse, and the three state prisons in the county. County Executive Anthony Picente Jr. said the county has some 28 nursing homes, with residents numbering "in the thousands," and the concentration of the disease in facilities shows that the bulk of new cases are spread in facilities, not among the general population.

"We think that needs to be looked at as we reopen in terms of how it affects our statistics," Picente said. "How we're keeping our community-spread levels and numbers at such a low level because people are adhering to social distancing, wearing masks and doing other things."

Eighteen COVID-confirmed deaths have been reported in nursing homes in Oneida County through the most recent compilation, as of Wednesday, according to the state Health Department. In addition, there have been nine COVID-presumed deaths in nursing homes in the county.

Among the fatalities are eight confirmed and seven presumed-COVID at The Grand Rehabilitation and Nursing at Rome, and seven confirmed and one presumed COVID death at Rome Memorial Hospital’s nursing facility, according to the state Health Department. The data are provided to the Health Department by facilities and does not reflect deaths that occurred outside of the facility.

No fatalities from COVID-19 were reported in Oneida County in the 24 hours ending at noon Friday.

County Health Director Phyllis Ellis said she did not immediately have statistics on the number of deaths in nursing homes in a normal year, which are kept by the state Health Department, but made clear it is far less than what has been experienced during the pandemic. Nursing homes are among the type of facilities highly vulnerable, because residents typically have many serious medical conditions, which makes it hard to fight off the infection, and are in close quarters, she added. Making it worse is the highly contagious nature of COVID-19 and the fact that people who don't even have symptoms can transmit it unwittingly.

"This virus also is extremely infectious," Ellis said. "We're seeing people that don't even know that they were exposed to someone that are young and healthy that are getting the virus."

Picente and Ellis pointed out that, under a state directive made last week, nursing home staff are to be tested for COVID-19 at least twice a week, with results reported to state authorities and positive workers kept from working and quarantined.

It is one reason the number of tests, and likely positive cases, are expected to increase significantly starting next week, Picente said. Another is the increasing availability of testing -- it's offered to the general public at the Rite-Aid store on Commercial Drive in New Hartford, and at a state-run site assisted by the National Guard at Griffiss International Airport in Rome. And Picente ordered testing for all approximately 1,500 county employees. He said he was tested Friday, and found the procedure a little uncomfortable but painless and quick.

And Ellis noted many people just want to get tested out of caution.

"People are choosing to make sure that they protect themselves and their families and their co-workers and the public they come in contact with," Ellis said. "Because of that we are seeing people without symptoms that are testing positive.

"The take-home message is it's not difficult, it doesn't hurt, it's pretty painless and it doesn't cost anything at these two facilities, and you should for your sake, your family's sake and the community's sake, your co-workers sake, get your test."

Positive tests are reported to state and local health authorities and will lead to a mandatory self-quarantine at home for 14 days. Quarantined persons are to keep a log of temperature and any symptoms and report to county case tracing personnel daily. Public health authorities recommend home quarantined people separate themselves from non-positive family members as well.

As of Friday, 921 county residents were in mandatory quarantine, and 888 in precautionary quarantine because someone they had been in close contact with had tested positive. Since tracing began in march, 7,972 county residents have been discharged from either form of quarantine or isolation.

Ellis reiterated the state and county rule that masks or other face coverings should be worn when in public and it's not possible to maintain distance from non-household members, generally considered to be at least six feet. Cloth masks, including those homemade, are acceptable, but so are scarves, kerchiefs, bandannas and the like as long as they are snug enough to block secretions from the mouth and nose without compromising breathing, Ellis explained.

Cloth masks should be laundered, and disposable masks should be discarded if their thickness is diminished. Children under age 2 or anyone unable to remove the mask should they have breathing difficulty are exempt.

Picente on Friday again expressed optimism that the region will qualify to enter the second phase of reopening on June 1. Quoting Abraham Lincoln's Gettysburg Address, he said there's never been a better time to honor the spirit of Memorial Day and honor the holiday responsibly by avoiding congregating, wearing a mask when in public, and maintaining social distancing. "Please be safe, please be responsible and God bless America and Oneida County."
 

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