The coronavirus outbreak at Burlington Health & Rehabilitation Center widened as confirmed cases there jumped and state officials sought federal help to contain the spread.
Four more residents of the Pearl Street nursing home have tested positive, officials said Friday, just a day after an elderly resident died from the infection. And at least 25 other residents and staff were being tested, a Vermont Department of Health spokesperson said.
The latter figure means that many more at the facility are exhibiting respiratory symptoms, though health officials cautioned that other viruses such as the flu are also prevalent.
During a Friday afternoon press conference, Burlington Mayor Miro Weinberger described the unfolding situation as “the largest outbreak in the state.”
“Clearly, it’s a serious situation,” the mayor said. “The state has very substantial resources, and those resources are really being stretched by the rapid spread of this virus.”
The first patient at the nursing home was publicly disclosed on Tuesday, though Weinberger said his office had been notified on Monday.
Vermont Health Commissioner Mark Levine said the department had called the Centers for Disease Control and Prevention to request on-site assistance with the ongoing investigation into exposure at the facility. Health department staff later had a discussion with CDC officials and agreed that the state doesn’t need federal reinforcements at the moment.
“They said we're on the right track,” state epidemiologist Patsy Kelso told members of the state legislature’s Joint Rules Committee on Friday afternoon.
The outbreak is taking place despite what the state said were adequate policies at the home, such as barring most visitors and using protective equipment to reduce the risk of infection.
State health officials contacted the facility, owned by eldercare conglomerate Genesis HealthCare, after the first positive case was identified. State officials didn’t dispatch an infection control specialist onsite until Thursday, after the four new cases were confirmed, Kelso said. They were still tracing the contact history of the swelling number of infected residents and administering more tests.
The health department said it was not planning to test all 90 or so residents or all workers, just those who display symptoms of infection.
“That would probably not be an effective use of resources,” Levine said. “Our investigation will help determine who needs to be tested.”
Weinberger told reporters he had asked for certain assurances from Levine about the facility — but hadn’t yet received some answers.
Among those questions: Have Burlington Health & Rehab staff worked at other eldercare facilities in the region, as is commonplace within the industry? Has the nursing home isolated patients who are ill?
Eldercare homes are especially vulnerable to deadly outbreaks of COVID-19. It has swept through dozens of facilities around the country, according to a Wall Street Journal report. Those homes have seen as many as 45 cases, as in Willowbrook, Ill., and 35 deaths, as in Kirkland, Wash.
Thursday night, when Scott and Levine announced that a female resident had died from the illness, the health department maintained that there was still only one confirmed case at the facility — previously described as a male patient who was hospitalized.
A Genesis spokesperson said Friday that the first patient “remains in care outside of our facility,” and that the deceased resident was the home’s second case, which was discovered on Thursday.
The three additional cases involve elderly residents who are not currently hospitalized. They include a man in his 70s, a man over 80 and a woman over 80, according to the health department.
Spokesperson Ben Truman told Seven Days that the department is not aware of any Burlington Health & Rehab staffer who also worked inside other facilities while sick. “There are BH&R physicians and other providers who do practice in other settings,” he said.
“When we speak with staff, we are clear that any recommendations for exclusion also apply to other workplaces,” he said.
Mohamed Basha, CEO of TLC HomeCare and Nursing, said his South Burlington staffing agency employs two healthcare workers who are assigned to Burlington Health & Rehab. One of the individuals had direct contact with an infected patient and was placed on 14-day quarantine on Wednesday, he said. That worker’s test has since come back negative.
The second worker was not in contact with the initial patient and was still working at the facility as of Friday, Basha said.
Neither person has worked at other health care facilities through TLC in recent weeks, he said.
Genesis spokesperson Lori Mayer said the company has alerted patients, residents and families who have come into contact with the center and is hosting twice-daily family video calls to keep them informed.
“We are doing everything possible to minimize any additional cases,” Mayer said.
A South Burlington daughter of a rehab patient who left the facility on Tuesday told Seven Days her family had still not heard anything from the nursing home or health officials.
Eldercare homes across Vermont are still struggling to procure masks, gowns, eye protection and hand sanitizer. “We hear from providers every day,” said Laura Pelosi, a spokesperson for the Vermont Health Care Association, which represents the industry.
She said the homes are conserving what they have and working with the health department to access more.
Too few supplies were one of five factors that contributed to the country’s first known coronavirus outbreak, at Life Care Center of Kirkland in Washington State, earlier this month, according to a new CDC report. The other factors included: staff members who worked while symptomatic, staff who worked in multiple homes, failure to follow protective measures and delayed recognition of cases.
Kelso, the state epidemiologist, told lawmakers Friday that the equipment crunch didn’t appear to drive the outbreak at Burlington Health & Rehab.
“I think it was more their habits, and how and when they were using personal protective equipment,” she said, “which is not dissimilar from what happens in every long-term care facility nationwide.”
Courtney Lamdin and Colin Flanders contributed reporting.