Nearly three dozen Maryland doctors, nurses and other health-care professionals who care for the elderly urged Gov. Larry Hogan (R) on Friday to mandate that testing for covid-19 take place inside nursing homes and assisted living centers, and that they be given more masks and other protective gear — predicting that that vulnerable population alone could overwhelm the state’s hospital system if more aggressive steps aren’t taken to prevent the spread of the novel coronavirus inside such facilities.
Also Friday, Montgomery County put out an urgent call for personal protective equipment. The county’s stock of gloves, masks and surgical gowns for first responders and county Health and Human Services employees will last only two to three more weeks, said the county’s head of emergency management, Earl Stoddard.
“We have seen what happens when the coronavirus gets into a long-term care facility,” read the letter co-signed by Nicholas Schor, the local president of the American Geriatric Society, and 34 other health-care professionals, including executives of nursing homes and assisted living centers. The letter cited recent outbreaks in elderly care facilities across the country, including one in Carroll County, where the Pleasant View Nursing Home has had 77 residents and staff test positive, with five deaths so far.
“Alarmingly, many patients there tested positive in the absence of symptoms,” the letter said. “In the absence of the testing proposed above, our state facilities and their residents will be devastated by covid-19.”
The letter was sent to Hogan (R) just before the governor announced Friday that he has ordered nursing home employees to wear masks at all times, citing the fact that 60 of those facilities in the state have at least one case of coronavirus infection.
Earlier Friday, the federal Centers for Disease Control recommended that more testing be done inside senior homes and that those who test positive be isolated from those whose results are negative — with each category of residents being tended to by separate caregivers.
That guidance leaves out assisted-living centers, which in Maryland are home to about 15,000 elderly residents, said Roy Fried, a senior care physician in Montgomery County who co-wrote the letter to Hogan.
In a spreadsheet analysis attached to the letter, Fried projected that nearly 20,000 elderly residents inside those facilities will become sick enough to need hospitalization and that about 10,500 may die.
“This is just an estimate, just to give you a sense of the freight train that is bearing down on our hospitals,” Fried said in an interview. “We want everybody to get tested, like now. So, we can segregate the positives and the negatives.” Fried noted that workers in those facilities will often be working with 10 patients on a given day, helping to feed, bathe and clothe them.
“They’re doing it with gloves, but they don’t have masks for everybody,” he said. “They don’t even have enough masks in the hospitals. Can you imagine what it’s like in these assisted living facilities?”
Montgomery has more shipments of PPE on the way, but officials are wary of counting on those supplies until they arrive. On multiple occasions, Stoddard said, manufacturers have called to delay orders, sometimes even on the scheduled delivery date. “If we get nothing soon, we only have two to three weeks’ worth,” Stoddard said. “That’s what makes us nervous.”
Demand for PPE is rapidly growing. In recent weeks, dozens of private organizations, including funeral homes and providers of in-home care, have appealed to the local government for PPE, Stoddard said.
At a news conference Thursday, Maryland state officials said employees at all nursing homes must start wearing full PPE to treat patients. In Montgomery, where 10 nursing homes have reported cases of covid-19, all nursing homes have been provided with a two-week supply of PPE, Stoddard said — but not more than that. “Some people have asked for two months', three months’ worth,” he said. “I mean, we’re not in the situation to provide that. For anyone.”