The Boston Globe - 11.03.2020

WEDNESDAY, MARCH 11, 2020 The Boston Globe Metro B

By Robert Weisman
GLOBE STAFF
Skilled nursing and assisted
living homes across the nation
will begin screening all visitors
and restricting entry to all but
essential health care workers in
an effort to prevent new out-
breaks of coronavirus, opera-
tors of the facilities said Tues-
day.
Citing new guidance from
the federal Centers for Disease
Control and Prevention, trade
groups representing long-term
care residences housing 2.
million older Americans said
they’ll screen all family mem-
bers, employees, contractors,
and government officials before
permitting them to enter — and
telling family and friends to
stay away.
The action is being taken to
protect residents because the
Covid-19 mortality rate for peo-
ple over 80 with serious under-
lying medical conditions — a
common demographic in long-
term care facilities — looks to
be “shocking,” said Mark Par-
kinson, president of the Ameri-
can Health Care Association
and the National Center for As-
sistedLiving.
While he wouldn’t give a
precise number, other associa-
tion officials estimated it could
be as high as 15 percent of
those infected. That’s based on
data from countries and re-
gions where the virus has
spread widely, including China
and Kirkland, Wash., where
dozens of residents at the Life
Care Center nursing home —
considered the US epicenter for
the virus — have died and 70
workers have been sickened
over the past few weeks.
“We face one of the most sig-
nificant challenges, if not the
most significant challenge in
our history,” Parkinson said in a
teleconference Tuesday morn-
ing.
In a Boston news conference
Tuesday afternoon, Massachu-
setts officials echoed a call for
visitor restrictions already giv-
en by some other states.
Marylou Sudders, the state
secretary of health and human
services, said Massachusetts
would offer new guidance
Wednesday. Nursing homes
will be directed to actively
screen and restrict access to vis-
itors to ensure safety and health
of residents, she said.
There will be no access for
visitors with Covid-19 symp-
toms or those who’ve had con-
tact in the last two weeks with
someone infected or suspected
to be, she said. People who’ve
traveled overseas in the past 14
days or live in a community
where the coronavirus has
spread will also be restricted.
Long-term care facilities will be
required to actively screen em-
ployees and vendors.
In place of social visits, se-
nior living operators will be ad-
vising loved ones to deploy
technology and helping find
“alternative ways for family
members to stay in touch” with
residents, Parkinson said.
Association officials has-
tened to say they were not im-
posing a complete ban. But
they cited guidance issued by

the CDC late Monday noting

the heightened risk to older

adults with chronic medical

conditions such as heart dis-

ease, diabetes, and lung dis-

ease. It urges them to stock up

on supplies, avoid contact with

anyone who is sick, and stay

home as much as possible to re-

duce the risk.

Tim Brown, marketing and

communications director at

Athena Health Care Systems,

said it’s already greatly limited

visits to its 20 nursing homes

and assisted living facilities in

Massachusetts, stretching from

the Boston area to Cape Cod

and the Berkshires. Brown said

most contractors are being re-

stricted to designated delivery

areas.

Family members who are

feeling sick have been asked not

to visit residents, he said. If

they insist, the residences re-

quire they and the residents

wear protective masks, gowns,

and gloves during the visit.

Brown said he’s not sur-

prised by the new policy of the

national trade associations and

expects the restrictions to be-

come more stringent.

Public health officials in

Connecticut, where Athena is

based, have already required

long-term care facilities to re-

strict all social visits, he said.

Thecompanyisawaitingsimi-

lar official guidance from

health officials in Massachu-

setts and Rhode Island, where

it also operates long-term care

centers, he said.

One exception to the no-vis-

its policy, he said, is that family

members who want to visit

their loved ones at the end of

life are still permitted entry.

Operators said most resi-

dents and their families appre-

ciate the vigilance despite the

inconvenience, recognizing the

threat posed by coronavirus.

“We have canceled all activi-

ties coming in from the out-

side,” said Debbie Meade, board

chair at the health care associa-

tion and chief executive of

Health Management, a Georgia

company that runs skilled nurs-

ing and assisted living proper-

ties. But she said, staff will run

more bingo games for resi-

dents.

Meade said her long-term

care facilities have been calling

and sending letters to family

members explaining the need

for the new policy. Almost ev-

eryone supports the restric-

tions, she said.

“My parents have told me

not to visit them,” said Dr. Da-

vid Gifford, chief medical offi-

cer for the associations, saying

long-term care residents are

bowing gracefully to the new

reality. “So this is how we oper-

ationalize this going forward.”

Robert Weisman can be reached

at [email protected].

Follow him on Twitter

@GlobeRobW.

Long-termcarefacilitiesmovetolimitvisitors

A SPREADING THREAT

DAVID GOLDMAN/ASSOCIATED PRESS

Vietnam War veteran Leo Marchand, 71, made his way to the dining room for lunch at the South Shore Rehabilitation and

Skilled Care Center on Friday in Rockland. He said that with his lung disease the virus is “a concern. It really is.”

said, “but London seems to be
business as usual and I don’t
think it makes sense to put your
life on hold.”
With coronavirus cases mul-
tiplying exponentially and so-
cial norms changing rapidly,
the border between prudence
and nervous Nellie-ism is mov-
ing fast. What might have
seemed alarmist two weeks ago
— beware the gas station’s self-
serve nozzle because it might be
contaminated — now sounds
kind of wise.
We’re being told the risk in
Massachusetts is low, but Har-
vard University is telling stu-
dents to stay away from cam-
pus, and Boston has canceled
its St. Patrick’s Day parade.
The stakes are so high. It’s
not just about keeping yourself
from getting sick, it’s about not
spreading the illness to others.
But in the face of scant specific

uCHANGES
Continued from Page B

advice from leaders, except to

avoid cruise ships, Bostonians

are wondering whose precau-

tions should we follow?

MIT has banned events with

more than 150 people. Does

that mean it’s OK to go to a

wedding as long as the bride

keeps the guest list to 149?

What if a “no” RSVP comes af-

ter all?

The drug giant Takeda, with

some 5,000 employees in Mas-

sachusetts, is telling workers

who come to the office to keep

six feet away from each other.

Does that mean you can safely

go to an intimate dinner party

as long as you keep your dis-

tance from other guests?Can

you toss the butter?

Starbucks has halted the use

of reusable cups. So maybe you

shouldn’t touch a water glass in

a restaurant if the waiter who

handles it isn’t wearing gloves?

What if the gloves themselves

are contaminated?

“I’m a mess of contradic-

tions,” said writer Beth Jones.

She’s stopped going to the pub-

lic library “because it’s not well-

ventilated,” but she’s also look-

ing for international hotel

deals. “I’m trying to figure out

what to do on a minute-by-min-

ute basis.”

The world is waiting to see

where the spiraling epidemic

will go, but one thing is already

clear: We’ve definitely reached

the judgment phase.

In Boston, an office worker

who brought a towel soaked in

bleach solution to sanitize his

keyboard and phone scoffed

when told of a woman who had

bought a second freezer for sup-

plies. As if her planning was

over the top but his precautions

weren’t.

“Is she expecting the siege of

Leningrad?” he asked.

People downplaying the cor-

onavirus’s danger are being ac-

cused of acting like Trump. Peo-

ple texting corona death re-

ports to friends and family are

being accused of fear monger-

ing.

But the epidemic is so big, so

scary, that many people are not

only judging others but them-

selves.

In the span of one brief con-

versation at the Fenway Target

on Sunday morning, Angela

Marini, a project manager for a

large Boston firm, criticized

people for overreacting and

then speculated she herself

might go bananas.

“People are so crazy that

soon we are going to run out of

bottled water,” she said. Then, a

few minutes later: “But talk to

me in one month, I don’t know

what I’ll tell you.”

As cancellations mount,

costing people money and op-

portunities, a backlash is form-

ing.

At Worcester Polytechnic In-

stitute students unhappy that

the school canceled travel for

international projects have

signed a petition on Change.org

urging the school to allow the

students to make their own de-

cisions.

The coronavirus is as vast as

the entire world, but also as ti-

ny as the marital bedroom.

Which is to say it has,of course,

entered the family and marital

counseling space. “People have

different ideas about how much

caution to exercise,” said Liz

Brenner, a clinical social worker

in Watertown.

Such is the divide that in one

suburb, a wife is planning to

hide hundreds of dollars of

emergency supplies from her

beloved. “I’m paying cash,” she

said.

Oh, for the good old days,

when people concealed design-

er handbags and expensive fish-

ing reels from each other, and

the scariest thing about a cruise

was the weight gain.

Beth Teitell can be reached at

[email protected]. Follow

her on Twitter @bethteitell.

Ascasesmount,howparanoidorcautiousshouldwebe?

president of BaneCare Manage-

ment in Braintree, which runs

a dozen Massachusetts nursing

homes and has reported 1 out

of 6 positions are vacant at its

homes in Berkshire County.

“Everybody wants to do the

right thing. Nursing homes are

used to providing good infec-

tion control. But this could put

another drop in a rain bucket

that’s overflowing.”

Tara Gregorio, president of

the Massachusetts Senior Care

Association in Waltham, said

the ratio of nursing staff hours

devoted to long-term care resi-

dents daily in Massachusetts is

lower than the national — or

Washington state — ratios.

“We’re in the midst of a his-

toric staffing crisis,” Gregorio

said. “The concern is that, if we

have to self-quarantine [staff-

ers], we may not have the work-

ers we need to meet the needs

of residents.”

That concern was echoed by

Dr. David Gifford, chief medical

officerattheAmericanHealth

Care Association and National

Center for Assisted Living, in a

conference call with reporters

last Friday. He said many of the

nation’s nursing homes and as-

sisted living centers, which

house about 2.5 million, face

worker shortages even as they

prepare their staff to handle a

crisis.

The protocols are being

modeled on those they use an-

nually for influenza: isolating

infected patients; restricting

uSTAFFING

Continued from Page B

visits by sick family members;

and requiring staffers to wear

masks and gowns to care for in-

fected residents. But the novel

coronavirus is considered a

more serious challenge because

much about it remains un-

known, and there are currently

no vaccines or other treat-

ments.

“Our top priority is making

sure the virus does not get into

any of our nursing homes or as-

sisted living facilities because

the people in these facilities are

very susceptible” to Covid-19,

the illness caused by coronavi-

rus, Gifford said. As the virus

continues to spread, the death

toll has reached more than

4,000 worldwide, including 27

in the United States.

Life Care Center in Kirk-

land, across Lake Washington

from Seattle, is considered the

epicenter of the US coronavirus

crisis. At least 13 nursing home

residents who died after being

taken to hospitals tested posi-

tive for Covid-19. More than

two dozen residents have died

in the acute care facility since

mid-February, though it’s not

known how many of the deaths

were caused by the virus. Sev-

enty Life Care employees,

meanwhile, have shown symp-

toms of coronavirus and are

self-quarantined at home.

“The situation in Seattle is

extraordinarily scary,” said

state Senator Pat Jehlen, Dem-

ocrat of Somerville, who co-

chairs the Legislature’s Joint

Committee on Elder Affairs.

“Nursing facilities are not good

places to be when viruses and

infections are going around.

And we have a very tight labor

market and no good way to re-

cruit people to work in these fa-

cilities.”

At a hearing of the elder af-

fairs committee last month,

front-line care workers and se-

nior living officials attributed

the labor shortage to low wages

and a supply of better-paying

jobs in the state. The average

hourly wage in Massachusetts

is $13.98 for personal care

aides, $14.82 for home health

aides, and $16.12 for certified

nursing assistants, according to

the most recent Bureau of La-

bor Statistics data.

Tom Grape, chief executive

of Benchmark Senior Living, a

Waltham company that manag-

es 31 senior living residences in

Massachusetts and a total of 62

in eight states, said the tight la-

bor market is affecting some of

his properties. In preparation

for the coronavirus, he said,

Benchmark is setting up a sepa-

rate sick bank so employees

staying home with Covid-

symptoms don’t lose sick time.

It’s also working on establish-

ing day care for employees in

the event their children’s

schools are shut down.

“Sometimes [employees]

who are dedicated to their jobs

or don’t want to miss a pay-

check will come to work when

they’re feeling sick,” Grape said.

“We don’t want them to do that

now. We’re trying to reduce the

exposure to our residents.”

Though most nursing facili-

ties prefer to hire staffers,

many have turned to tempo-

rary agencies when they ha-

ven’t been able to fill jobs, said

Elissa Sherman, president of

Leading Age Massachusetts, a

Newton group that represents

nonprofit housing and aging

services for older adults. “I as-

sume that if facilities face staff

shortages due to staff being out

sick, they will need to turn to

staffing agencies in the short

term to fill the gaps,” Sherman

said.

As senior living facilities

beef up their precautions,

many are preparing to activate

a mutual aid evacuation and

supply plan to allow them to

share supplies and vendors in

the event of an emergency.

But the plan currently

doesn’t cover the transfer of di-

rect care workers from one em-

ployer or one part of the state

to another if a coronavirus out-

break were to sideline a crew of

employees, said Helen Ma-

gliozzi, director of regulatory

affairs for the Massachusetts

Senior Care Association, who

manages the mutual aid plan in

the state.

Extending the aid provision

to staffers would require guid-

ance by the state Department

of Public Health, senior living

officials said. “This is unchart-

ed territory,” Magliozzi said.

Robert Weisman can be

reached at

[email protected].

Follow him on Twitter

@GlobeRobW.

Outbreak stirs fears over staff shortages

‘Wefaceoneofthe

mostsignificant

challenges,ifnot

themost

significant

challengeinour

history.’

MARK PARKINSON,

president of the American

Health Care Association and the

National Center for Assisted

Living

‘Peoplearesocrazythatsoonweare

goingtorunoutofbottledwater.But

talktomeinonemonth,Idon’tknow

whatI’lltellyou.’

ANGELA MARINI,Boston project manager