Nursing Homes + Infectious Disease = Trouble

At Va. facility where virus killed 40, doctor blames society’s willingness to ‘warehouse’ elders
Dr. James Wright, medical director at Canterbury Rehabilitation & Healthcare Center, speaks at a news conference on Friday in Richmond. (Steve Helber/AP)
By 
Laura Vozzella 
April 11, 2020 at 7:00 a.m. EDTRICHMOND — The doctor in charge of a Richmond-area nursing home with one of the nation's highest numbers of coronavirus deaths says society is partly to blame because of its willingness to "warehouse" the elderly in underfunded public facilities.
James Wright, medical director at Canterbury Rehabilitation & Healthcare Center, was asked at a news briefing Friday what he might have done to better stem the spread of the novel coronavirus, which has infected 148 residents and staff, killing 40.
“If I were to do something different, I would have a nursing home that had enough staff around-the-clock, around all the time,” he said. “I would have a nursing home where everyone had private rooms. I would have a nursing home where there was greater access to the outdoors. In other words, I would have a nursing home funded by a society that puts more emphasis on treating our elders the way they should be treated.”

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ADVERTISINGWright acknowledged the need to look back and consider how he and the Henrico County facility responded to the outbreak that began about a month ago. But he said the examination can’t stop there.
“It’s also important to see what we, as a society, could do differently, because this will not be the last untreatable virus to decimate our elders,” he said. “When we, as a society, see that it’s appropriate to warehouse our elders, and to put them in small spaces, to underpay their staff so that there are chronic staffing shortages — I think if we see that as an adequate treatment of our elders, then we’re going to have a bad time. We are going to see this over and over again. We all opted for this type of environment for our elders. And as a result, this virus spread through a publicly funded nursing home . . . like wildfire.”
Without improvements, he warned, “a publicly funded nursing home is a virus’s dream.”

ADWright called it “ridiculous” and “stupid” that the Washington state nursing home with the nation’s first major outbreak of the novel coronavirus faces a potential $611,000 fine for deficiencies that contributed to the spread. Forty-three deaths have been associated with that Seattle-area home, Life Care Center of Kirkland.
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Washington state nursing home faces $611,000 fine over lapses during fatal coronavirus outbreak
Wright said federal health officials should “mentor” facilities with problems and supply additional staff, not fine them.
“We need to do something different than just punish,” he said.
Canterbury temporarily lost much of its staff — to illness, fear and economic necessity — at the start of the outbreak. Many low-paid health care workers hold down jobs at multiple nursing homes. Some had to quit Canterbury because their other employers stopped accepting anyone who was pulling shifts at Canterbury.

ADWright declined to specify just how much his staff shrank but said he wound up on the front lines. “I was changing patients, cleaning beds,” he said. His wife, a palliative care doctor at an area hospital, took a week and a half of leave to volunteer at Canterbury.
“My wife was in there, much to her delight at times and much to her chagrin,” he said. “Glad I married her.”
Wright indicated that Canterbury may be turning a corner in the crisis, despite stubborn shortages in protective gear. He said about 85 infected patients were recovering well enough that they could soon resume some group activities, such as eating meals together. They will remain separated from the rest of Canterbury’s population. Thirty-five residents have tested negative.
At care facility linked to three coronavirus deaths, official says staff need more protective equipment to halt spread
Some of the 25 staff members who tested positive for the virus are back on the job. Some were ill but have recovered. Others tested positive but never showed signs of illness; those employees are working exclusively with residents with covid-19, so there is no chance of infecting those who are negative.

ADCanterbury is exploring whether it can use those workers, who are “theoretically immune” because of their prior exposure to the virus, to specialize in caring for covid-19 patients, Wright said. The facility is working with a lab to see if testing can be developed to demonstrate immunity.
“We feel like we’re the experts in treating covid-positive patients now,” he said. “It’s not a great niche to be in, but it’s the niche we’re in.”