Second outbreak hits Visalia nursing home

Linwood Meadows sees number of cases, deaths double in a week as nursing homes represent about 25% of all cases and half of all deaths

VISALIA – After weeks of containing the spread of the coronavirus to a minimum, one Visalia nursing home had a second outbreak that doubled its number of cases in a week.

On June 9, Tulare County Health and Human Services Agency Director Tim Lutz reported the outbreak at Lindwood Meadows Care Center to the Board of Supervisors that included 18 new cases and three additional deaths. Between June 2 and June 9, the skilled nursing facility (SNF) saw its cases increase from 13 to 31 and deaths jump from five to eight. There have been 53 residents and 30 team members who have tested positive for COVID-19 since the county’s first case of the virus was discovered in mid-March.

Lutz said the facility has requested additional help as 29 of its staff have tested positive for the virus. As in the past, Lutz said the county is requesting the state to send a California Medical Assistance Team (Cal-MAT), a rapid deployment team of health care and support professionals for emergency events. CalMAT teams have already been deployed to Tulare County to assist with large outbreaks at Lindsay Gardens and Redwood Springs Care Center in Visalia.

Tulare County Health and Human Services Agency clinical liaisons remain in contact with the facility to provide guidance.

“We continue to work with them to contain that spread,” Lutz said.

On its web site, Linwood Meadows says it is taking every precaution to prevent the spread of the virus at its facility. Infection control measures include:

  • Daily screening of staff members for respiratory symptoms or fever;
  • Staff members experiencing respiratory symptoms or temperature of at least 100.4 degrees are directed to stay home and self-quarantine 7 days or until they are symptom free for 72 hours, whichever is longer, or test negative for the virus;
  • Daily monitoring of staff hand hygiene compliance;
  • Limiting access to the facility to one entry point;
  • Posting infection prevention signage at the entrance and throughout the facility;
  • Prohibiting visitors except for end-of-life, compassionate care situations;
  • Screening essential workers, who are not staff, for symptoms and temperature before entering the facility. Those exhibiting a temperature over 100.4 and/or respiratory symptoms are denied entry;
  • Providing residents with up-to-date education on guidelines and all mandated restrictions;
  • Daily monitoring of residents for fever and respiratory symptoms. 

COVID cases at nursing homes have played a critical role in determining if the county is meeting minimum thresholds to keep up with the state’s phased approached to reopening sectors of the economy. Residents and healthcare workers at SNFs represent about a quarter of all COVID-19 cases in Tulare County and half of all deaths. It’s one of the primary reasons why county health officials chose the positive test rate metric instead of the new case rate metric to meeting state standards for containment. The new case rate requires counties to have less than 25 cases per 100,000 residents in the past 14 days and includes all positive tests, including nursing home residents who are tested every week as part of prevention efforts. The positive test rate option requires that less than 8% of the population tests positive for the last seven days. By not including duplicates, such as testing at nursing homes, the county’s rate drops from 11.5%, well over the 8% threshold, to 7.5%, just under the threshold.

“At our SNFs, you are testing residents multiple times,” Lutz explained. “We already know they are positive, it’s not going to be a new positive on our count, but the state insists on counting every single one of those tests as contributing to the new case score.”

Chairman Pete Vander Poel pointed out the double standard set by the state between cases in state-run prisons and cases in state-regulated nursing homes.

“We’ve been asking all along that the SNFs be removed from the Tulare County numbers,” Vander Poel said. “It’s funny the Governor will grant that for prisons but, for SNFs which have the same oversight and responsibilities to the state, he won’t do that.”

Tulare County is meeting all of its state attested metrics including a 14-day supply of on-hand personal protective equipment at all SNFs, a testing capacity of 1.5 people per 100,000 residents, 15 contact tracers per 100,000 residents, available temporary housing for 15% of the homeless population, testing sites within an hour from 75% of the county’s population, a hospitalization rate of less than 5% and a hospital surge capacity of 35%.

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