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Death at California senior home raises quarantine questions

Posted at 3:42 AM, Mar 12, 2020

Residents of a Northern California assisted living facility were under a two-week isolation order after a woman in her 90s died of the coronavirus.

Health officials on Wednesday defended their approach of not quarantining the Carlton Senior Living facility in Elk Grove even as a new dispute arose over whether Sacramento County officials were getting a sufficient number of kits to test residents and staff for the virus.

Elderly people with underlying health issues are particularly vulnerable to the illness. A nursing home in suburban Seattle has had the deadliest outbreak in the U.S., with 22 residents succumbing so far. Family members there criticized facility operators and local government for not moving more quickly when the virus first appeared.

Carlton Senior Living, which has 13 assisted living facilities in Northern California, said the resident in Elk Grove, near Sacramento, died at a hospital Tuesday. The company statement said the facility had “implemented isolation protocol for the next 14 days.”

Isolation is a less restrictive order that separates people with a contagious disease from people who are not sick. A quarantine restricts the movements of people who have come into contact with a contagious infection to see if they become sick, according to the federal Centers for Disease Control and Prevention.

Robert Luke, whose 94-year-old mother-in-law lives at the Elk Grove facility, visited Wednesday but, wary of the virus, stayed in the parking lot. He’s considering moving his mother-in-law out and believes a quarantine is needed “to minimize any contact with this virus with the general community,”

Tyler Cooke of Sacramento, whose mother lives at the facility, said Carlton hasn’t provided necessary information. He said he first learned that a resident was infected through a media report and hasn’t gotten updates on what is being done to help his mother, who is 71 and has “a plethora of health issues.”

His mother can’t move without help, and her family has an outside worker assist her. That person can’t come now that the facility is in isolation.

“I understand them implementing the no-visitation policy because it is their responsibility to keep my mom and all the residents safe,” he said. “But it’s completely inappropriate to leave me in the dark.”

A Carlton spokesperson did not return calls and emails seeking additional information.

Sacramento County public health spokeswoman Brenda Bongiorno said under isolation orders precautions include limiting visitor access, freezing new admissions to the facility, closing common areas and enhanced cleaning measures. She would not release information on other residents in quarantine or whether any residents or employees were showing symptoms or tested positive, citing the need to protect health confidentiality.

The Elk Grove facility can house up to 180 residents and offers on-site nursing and a variety of care, including for people with memory loss. State inspection reports showed no significant health violations for the facility.

In the hours after the isolation was announced, it appeared business as usual. Delivery people and workers came and went, as did residents. One of them, 95-year-old Bob Sutherland, left on his bike.

He said what’s happening inside is similar to what has occurred during flu outbreaks.

“We no longer have any meetings. And they even closed the exercise room where I go,” Sutherland said. “We just have to wait in rooms, and they bring the food up and everything. We’ve been through it before with the flu virus. Same protocol.”

No information about the woman who died has been released by Carlton or local health officials. Sutherland said she was 97, chair of the facility’s food committee and “always very friendly.”

She was taken to the hospital late last week, he said, but it was a couple days before residents learned why she was there.

On Tuesday, Sacramento County health director Peter Beilenson indicated frustration at the pace of testing for the disease. Under federal guidelines, the county is only allowed to process 20 tests per day.

“I know they have more than 20 people there, and that’s part of the problem of not having enough tests, so we will do circles around the person who initially tested positive.” Beilenson earlier told The Sacramento Bee.

California Health and Human Services Agency spokeswoman Kate Folmar said state public health officials on Tuesday provided Sacramento County “with enough testing supplies to test 300 specimens, so that the county can address any testing backlog it may have including people at the assisted living facility. More supplies are coming.”

Los Angeles County Public Health Director Barbara Ferrer said the question is not so much having enough kits as how fast they can be processed. Her county can run about 30 tests per day using just one machine and have ordered two more.

Newsom and Ferrer said they expect more supplies to be delivered soon, but she said in the meantime the county lab could still perform “hundreds and hundreds” of tests.

Bongiorno said Sacramento County’s current turnaround time between collecting a sample and getting results ranges from 24 to 48 hours.

State and public health officials are isolating and testing Elk Grove care facility residents in their apartments if they have fevers or acute respiratory symptoms, Folmar said. The facility will keep doing so as new symptoms emerge for 14 days after the last day the woman who died was in the facility.

The facility identified all employees who potentially were exposed to the woman and told them to monitor themselves for fever or respiratory symptoms for 14 days after their last exposure. They were told not to come into work if the are ill or to wear face masks for 14 days even if they don’t feel sick. The facility also isn’t accepting new residents.

California cities have started instituting ever-increasing methods to curtail spread of the virus. San Francisco, Oakland and Santa Clara County, which includes San Jose, have banned gatherings of 1,000 or more people.

The Los Angeles City Council announced it would hold just one public meeting a week instead of the usual three for the remainder of the month.

California corrections officials canceled daily visits at all state prisons until further notice. There are no suspected or confirmed cases of the virus at any lockups and the move was made as part of wider prevention efforts.

Meanwhile, officials in Oakland continued Wednesday with the painstaking process of disembarking more than 2,000 passengers from the cruise ship Grand Princess and moving them to military bases around the U.S. for a two-week quarantine. More than 20 passengers have been diagnosed with the virus, as well as 19 crew members.