Editor’s Note: Brighton Rehabilitation and Wellness Center has issued the following statement to the press in response to recent reporting about an outbreak of COVID-19 at its facility. BeaverCountian.com is publishing the statement in full as submitted.
Brighton Rehabilitation and Wellness Center—Statement for Concerned Members of Our Community Dated 4/1/2020, 1:00pm
According to the Department of Health, yesterday there were 693 new confirmed cases of COVID-19 in Pennsylvania. This one day total shows less about the number of cases that are occurring, but rather about the amount of testing taking place. The actual number of cases is suspected to be much larger, as tests are not widely available and some institutions are reluctant to test for fear of causing panic. Others may not be tested because they do not show symptoms or symptoms which are severe enough to be recognized as potentially related to COVID 19. The CDC believes as many as 25% of those who are positive show no symptoms. That said, the 693 confirmed cases statewide in one day is enough for us to understand that the virus is likely in our communities. While the incubation time was initially thought to be 14 days from exposure to symptoms, those initial thoughts are being re-evaluated in light of the new evidence.
The majority of people infected have none, mild, or moderate symptoms, including those who are infected and living in nursing homes. In a minority of people, symptoms have been severe and sometimes fatal. If all people were tested, and we knew the true number of persons who were positive, it is believed that the actual mortality rate would likely be significantly lower.
Seeing how COVID 19 was ripping through China, Italy, Spain, much of Europe, Asia, the Middle East and our own country, Brighton Rehab and Nursing Center attempted to be hypervigilant early on. Weeks ago the facility took the following steps:
• Closed its doors to visitors and other non-essential persons;
• Reduced the number of building entrances to one;
• Screened and temperature-tested all persons coming in and out;
• Instituted a policy of not permitting those with fever or respiratory symptoms to work;
• Actively tested residents who showed signs or symptoms that were consistent with Covid-19, initially through the Department of Health, and then through a private lab in order to expedite the process;
• Provided in-servicing (training) for its hundreds of employees concerning infectious disease control measures and enforced the guidelines;
• Reduced social interaction within the facility by reducing, and in many cases eliminating, use of social areas like the dining room, and increasing resident to resident distancing and when possible increasing resident to staff distancing except for as-need for required care;
• Eliminated programs that caused people to congregate in close proximity such as group physical therapy or group activities and outings;
• Monitored and took guidance from the CDC at least once a day and often more as guidance changed;
• Participated in Webinars and educational programs to try to understand as much as possible from the CDC, educators, trade organizations, and provider groups;
• Consulted infectious control experts to confirm that it was taking all appropriate actions;
• Secured N-95 and surgical masks, ensured it had goggles, hand sanitizers and other PPE (personal protective equipment);
• Sought and obtained leadership from its medical director and senior staff who began working on developing COVID-19 treatment and care plans;
• Created emergency preparedness plans which ultimately included reserving a newly renovated unit for people who needed isolation
Consistent with its early detection and testing policy, Brighton began testing select residents who had signs or symptoms that could be consistent with COVID-19. Unlike many other institutions it desired to know if there were positive residents within its community. The first batches of testing performed all came back negative. Brighton continued testing. The first positive tests came back last Thursday night. Pursuant to its plan, Brighton continued each and every precaution it had previously put into place, and in addition:
• Transferred the positive resident and those residents who came into close contact with the resident to the hospital for temporary quarantine and immediate testing;
• Notified the Department of Health;
• Notified families of affected residents;
• Re-examined all facility residents for signs or symptoms;
• Staffed its reserved unit and transferred residents who had a high likelihood that they were not positive for COVID 19 to that unit;
• To the extent possible, assigned fixed staff to the quarantined wing;
• Fit-tested N-95 masks for the staff working with affected resident, which, according to the Department of Health, is necessary to make the masks effective (approximately 20 staff members assigned to the affected unit received fittings in the first day, and fittings are now ongoing on-site);
• With the assistance of the Department of Health and vendors, all PPEs were restocked. The Department of Health assisted in the delivery of gowns and alcohol-based sanitizer;
• Bonuses and gift cards were offered to staff to help fill any gaps left by those few who were afraid to come in and serve the residents, or whose personal circumstances prevented the same;
• Staffing agencies, community health practices, and other caregivers such as therapists were contacted to step into action as needed;
• Isolation and infectious disease control measures were reviewed;
• The Medical Director finalized a treatment protocol and put the same into effect;
• The facility continued to follow CDC guidance as well as have regular telephone conferences with the Department of Health to report, request support as needed, and be permitted to learn from their experiences at other facilities. (for example, DOH advised not to use N-95 masks without fit tests and the necessity to only use on quarantined residents. They also provided contacts to assist in obtaining emergency supplies.)
Over the next few days as tests came back and residents continued to be tested, the number of confirmed positive cases within the wing of discovery grew. A material number of cases also came back negative. Fortunately, all cases have thus far been confined to one wing isolated from other wings.
As of today, 34 positive residents are in-house, all within the affected wing. There are seven tests pending. All residents are in the isolated wing and are being aggressively treated by our Medical Director for any symptoms they have developed.
While some of our residents, families and staff have fears that are only natural when dealing with a pandemic that is not well understood and has reached our doorstep, there has been absolutely no mass exodus of staff. To the contrary, staff has largely been amazing, supportive and working unbelievable hard to ensure care is as strong as can be expected under the circumstances. The facility of course continues to hire; to remobilize therapists and the like; and to enter into additional staffing contracts through agencies. Facility staff with symptoms are asked not to work. We are performing on-site testing of employees who have requested the same as fast as laboratories can supply swabs. The CDC guidelines for return to work are being followed. Those without symptoms are asked to care for our residents that need them.
The Facility has a supply of approximately 485 N-95 (respirator masks) and is asking all direct caregivers, after being fit tested, to utilize them when in or around isolated residents, and those engaged in care that presents a high risk of there being air-born droplets. All other persons are required to wear surgical masks for droplet precautions. The Facility has over 600 surgical masks in-house in reserve beyond those that are currently in use, and with access to a much larger back-up reserve. The CDC has advised not to remove the mask when moving between residents and to wear the same for the entire shift. The facility has just received a 2500 reserve of surgical gowns. Gloves are in ample supply. 60 gallons of alcohol-based sanitizer is anticipated to arrive tomorrow to supplement the current supply. The facility is now one of the first facilities in the State and one of the few in the country to have the ability to fit-test N95 masks in-house and has an in-house sterilization machine to sanitize N95 masks when not in use. The foregoing well exceeds CDC guidelines.
All Americans are nervous about COVID-19 in one way or another. At a Skilled Nursing Facility the anxiety level is even greater, and in one that tests and treats residents openly it can perhaps be even more difficult. Scattered reports of unconfirmed allegations, which are nothing more than a human’s fear manifesting itself, breeds more fear. Our response as a facility needs to be by the book which is being created by the CDC and the Department of Health, and which is professional, compassionate and up-to-date. We apologize to those who believe we have not appropriately communicated and take responsibility for our shortcomings. We are care providers, whose efforts have been to help ensure the safety of our residents and staff; to obtain all necessary PPEs, staff, and tests; to isolate; to train and educate and to learn from experts and most of all to provide quality care to our residents in their time of need.