Coronavirus cases in Mississippi are continuing to surge and the number of outbreaks in long term care facilities are higher than ever before. Experts are calling on the community to minimize virus transmission saying it's the best tool to reduce outbreaks inside nursing homes. But, an employee inside a nursing home believes community transmission is only part of the problem.
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Marche' Smith works at a nursing home in Rankin County. She's been a licensed practical nurse for 20 years and has spent the bulk of her career working in long term care facilities.
"There are people that need to be cared for. We know that somebody has no other options but to be where they are so it's up to us to go and help them do what they can't do," said Smith.
Smith says there's been a number of outbreaks inside the nursing home throughout the pandemic, including a current outbreak she says is straining their system.
"We've gone from having four-to-five CNAs per shift basically pre-pandemic typically to two-to-three per shift. And when you're talking about 60 residents? That's a lot of changing, showering, feeding, trying to pass trays to... I mean it's nonstop work and it just doesn't seem like it's coming to an end," said Smith.
Smith says healthcare workers are stressed and often overworked, especially when a colleague is out sick or quarantined. But what really concerns her, she says, is the lack of infection control among residents inside the nursing home.
"You feel like things that are just common sense that could be done are not being done. And you feel like the people that are being paid to care about all this just don't."
"What I see is nothing," said Smith. "You're allowing the residents to go and do as they please, they're all in each others' rooms, they're outside smoking in each others faces, they're sharing everything under the sun the ones that are walking around and those that are in their wheelchairs as well."
According to guidelines mandated by the Centers for Medicare and Medicaid Services (CMS), in the event of an outbreak nursing home leaders are to encourage residents to remain in their rooms. If they leave their room, residents should wear a facemask to cover their mouth and nose and stay at least 6 feet away from others.
Smith says that hasn't been the case at her facility and she believes this can't be an isolated situation.
"Very frustrated because you walk in and you feel like things that are just common sense that could be done are not being done. And you feel like the people that are being paid to care about all of this just don't," said Smith.
According to CMS, Mississippi ranks fifth in the nation for the average number of coronavirus cases among nursing home residents.
"We had a couple of people who popped up positive and they felt fine... Unfortunately, they were working COVID positive for those days that we didn't know it and that's how it gets in... that's how it spreads."
The total number of outbreaks in long term care facilities recently reached the 200 mark for the first time since the summer peak and is steadily increasing. In July, the Mississippi Department of Health reported that nearly 50% of all COVID-19 related deaths in the state occurred inside nursing homes. And experts believe the state could soon see that same level of deaths in these facilities again.
State Epidemiologist Dr. Paul Byers says some restrictions have loosened over the course of the pandemic. But as coronavirus transmission continues to escalate in Mississippi, he warns nursing home leaders not to let their guards down.
"I would encourage administrators to continue to stay the course on testing their employees," said Byers. "To continue to identify those employees that may be asymptomatically infected that we can exclude from the nursing home or the long term care center before transmission occur."
Researchers estimate that people who get infected with the coronavirus can spread it to others 2 to 3 days before symptoms start and are most contagious 1 to 2 days before they feel sick.
"Until we get a vaccine, and not just get the vaccine but get people vaccinated, this is what we're in right now."
Tony Hamrick is an administrator at Columbia Rehabilitation and Healthcare Center. He says the coronavirus can make its way into nursing homes even if you test workers two times a week, as recommended.
"I know I was in the testing area last week and we had a couple of people who popped up positive and they felt fine," said Hamrick. "They were working that day, came in, they had no fevers, they had no complaints, no nothing, and then we ran their tests and they were positive. So, unfortunately they were working COVID positive for those days that we didn't know it and that's how it gets in... that's how it spreads."
Hamrick, who's also president of the Mississippi Health Care Association, says he's currently taking advantage of a free COVID-19 specialty training offered by the federal government to help mitigate spread inside facilities. Some facilities that have participated in the training are reporting fewer cases compared to those that have not. According to CMS, less than 15% of Mississippi’s nursing homes have completed the training as of early November.
Marche' Smith says this is her first time hearing about the training but hopes the administrators at the nursing home where she works will soon prioritize it. With COVID-19 vaccines on the horizon, Smith believes that'll be the saving grace for many residents inside nursing homes.
"Until we get a vaccine, and not just get the vaccine but get people vaccinated, this is what we're in right now. This is what it's going to be until the actual vaccination occurs."
State health officials expect vaccines will be available to healthcare workers and long term care facilities by the end of the month.