Some patients being transferred to nursing homes will be COVID-positive

Charlie Megginson Government, Headlines, Health

On average, one out of every four Delawareans who tests for COVID-19 is testing positive, Gov. John Carney said during his weekly briefing Tuesday afternoon. 

That is, in part, a result of increased testing in the state — although Carney also blamed the surge on holiday gatherings and the highly contagious omicron variant. 

Approximately half of the state’s cases are omicron cases, with the other half being delta variant cases.

Carney said Monday’s snowstorm that covered some parts of the state with a foot of snow or more may have helped stop the spread — albeit for a short period of time. 

“The only good news there is that it kept people at home and maybe out from getting close to others that might be COVID-19 positive,” Carney said. 

The weekly briefing came on the heels of a renewed state of emergency declaration that took effect Monday. 

Under the state of emergency, Carney will deploy up to 100 members of the Delaware Army and Air National Guard to work as certified nursing assistants in skilled nursing facilities.

Those National Guard members are currently undergoing training and will be deployed to nursing homes with the ultimate goal of transferring patients who may need continued care but who do not require the level of acute care provided in hospitals. 

Most patients who are transferred to nursing homes will have already been patients at those facilities prior to being sent to the hospital. 

The problem the administration is hoping to address is not a lack of hospital beds, explained A.J. Shall, director of the Delaware Emergency Management Agency. The problem is a staffing shortage. 

Health care facilities are particularly vulnerable to such shortages as workers remain in close contact with the virus. 

The problem may also be exasperated by the hundreds of health care workers who were fired for refusing the COVID-19 vaccine.

ChristianaCare alone fired at least 150 employees for failing to comply with its vaccine mandate.

“We need really capable trained licensed bodies,” Shall said. “We have relaxed licensing requirements … to allow retired individuals — individuals that may not be licensed in Delaware but that are licensed in another state — to come help in the State of Delaware and what we’re hearing from the hospitals today is — you know, they’re seeing the same staffing issues that everybody else is.”

“You go into a restaurant today, you know, you might have to wait for a table and it’s not because they’re all taken,” Shall explained. “It’s because they don’t have enough people to work the tables and that’s what the hospitals are doing right now.”

He said that relying on the federal government for assistance is not a feasible option at the moment because every state in the country is facing similar difficulties. 

Corinna Getchell, director of the Department of Health and Human Services’ Division of Health Care Quality, said in an interview with Delaware LIVE News that hospital patients who are COVID positive will, in some cases, be transferred to nursing homes. 

“There are a couple of things that need to be considered if it is a COVID-positive patient,” Getchell said. “First of all, that patient would have to be medically cleared for discharge by their physician or their practitioner at the hospital.”

In the event a patient is discharged to a nursing facility and is still COVID-positive, the hospital and receiving nursing home will need to determine what precautions must to be taken before they are transferred. 

A long-term care facility could admit COVID-positive patients if they determine that they have the capacity to care for that resident.

Such capacity considerations could include questions of adequate staffing, personal protective equipment, skills and supplies needed to provide safe and adequate care, Getchell said. 

During the same interview, Jill Fredel, director of communications at the Department of Health and Social Services, noted that patients can test positive for COVID-19 without being infectious. 

“Like the NFL players who are testing positive — they could still test positive in a month from now or two months from now — it doesn’t mean that they’re infectious,” Fredel said.

Getchell noted that not all patients who will be transferred out of hospitals will still be COVID positive and decisions on those transfers will be made on a case by case basis. 

And others will have never had COVID in the first place.

“A lot of the patients that are waiting for discharge right now in the hospital are not necessarily COVID positive patients,” Getchell said. “A lot of patients have delayed getting health care because of the pandemic.”

In the event that a patient is ready to be transferred to a nursing home but the facility isn’t equipped to care for them safely, the hospital will put out a query to other nursing homes to determine where to send the patient, she explained. 

National Guard members who complete the CNA training will be authorized to work in those nursing facilities as long as the state of emergency remains in effect.

Because their CNA certification is just the same as anyone else’s, they could elect to seek employment in those facilities even after the emergency declaration lapses. 

“They will have to go through the requisite training and take the required number of classroom and clinical hours before taking the certification exam,” Getchell said. “So if some of them end up in the facilities and really enjoy the job, they could choose to seek employment as a certified nursing assistant with that facility — but as far as the assignment with the National Guard — that will not go on forever.”

As of Monday evening, 88.7 percent of Delawareans ages 18 and over are vaccinated with at least one dose of a COVID-19 vaccine. 69.1 percent of the total population have received at least one dose. 63 percent of the eligible population have been fully vaccinated.

In the past seven days, 26.9 percent of COVID-19 tests have yielded positive results.

Nearly 10,000 fully vaccinated Delawareans have reported a breakthrough infection — approximately 1.74 percent of the fully vaccinated community.

2,095 Delawareans are confirmed to have died of the virus.

The Division of Public Health announced last week that it will adjust its guidance to reduce the amount of time that people should isolate or quarantine after COVID-19 exposures from 10 days to 5 days.

The move came after the CDC made the same recommendation. The CDC adopted the change after determining that the majority of COVID-19 transmission occurs early in the course of illness — generally in the one to two days prior to the onset of symptoms and the two to three days after.

The Division of Public Health also said it will refocus its contact tracing efforts on case investigation, specifically in high-risk settings such as schools and long-term care facilities.

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