As COVID-19 cases increase in Centre County, numbers in long-term care facilities soar
Cases of coronavirus among long-term care facility residents in Centre County and deaths attributed to the disease have surged since October, leading to concern about the most vulnerable population.
On Oct. 1, the state Department of Health reported 45 cases among nursing or personal care home residents and 36 cases among employees across 11 facilities.
As of Friday, there are 224 cases among long-term care facility residents and 50 cases among employees at 13 facilities, according to the DOH. In the past seven days, there have been 72 new cases in long-term care residents.
Fourteen deaths have been attributed to COVID-19 since Oct. 1 by the county coroner’s office; six were long-term care facility residents.
It’s unclear how the respiratory illness infiltrated facilities in Centre County, but the rise came after the county’s overall case count exploded in September.
Cases spread across 13 facilities
A growth in cases among the cohort at highest risk of death or serious illness is anything but surprising to the Pennsylvania Health Care Association, a statewide advocacy organization for long-term care facilities and their residents.
“It’s something we’ve been talking about and warning about for the last few months. Community spread very much has a correlation to spread in our long-term care facilities,” organization President and CEO Zach Shamberg said. “Back in March and April and May, when we were asking for support for our long-term care providers ... we were asking for that support because we knew that once Pennsylvania was going to be reopened, we were going to increase the risk for the virus to come back in.”
Only 10 of the 13 Centre County facilities with cases are identified by the DOH — Eagle Valley Personal Care Home, Eagle View Personal Care Home, Schreffler Manor, Foxdale Village, Centre Crest, Windy Hill Village, Hearthside Rehab Center, Juniper Village at Brookline, Elmcroft of State College and The Village at Penn State.
Facilities are required to report cases among residents and employees, but not among contractors or agency staff members, DOH spokesperson Nate Wardle wrote in an email.
There are also reporting discrepancies between the state and individual facilities, which are supposed to report cumulative data.
All 224 resident cases, which Wardle called “facility-reported data,” cannot be accounted for through the state’s facility-level breakdown, making it impossible to tell which nursing or personal care homes are hardest hit.
The reason for the discrepancies, which have been reported statewide, remain unclear, and the DOH does not comment on specific cases or clusters of cases.
Some facilities post updates online, while others limit updates to communications with families of residents. At Hearthside, an email to families obtained by the Centre Daily Times shows an outbreak at the State College facility, with 100 residents and 49 staff members testing positive as of Thursday.
The facility tests employees twice a week and has two dedicated “Red Zone” COVID units, according to the email, to try and contain the spread of the virus.
“We are screening our employees on a daily basis, increasing housekeeping rounds, monitoring for changes in conditions, monitoring residents’ vital signs, testing as per doctors’ orders and masking employees during their work shifts,” the email states. “We will continue to (monitor) the COVID-19 situation and will continue to follow all recommended guidelines that have been provided to us by our State Department of Health and CDC.”
The facility did not respond to multiple requests for comment.
Rising community concerns
Centre County is far from alone in seeing spillover from the general population to long-term care facilities, which is something county Commissioner Mark Higgins said the county’s top executives are “concerned” about.
The number of cases in nursing or personal care homes is included in ZIP code specific data across Centre County.
There are three nursing homes and three prisons in the 16823 ZIP code, for example, and cases from all of those facilities are included in the overall count. In a letter last month to families, Bellefonte Area School District interim Superintendent Tammie Burnaford noted the difficulty in interpreting community spread based on those inclusions.
“The DoH will not identify where the cases are specifically in our community, so it’s so difficult to know exactly what the impact is,” she wrote.
Centre Crest Administrator Andrew Naugle, who has worked as an executive for about nine years, said he’s “never felt anything like this.”
The Bellefonte facility has 52 active confirmed COVID resident cases, according to a Saturday notification letter posted to its website.
“It’s not just nursing homes that have to worry about it; it’s not just family members that have to worry about it. It’s everybody in the community that needs to worry about it,” Naugle said. “It needs to be a thing of the presence. It’s not just, ‘Oh, I don’t work in the health care field. I don’t need to worry about that.’ No, it’s everybody needs to worry about it.”
Has Penn State impacted the rise in nursing home cases?
A Harvard University study found the intensity of COVID-19 outbreaks in long-term care facilities mirrored the rate of spread among the general population.
In Centre County, rising case counts have at least partially been fueled by Penn State, the county’s largest employer who welcomed back thousands of students in late August. More than 90% of the county’s 5044 cases were reported after students returned.
The university’s reopening “did not go well” and led to “widespread community transmission” in central Pennsylvania, Dr. David Rubin, director of PolicyLab at the Children’s Hospital of Philadelphia, said.
“Eventually the students transmitted to people in the stores and staff, and you can see multiple cycles of transmission,” Rubin said. “And, eventually, staff who were working at those (long-term care) facilities were exposed and rates became really high in Centre County. And they’ve been really high now for a while.”
Matthew Ferrari, a researcher in Penn State’s Center for Infectious Disease Dynamics, was more cautious when speaking about spillover from the university to the broader Centre Region.
It’s difficult to develop a complete understanding of how thousands of cases spread. Could a relative of a long-term care facility resident have vacationed in a high-risk area before returning to visit? That’s possible.
Could a nursing or personal care home employee participate in a high risk activity, be asymptomatic and unknowingly spread the disease? That’s plausible too.
“The risk to long-term care facilities is because one case equals many cases really quickly. The amplification that you get in long-term care facilities is really, really high,” Ferrari said. “It’s a rare event that a case gets in there, but once that happens, it’s just really bad.”
This story was originally published November 12, 2020 at 11:37 AM.