Florida’s Elder-Care Facilities Buckle as Covid-19 Deaths Climb Experts warn that without the ability to test staff every time they arrive, there is no way to fully insulate the facilities https://www.wsj.com/articles/floridas-elder-care-facilities-buckle-as-virus-deaths-climb-11596628812 Florida was one of the earliest states to lock down elder-care facilities in the coronavirus pandemic, and the move helped stave off widespread deaths at such centers in the spring. But as the state contends with a surge of new infections, those defenses have faltered, triggering a fresh round of government interventions. Daily fatality counts from elder-care facilities in Florida climbed to their highest level so far in the past week, with the seven-day average reaching 56 on Monday, about triple the average a month ago, according to an analysis of state data by The Wall Street Journal. Total long-term care deaths rose to 3,155 on Monday, representing about 42% of the state’s 7,526 fatalities overall, in line with the national trend. Confirmed cases among long-term care residents have plateaued in recent days. In June, the state began requiring facilities to test staff every two weeks. But public-health specialists say that unless the centers test staff, vendors and others for the virus every time they arrive, there is no way to fully protect the elderly residents. Staff members may become infected at home but not show symptoms, and then come in close contact with residents. About one in five residents in Florida is a senior citizen—the highest proportion in the U.S. along with Maine. Florida initially appeared to dodge the worst of the pandemic. Then new infections began soaring in June, peaking in mid-July. Of 62 counties recently identified as viral “hot spots” by the Centers for Medicare and Medicaid Services, 24 are in Florida, including those containing Miami, Fort Lauderdale, Tampa and Orlando. The intensity of outbreaks in elder-care facilities often mirrors that in the broader community, according to a study by Harvard University researchers. A Journal analysis of data from local public-health departments and facilities’ reports to a federal tracking system shows more than 64,800 Covid-19 deaths linked to long-term care centers since the pandemic began. “The storm is here,” said Steve Bahmer, chief executive of LeadingAge Florida, an industry group that represents elder-care facilities, on a recent call with reporters. “It’s gathering intensity, and it’s putting enormous pressure on the providers who care for Florida’s most-vulnerable citizens.” At Palm Garden Healthcare’s 14 Florida facilities, where 31 Covid 19-positive residents have died, administrators are intent on sealing off the centers from the outside world as best they can, said Luke Neumann, vice president of service and relationship development. The company set up isolation wings for infected patients in three facilities, tests staff and residents every two weeks and stocks a two-to-three-week supply of personal protective equipment, he said. “We have essentially set up the closest thing to a virtual Covid wall,” Mr. Neumann said. “But what you can’t control is friends and family of caregivers.” In St. Petersburg, Bon Secours Maria Manor Nursing Care Center resident Pat Bendel appeared to be faring well early in the pandemic, said granddaughters Brittaney Babineau and Katelyn Keane. The 85-year-old Elvis Presley fan and skilled doll maker called them regularly and said she missed going out to lunch. “They were in lockdown,” said Ms. Keane, 24. “We thought that she was safe.” In late June, the family received a call from the facility saying Ms. Bendel had tested positive for the coronavirus, Ms. Babineau said. At first, she had a fever and a cough, but her condition worsened to the point she could only communicate by blinking or tilting her head. On July 4, family members spent hours with her on FaceTime, telling her stories and playing Elvis songs, until her heart stopped. “It doesn’t feel real yet,” said Ms. Babineau, 27. A spokeswoman for Bon Secours Maria Manor, where 20 residents with Covid-19 have died, said the company doesn’t comment on individual patients for privacy reasons and follows federal and state safety protocols. At the outset of the pandemic, Florida officials cut off virtually all visitation to long-term care facilities, deployed support teams to train staff on infection control and sent them personal protective equipment. More recently, officials expanded the number of isolation centers to help segregate Covid 19-positive residents to 23 around the state. “We’ve put more resources towards protecting our long-term care facilities than any state in the country from the very beginning,” said Republican Gov. Ron DeSantis at a news briefing last week. The federal government has stepped up its response to long-term care deaths around the U.S. in recent weeks. It dispatched public-health teams to 18 nursing homes in six states, including Florida, to help address outbreaks. The Centers for Medicare and Medicaid Services said late last month it would begin requiring all nursing homes in states with a 5% positivity rate or greater—true of Florida—to test staff weekly. To support the effort, the Health and Human Services Department plans to send more than 15,000 rapid-test machines to facilities around the U.S. in the next few months. The devices perform antigen tests, which aren’t as useful as molecular tests in identifying people who are infected but asymptomatic, said Brian Lee, executive director of Families for Better Care, a national nursing-home watchdog group. In areas with high prevalence of the virus, Food and Drug Administration guidance recommends confirming a negative result on an antigen test with an alternate test like a molecular one. The issue could become pressing as Florida weighs whether to allow for visitation of long-term care residents again, given the health risks of prolonged isolation. While Mr. DeSantis has said rapid antigen testing could help facilitate that, Mr. Lee said such a move would be disastrous without molecular testing as well. “If he enacts that policy, that will kill people,” said Mr. Lee, explaining that infected staff who test negative on antigen tests might continue working and spread the virus to residents. A spokesman for the state health department said it follows guidance by the FDA and other federal agencies on use of testing resources. Tatyana Prudinsky is keeping her distance from her mother, Sofia Polyakova, a resident of Palm Garden’s facility in Aventura, Fla., who so far has tested negative. She can’t hug Ms. Polyakova or bring her the caviar and herring that remind her of her Russian homeland. In July, they celebrated Ms. Polyakova’s 100th birthday on opposite sides of a glass wall. “It’s very sad and frustrating,” said Ms. Prudinsky, 75. “But that’s life…We all have to be safe.”
"DeSantis for the win" How many health workers has COVID killed? Fla. says it has no data. False, ex-data guru says https://www.miamiherald.com/news/politics-government/article244582087.html One of the tragic consequences of the COVID-19 pandemic has been the toll exacted on front-line healthcare workers. Dozens of doctors, nurses and others working punishing hours to save the lives of COVID-19 patients have lost their own lives. People like Jackson Memorial Hospital radiology technician Devin Francis, who was engaged to be married in a couple of months, and William Vincent Murdock, an MRI technologist at University of Miami Health System, and Araceli Buendia Ilagan, a nurse for 33 years at Jackson. The Florida Department of Health maintains a tally of fallen healthcare workers, according to the woman who used to run the state’s COVID-19 dashboard and had access to all of the numbers. But the Health Department claims it doesn’t It has refused to fulfill a public records request from the Miami Herald, insisting the record does not exist. Under the state’s public records statute, FSS 119, Florida records are considered public — and must be turned over — unless the state can cite a specific exemption under the law. “After a thorough search there are no records responsive to your request for the case line data for Florida healthcare workers who have died of COVID-19,” an email signed “DOH Communications” says. “The Department does not maintain that specific record. The Department is required to provide the public access to inspect and copy the agency’s existing public records pursuant to Section 119.07, Florida Statues [sic],” the email goes on. “However, the Department is not required to create records to fulfill a specific request. Instead, the Department provides access to existing records, in the format in which they are maintained by the agency.” But Rebekah Jones, the former government employee, says that’s not true. “DOH keeps detailed data about every COVID-19 victim, including occupation and profession, and any insinuation they don’t is a bold-faced lie,” said Jones, who was fired in May for speaking out against the department. At the time, Gov. Ron DeSantis’ spokeswoman said Jones was ousted for insubordination— just days after going public with concerns about the DOH’s commitment to “accessibility and transparency.” “On the day I left DOH, we had occupation data for 1,744 COVID-19 victims. Only 2% of the data for occupation was listed as ‘unknown,’ ” she told the Herald. As of mid-May, state records maintained by the DOH and obtained by the Herald through unofficial channels indicated 25 healthcare workers had died of the virus through one tally and 64 through another. The first number comes from a data set in which a box is marked “yes” if the person who died was a healthcare worker. The second number comes from a different DOH data set in which data on the deceased is broken down by industry/occupation. The only COVID-19 data on healthcare workers that the DOH has officially released to date is the number of long-term care facility workers who have died from the virus, and it’s up to more than 40. But that spreadsheet does not account for nurses, doctors or other healthcare workers whose jobs aren’t in long-term care. Two weeks ago, the Herald asked the DOH for updated data on healthcare workers. The latest statistics the newspaper had — from the middle of May — were outdated. After receiving the denial from the DOH on Tuesday, a reporter emailed back that the Herald knew the data existed. DOH spokesperson Alberto Moscoso responded that a healthcare worker metric “has not been a part of the line list on the dashboards [sic] data portal” and that the DOH had “not produced a report that states if cases were a healthcare worker.” The Herald did not ask about the DOH’s data portal or any reports that have been produced. It simply asked for the raw data. “It may be literally right that they haven’t run a report. But if they have a database from which you could extract it, they could provide you with the database,” said Frank LoMonte, the director of the Brechner Center for Freedom of Information at the University of Florida. A Miami Herald reporter then followed up with Moscoso to further explain the data it is looking for but did not hear back. While it is correct that the DOH does not have to create a record in response to a public records request, it shouldn’t matter in this case if the information already exists, LoMonte said. “I think it’s extremely important for the public to know. For example, if you have a high death rate in a particular hospital, it’s something that the public needs to be aware of,” said Jude Derisme, vice president of the local healthcare workers’ chapter of the Service Employees International Union. “This lack of transparency is troubling. DOH is supposed to give us the confidence that our state government’s role in this moment is to inform the public on what to do to help fight this virus. Hiding information from the public does not instill confidence.” Some other states like California, which is also experiencing a massive surge of coronavirus cases, have been reporting COVID data on healthcare workers to the public. It has reported 121 COVID-19 deaths among healthcare personnel. But others like Texas aren’t making the data public, according to Zenei Cortez, president of National Nurses United, the largest organization of registered nurses in the country with nearly 155,000 members. “They don’t want to take the blame for the number of deaths because they have failed the workers,” she said. The Centers for Disease Control and Prevention is keeping a tally of COVID-19 cases and deaths of healthcare workers and providing the information to the public via its website. As of July 30, nearly 600 workers had died of COVID-19 nationwide, though the agency acknowledges it is likely an undercount. Cortez estimates the actual number of healthcare workers who have died from COVID-19 is closer to 1,300 at minimum. This incident isn’t the first time the Herald has experienced difficulty obtaining coronavirus data from the state. For more than a month, the Herald called on Gov. Ron DeSantis, the DOH and the Agency for Health Care Administration to release data on residents of long-term care facilities who were infected with the virus and/or died from it. Eventually, the Herald, joined by other media outlets, filed a lawsuit in Leon County Circuit Court asking a judge to order DeSantis to turn over the information. The data was finally made available at the end of April and showed alarming numbers of elders testing positive for COVID-19.
"DeSantis for the win" Company that bungled Florida unemployment system gets new $135 million state contract https://www.miamiherald.com/news/politics-government/state-politics/article244739707.html Gov. Ron DeSantis’ administration is preparing to award a nine-figure state contract to the company responsible for Florida’s disastrous unemployment system. Deloitte Consulting beat out four other companies for a contract to centralize and manage Florida’s Medicaid data, the state Agency for Health Care Administration announced Monday. The agency is expected to enter negotiations with Deloitte in the coming weeks. The announcement came after the company has weathered months of scorn for its 2013 overhaul of Florida’s unemployment system. Deloitte was paid more than $40 million to create CONNECT to handle unemployment claims. Amid a crush of coronavirus-related unemployment claims in March, it failed immediately and repeatedly. (More at above url)
He's telling the interviewer he'll suggest a policy that follows the CDC. You can say all you want about it, but that's what he said.
Medical professionals have pointed out there is no CDC policy that aligns with what DeSantis is proposing.
Ah, medical "professionals". So you've got folks that say one thing, he has folks saying another. Actual text of what was said. DeSantis: It’s going to be very difficult to do contact tracing if I can’t tell you in a PCR test whether an asymptomatic carrier actually has live virus. And we now know you can’t do that. I think at the beginning we tended to think if you test positive, you have live virus. Well, now we’ve seen people that’ll test positive 30 days and CDC says up to 12 weeks. That makes the contact tracing of asymptomatic very difficult, even if you got an immediate turnaround. It would still be somewhat difficult, but a seven-day turnaround just makes it very difficult. DeFede: That’s the second time you cited the CDC study that talks about a live virus or dead virus remaining in the system for 12 weeks. I talked to a number of epidemiologists and folks who study infectious diseases, and that is not clear to them… So with that study in your mind, do you foresee, for instance, saying that it’s OK for a person who has a positive test to go back to work if it’s been a week or two or three weeks since their positive test? DeSantis: Well, that’s what CDC guidance is. DeFede: But is that what you are about to do? DeSantis: So we’re going to follow their guidance. So basically, it’s a symptom-based approach if you test positive. You obviously isolate. But then if you have had a certain number of days, I think it’s between 10 and 14, depending on the circumstances with no symptoms or the symptoms have subsided, no fever, then there’s a pathway for you to go back. DeFede: So this is a new policy that you’re going to be implementing? DeSantis: Well, this is the guidance we’re gonna give to employers. I mean, we’re not obviously requiring, we’ve never necessarily required a negative test, except for nursing home situations and a few others. Most of the employers, though, have been doing the negative PCR tests. And I think CDC guidance is we should focus more on a symptom-based approach rather than a test-based approach. And I think that that’s probably the better way to go. So, yeah, we’re going to follow that. I think Department of Health is putting out some guidance on that today. It’s not necessarily mandatory, but I think most employers will look at that and probably feel that’s a little bit more flexible.
First day in the green. For the win, baby! (that phrase thrown in there to trigger GWB...onslaught of google articles incoming!)
Why don't you call up the families of all the dead and ask them what they think of this infection rate improvement? The rest of the stats from Florida are completely dismal - a sign of poor COVID leadership in the state. As noted earlier the infection rate presented is only an estimate. For Florida (and all the other states) without proper Contact Tracing the actual infection rate cannot be determined.
I think GWB and I have both asked what CDC policy says that postive tested people should go to work if they have no symptoms.... You keep saying deSantis is simply repeating a CDC policy but then stop there. That does not absolve DeSantis unless we can find a CDC policy that says just that.
THis is for Health Care Professionals but still demands a quarantine prior to returning to work after positive test https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html