Local Outbreak at Sherwood Oaks Nursing Facility
Miller Report for the Week of August 3rd, 2020; by William Miller, MD.
Mendocino County is experiencing an upswing in new cases of COVID-19. This is most significantly felt at our local nursing home in Ft. Bragg, Sherwood Oaks. An outbreak there began on July 3rd. Home to about 68 residents prior to the outbreak, Sherwood Oaks has seen a total of 22 residents test positive, 5 require hospitalization for illness and sadly 7 deaths. Fortunately, the 5 patients admitted to the hospital have all been slowly recovering. A total of 8 staff have been infected, none of them have become seriously ill and there have been no new cases in staff for over two weeks. Thus, the number who have fully recovered is 6 residents and 3 staff.
It should be made clear that Sherwood Oaks have taken this situation very seriously from the start and have been diligently following State and CDC guidelines. All of the nursing and administrative leadership at Sherwood Oaks are to be commended for their efforts thus far. However, despite these efforts, there continue to be one or two new cases every few days suggesting that other measures need to be employed.
A task force of local health leaders was formed last week to bring all of our community resources together on this ongoing challenge. This included Will Maloney the administrator of Sherwood Oaks, Dr. John Cottle the medical director of Sherwood Oaks, Dr. Naomi Doohan our County Health Officer, Judy Leach as Adventist Health – Mendocino Coast hospital administrator, and myself, as well as several others. We concluded that the best way to stop the continued spread within the nursing facility is to bring all new COVID cases to the hospital.
“We appreciate the partnership with our local hospital,” said Mr. Maloney. “This move, along with some support from the State, will help our staffing situation much better in the future. I especially want to thank all of our dedicated staff here at Sherwood Oaks who have done a phenomenal job during this very difficult time.”
We are not making our hospital a “COVID hospital”, but instead coming together as a community to pool our resources. At this time, we have brought nine COVID positive residents over to the hospital. This is the same strategy that other counties are employing to try to get control of outbreaks in their nursing homes. Hospitals simply have more resources to deal with these patients and this allows for the residents remaining at the care home to be spread out to one per room as much as possible.
The challenge of this crisis has been compounded by a sudden nationwide shortage of COVID testing ability. A combination of factors are contributing to this new shortage including the increasing outbreaks nationally. As a result, turn around times for tests, which had improved down to 3-5 days are now taking over 10 days. Some of the recent community surveillance samples done through MCC are now at 16 days with no results. There seems little point in doing a test on someone who is without symptoms if the results are going to take over 14 days to come back, the length of time recommended for self-isolation.
The State Health Department issued guidelines for medical facilities to do testing only in patients who are symptomatic and admitted to hospitals, for healthcare workers who are symptomatic and for a few other limited populations including nursing home residents. As a result, many who desire to be tested because they may have been exposed are likely to be told that they will not be tested. I know that this is not what we are used to being told, and it is frustrating for all of us including the doctors who would like to order the test for you.
The problem is at the federal level. The response to this pandemic at that level has been largely uncoordinated and insufficient. Writing to your local elected officials will not achieve much as the problem is much higher than at the county or even state level.
The most important things that we can all do remain so simple, yet so important. Wear a mask when in public. Avoid large groups, especially indoors. Wash hands frequently or use hand sanitizer. Stay socially distanced as much as possible. Only mingle without your mask within your own “social bubble” and make sure that everyone in that bubble doesn’t mingle outside the bubble.