Coronavirus puts pressure on nursing home staff, jail system as infections rise
While Gov. Ron DeSantis proclaimed on Tuesday that Florida is successfully beating back the spread of the novel coronavirus, the pandemic continued to put stress on nursing homes statewide and Miami-Dade County’s jail system.
Staffing shortages at nursing homes forced state officials to ask the federal Veterans Health Administration for help Tuesday. The facilities need physicians and nurses to fill jobs left open by staffers who have tested positive for COVID-19.
In Miami-Dade County’s jails, the number of inmates with confirmed COVID-19 infections surged from one to 59 — a sharp spike since the last public advisory on April 9. The new figure reflects increased testing across the system. Three-quarters of the county’s 3,000 inmates have yet to be tested.
The number of confirmed cases in Florida neared 28,000 Tuesday as Miami-Dade County became the first county in the state to top 10,000 cases and exceed 1,000 hospitalizations, according to the Florida Department of Health. The state has reported 811 more cases and 44 new deaths since Monday evening, bringing the statewide case total to 27,869 and the statewide death toll to 867.
Of the 44 new deaths, 23 came from South Florida.
In Tallahassee, DeSantis struck an optimistic tone as he contended that widely reported models predicting the state’s hospitals would be overwhelmed with COVID-19 patients were rendered inaccurate by the government’s response to the pandemic.
“Those predictions have been false,” the governor said at the start of his daily press conference. “Our work is succeeding. We have flattened the curve.”
DeSantis said that projections from last month showing that the state would become like New York and Italy, which were hit hard from COVID-19, the disease caused by the novel coronavirus, were incorrect.
“Now we’re in a situation where now the hospitals are not going to get overrun, we know the No. 1 thing that people were concerned about with this was that type of catastrophe, that’s not going to happen,” DeSantis said. “That’s not happened. We have all these extra beds and field hospitals and nobody’s there.”
The assessment requires context. Florida’s hospitals made major pivots to prepare for a daunting scenario where the number of beds would have been insufficient for the number of anticipated COVID-19 patients. Even as questions remained about the number of available ventilators and personal protective equipment for front-line medical workers, hospitals have spent weeks rearranging their facilities, converting emergency rooms and repurposing office space and conference rooms. Elective procedures were called off.
Outside hospital walls, social distancing has been heavily promoted in cities across Florida as the federal government assisted in opening field hospitals in anticipation of a surge — preparations DeSantis did note as necessary, just in case.
“We’re on the right track,” DeSantis said. “And I think it’s because Floridians have really pulled together and worked really well regardless of party.”
The number of new confirmed coronavirus cases reported by the Florida Department of Health has been volatile over the past month. Although DeSantis says the state is seeing a flattening, case data since March may not be complete.
A more complete picture of COVID-19’s penetration is not available due to a backlog in testing results that is not apparent in the state’s reports. It’s likely that the statewide total number of confirmed cases is significantly undercounted because the state reports only the number of Floridians waiting to hear test results from state labs, not private ones — and private labs are completing more than 90% of state tests.
It takes as long as two weeks to add the results of tests from private labs to the state’s official count, and there are thousands of pending tests. The state’s website does not say its figures exclude the vast majority of pending tests for the novel coronavirus.
Meanwhile, nursing homes and assisted living facilities have become a focal point in the pandemic. With aging and ailing residents, the elder-care facilities can become lethal incubators of the virus. Public access to the information has stirred controversy — it wasn’t until Saturday that state officials revealed for the first time the names of facilities where residents or staff had tested positive for the deadly respiratory infection. By Tuesday, 313 elder care facilities had reported COVID-19 cases.
Even with the release of those names, the data appears to be incomplete and some have questioned why the list doesn’t contain more useful information. The Miami Herald has identified at least four facilities that have notified residents’ relatives that they have a positive case, according to family members, but those facilities were not on the list Tuesday morning.
A window into the extent of the problem opened on Tuesday when the state’s Division of Emergency Management asked the U.S. Department of Veterans Affairs for assistance for at least the next month. The additional workers will substitute for nursing home staff who have tested positive for COVID-19.
Jason Mahon, spokesman for the Division of Emergency Management, said the Veterans Health Administration will provide up to 15 teams of six healthcare workers each to assist Florida’s nursing homes through May 21. Each team will have a physician, nurse practitioner, registered nurses, nursing assistants and therapist.
“These teams will be used as needed to augment existing staffing in facilities when staffing levels are critically impacted,” Mahon said.
He did not provide any information on how many state-licensed community nursing homes have staff shortages, where they are located, and how Veterans Health Administration employees will be deployed to them.
Another potential hot spot emerged Tuesday when the number of Miami-Dade County inmates with confirmed COVID-19 infections jumped to 59. The county corrections department said no inmates have died, and more than 700 have been tested so far in partnership with Jackson Health. Inmates have been tested whether they had symptoms or not.
On April 9, the corrections department reported just one inmate at Turner Guilford Knight Correctional Center had tested positive. Fifty-eight staff members have tested positive, according to the county, and 240 have tested negative.
“We are continuing enhanced, rigorous cleaning and sanitation of our facilities, have mandated the use of protective masks for all staff and inmates since April 3, 2020, and continue to emphasize the practice of strict social distancing to the greatest extent possible,” the department said in a statement issued Tuesday evening.
Inmates continue to battle the county in court over conditions at the Metro West Detention Center. The incarcerated have reported that numerous wings remain in isolation over possible sick inmates. Authorities have lowered the jail population to stymie the spread of the coronavirus, but close quarters and security challenges have made social distancing difficult.
Advocates have demanded more action. The Dream Defenders, which filed the lawsuit, have called the jails a “petri dish” for infections.
In contrast, the Florida prison system — which has undergone intense criticism over reporting of COVID-19 cases — has introduced expanded daily updates on its website, including information on how many inmates are being isolated because of infection concerns. The Florida Department of Corrections reports 98 staff members and 123 inmates have been infected, and four inmates have died.
As officials grapple with curbing the spread of the virus in vulnerable populations, business leaders and politicians are discussing how and when to reopen the state’s shuttered economy. DeSantis has appointed a task force to develop recommendations. A report is due Friday.
On Tuesday, business owners told the task force that restaurants should offer employees paid sick leave for up to 14 days. The owners advocated for clear guidelines before reopening businesses, guidance that would answer basic questions on social distancing, outdoor seating, the wearing of masks, and whether disposable utensils should be used.
“The clearer direction we can give the industry, the better off we will be,” said Tim Petrillo, co-founder and CEO of The Restaurant People, which operates 45 restaurants in five states.
Paid sick leave for up to 14 days for employees with COVID-19 symptoms should be offered to prevent them from feeling pressured to go to work, said José Cil, CEO of Restaurant Brands International, which owns Burger King, Popeyes and Tim Hortons restaurants.
Restaurant Brands’ hourly employees typically don’t have paid sick leave, he said, but the company offered it to its employees and encouraged its franchise owners to do so as well.
“Ultimately, the issue we need to address when we open up is we need to have certainty that our restaurants are a safe place to go for our team members as well as our guests,” Cil said.
The task force of more than 30 business owners, executives and state officials does not include any doctors or public health officials. It is led by Dana Young, the CEO of Visit Florida, the state’s tourism marketing arm.
On Tuesday, DeSantis said that as the state considers reopening businesses, the public’s confidence needs to be built up so that people feel comfortable going out again. People will need to be convinced it’s safe to return to normal.
Testing will be key. Public health experts say no state, including Florida, is providing anywhere near the number of tests that would determine just how safe it is to return and provide the population protection from a flare-up or another outbreak.
The lack of testing means the state is likely undercounting the number of COVID-19 cases. DeSantis said on Tuesday that Florida will provide the necessary testing to reopen the state.
“As people look at the next phase, they should understand that we’re all in on diagnostic testing, we’re all in on serological testing,” DeSantis said. “They’re both very, very important. We’ll probably have more testing sites in the next phase than in this phase because we don’t know what’s going to happen or how it’s going to pop up. We want employers to be able to send people to these places. I think that’s important.”
He didn’t say how many more tests will be conducted, at what cost or give a timeline.
This story was originally published April 21, 2020 at 9:41 PM.
