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Cuomo ends visitation at nursing homes to fight coronavirus

Gov. Andrew M. Cuomo said Thursday in Albany

Gov. Andrew M. Cuomo said Thursday in Albany that the number of confirmed coronavirus cases in New York State has grown to 328. Credit: Darren McGee- Office of Governor Andrew M. Cuomo/Darren McGee

ALBANY — Gov. Andrew M. Cuomo on Thursday suspended all visits to nursing homes as the spread of the coronavirus worsens statewide.

“This means no visitors in a nursing home,” Cuomo said. “If you care for someone in a nursing home, the last thing you want to do is endanger them.”

The exception will be for nursing home residents in hospice care and facing an end-of-life moment, Cuomo said.

“I leave that to the facilities if a person is in a dire situation,” he said.

All staff will have to wear protective masks, and no nonmedical staff will be able to contact residents, he said. There is no ending time for the latest order, aimed at stemming the rise in the COVID-19 virus.

“We just don’t know,” said state Health Commissioner Howard Zucker in an interview. “We’ll have to see. It depends on the course of the spread … We are being very aggressive in identifying anyone who has been sick.”

The homes are the first health care sector to get specific federal and state safety guidelines. Earlier this week, state and federal officials urged nursing homes to limit visitation because of the special threat the coronavirus poses to the 117,000 residents in more than 600 nursing homes statewide.

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“Nursing homes have always been a special case,” Cuomo said.

Dr. David Nace, medical director of the University of Pittsburgh Medical Center, said residents would most likely contract the virus through visitors and workers.

“A big concern is from visitors and health care workers who have no or minimal symptoms but retain infection and the potential to spread the illness,” Nace said.

Staff at nursing homes have their temperatures taken before entering the facility. They are sent home if they, or anyone they have been around, have a fever, cough or other symptoms that could be signs of the virus, said Stephen Hanse, president and CEO of the New York State Health Facilities Association, which represents nursing homes.

“While it’s a difficult situation, it’s a temporary situation, and it’s in the best interest of the men and women living in our nursing homes,” Hanse said.

But some health care professionals said the precautions exact a therapeutic price on residents. They take away visits and physical contact with loved ones and staff that can be so beneficial to a resident facing long days away from home and family, they say.

Hanse said residents are being given iPads if they don’t already own one to contact family through Skype, email, Facebook and other means.

“Nothing beats the direct personal touch or a hug. And when you can’t have that, it can be lonely,” Hanse said. “Our staff is really trying to help them communicate with their loved ones. It’s the next best thing.”

Earlier this week, state and federal guidelines allowed nursing homes to limit visitation hours, to question visitors about their health and recent travels, to test visitors for fevers, and to ban hugs and handshakes with residents.

In the state of Washington in January and February, the virus raced through a nursing home, killing 19 — nearly 20 percent of residents. The virus was confirmed in 10 of the nursing homes in the Seattle area.

No nursing home worker or resident in New York has tested positive for the virus, according to state health officials. A per-diem worker at a Greenport adult care community, Peconic Landing, which serves healthier residents than nursing homes, did test positive this week.

 “It is heading to nursing homes,” said Stefan Gravenstein, a physician and director of geriatrics and palliative medicine at Brown University. “We saw in Washington the mortality rate is sky high … the mortality rate is going to top 10 percent. It will be very severe.”

“In the case of the Washington nursing home, they didn’t have any reason to be suspicious about it until it was too late,” Gravenstein said. Today, “vigilance needs to be stepped up ahead of time." 

New York nursing homes share many of the same issues as facilities in Washington state, including a frail, often-ill community of residents, low staff levels with high turnover, many residents suffering from dementia who won’t wear protective masks, limited resources to buy large supplies of masks, gloves and disinfectants, and limited space to isolate infected residents, officials said.

 Last week Cuomo approved Zucker’s containment plan for a hot spot of confirmed cases in Westchester County that included ending visitation at New Rochelle nursing homes.

“That is the most vulnerable population,” Cuomo said earlier this week. “It is the most dangerous situation faced by the virus … that’s my nightmare. You are going to see pain and damage from this in nursing homes.”

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