Coronavirus: What Ohio is doing to keep those at-risk safe – The Columbus Dispatch

Caregivers for the most at-risk Ohioans are confronting the threat of coronavirus after the United States suffered its first deaths caused by COVID-19 last week.

The number of U.S. deaths had risen to 21 as of late Sunday, and nearly 4,000 worldwide had been killed by the disease.

Many of the first deaths reported in the United States were linked to a nursing home in Washington state.

Its a development that presents a challenge for officials across Ohio who are running facilities for seniors, including long-term care, assisted-living and memory and rehabilitation care.

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We have been very intentional and focused and have committed the necessary time and resources, said Ursel McElroy, director of the Ohio Department of Aging. We know we have a ways to go because this thing is changing every hour. But I dont think you can ask for a better infrastructure than we have right now.

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There are no confirmed cases of COVID-19 in Ohio yet. Local health departments are monitoring 255 people around the state who returned from other countries where the virus is more widespread and said on Saturday that they have tested at least 14 people who are showing symptoms. Of those, 10 tests have come back negative.

In general, the people who have died of COVID-19 have been older and also had other illnesses.

As the virus spreads in the United States, Ohio could become a hot spot because of its aging and ailing population. Two million of Ohios 11.5 million residents or 1 in 6 are 65 or older.

"We are trying really hard to not have (COVID-19) even introduced, McElroy said. There are things that we could begin to look at, such as visitors and who can come and go, when it becomes necessary to examine some of that.

Nursing homes are always vulnerable to infectious diseases. Before COVID-19 emerged, the federal Centers for Disease Control and Prevention estimates, as many as 380,000 people annually died in U.S. long-term care facilities of such things as urinary tract infections, diarrheal diseases and staph infection.

Bev Laubert, Ohios long-term care ombudsman, said her staff and certified volunteers will be visiting every Ohio nursing home in the next three weeks. They will talk to residents about any concerns they have about COVID-19, Laubert said.

Also at higher risk are thousands of Ohioans with deficient immune systems or a history of medical issues, and those without good access to food. That includes people who are donor-organ recipients or have autoimmune disorders such as ulcerative colitis, an inflammatory bowel disease, and the 24,000 Ohio residents who have HIV, the virus that causes AIDS.

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That puts a heavier burden on caregivers to exercise rigorous infection control, said Peter Van Runkle, executive director of the Ohio Health Care Association, the trade group for more than 1,000 facilities in Ohio.

It makes it more important to take whatever precautions are needed not that its not important for everyone, but the stakes are higher for our population, Van Runkle said. We direct our eyes to what the state and federal authorities are telling us. But its a constantly evolving thing.

People who have limited access to food also might have problems as COVID-19 spreads. In Ohio, 1.75 million people do not have a reliable food supply, and poor nutrition is a drag on the immune system.

LifeCare Alliance in Columbus, which provides services including Meals on Wheels to seniors and those with health needs, already is preparing for the virus to disrupt its food delivery.

If one of LifeCares more than 30,000 clients were to catch the virus, employees would be able to leave frozen or hot meals on their doorsteps, CEO Chuck Gehring said. The organization would also consider providing nonperishable items, such as tuna, soup and peanut butter, for people to eat if the virus outbreak were to become dire and interrupt deliveries.

Though contingency plans exist for Meals on Wheels, there are in-home services that LifeCare volunteers and employees just could not do, Gehring said. That includes helping people bathe, clean or change bedding.

"We're hopeful that it doesn't get that bad," Gehring said. We have no cases and the nice weather knocks out the flu, so hopefully (COVID-19) gets knocked out here soon and we can move along.

Across the state, health care providers also are preparing for children to be impacted by the virus.

In general, children have been a very small portion of the population testing positive for COVID-19.

Whether its the coronavirus or any other virus, Children often tend to cope better than adults, and there could be a variety of reasons. Thats the simple reality, said Dr. John Bower, a pediatric infectious-disease specialist at Akron Childrens Hospital.

Bower said theres limited information on patients getting infected with the virus, and health professionals are still getting a better understanding of it, but most likely its not that children dont get infected; they likely just get milder infection.

We dont want to create undue panic or alarm, Bower said. Families should continue to manage children as they normally would and recognize the potential of other viruses in patients of this kind.

Another group of people who are more at risk but are not always considered potential victims are the doctors, nurses and other medical staff on the front lines.

Van Runkle said his organizations members are already asking not just about how to best serve patients, but also how to protect themselves from the virus while treating others.

Do we stop admissions? Do we stop visits? Do we do particular things to try to protect patients? What do we do with our employees? he asked. Fortunately, these are not today issues for us. But they could be tomorrow.

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A concern for care providers is a potential shortage of equipment such as full-body coveralls and masks. A lot of those tools come from China, Van Runkle said, which is ground zero for COVID-19.

Dr. Mike Sevilla, a Salem primary-care doctor who often visits facilities to see patients, said caregivers need to step up the preventatives now used for influenza as a foundation for guarding against coronavirus. Sevilla said if the situation turns more serious, care facilities can take more steps, such as limiting visitors.

Theres no coronavirus vaccine yet, but you still can kind of take some initial steps as like for influenza, such as still getting your flu shot and hand-washing, Sevilla said. In a hospital setting, its also important to be wearing gloves. And for those patients or people who have flu-like symptoms, those people should be wearing masks.

Ohio has about 550 assisted-living facilities, and in those residences, caregivers are worried because they care for an older population with lots of existing conditions, said Jean Thompson, executive director of the Ohio Assisted Living Association.

In addition to hand-washing, Thompson said her members are getting the word to be cognizant of respiratory hygiene meaning you cough or sneeze into something disposable; nothing that stays or remains.

Right now, our goal in Ohio in assisted living and our goal as an association is to provide as much good information to our members in terms of prevention, she said. Its like ultra-good flu practice, is what we should be doing right now.

Joe Russell, executive director of the Ohio Council for Home Care and Hospice, which has 600 member organizations, said the agencies are taking the situation seriously. The agencies have had practice in preparing for outbreaks, dealing recently with worries about the Zika virus, Ebola and the H1N1, or swine flu, epidemic.

Our agencies are very susceptible to this, Russell said. They are going into peoples homes, and they might not only take something into the home, but they might pick something up and take (that) into the next house.

For more information on COVID-19 in Ohio, the state coronavirus call center can be reached by dialing 1-833-427-5634.

mfilby@dispatch.com

@MaxFilby

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Coronavirus: What Ohio is doing to keep those at-risk safe - The Columbus Dispatch