Oregon’s ambitious coronavirus testing plan for 60,000 people who live and work in care facilities leaves out one key group: the state employees who inspect facilities with outbreaks and investigate safety complaints.
That means nursing, assisted living and memory care staff face stricter testing mandates than employees of the state agency that oversees the facilities. It’s a policy that some experts say could put care homes at risk of potentially deadly outbreaks.
Residents in care facilities are especially vulnerable to COVID-19. About half of Oregon’s 427 coronavirus deaths have been linked to care homes.
So far, none of the Oregon Department of Human Services’ roughly 75 inspectors have been infected with the disease or, as far as state officials know, had symptoms, the agency said.
Listing a slew of safeguards to prevent inspectors from spreading or contracting the disease, spokeswoman Elisa Williams said the agency has not found that also testing them “would provide a significant benefit.”
Several other states, including California, plan to or already require testing for inspectors who visit care facilities.
Dr. Mike Wasserman, a California senior care home expert and advocate, said inspectors should be tested because of the potentially deadly consequences if the coronavirus gets into a facility.
Among possible scenarios, inspectors could get infected in the community then unknowingly bring it to a facility that has no identified cases of the disease, Wasserman said. And infected inspectors who visit facilities with outbreaks could spread the disease to sections of a home that don’t have any sick residents or staff.
“Why would we hold the nursing home staff to a higher standard than the surveyors?” said Wasserman, president of the California Association of Long-Term Care Medicine.
The Department of Human Services said its policy follows recommendations from the state’s lead health agency, the Oregon Health Authority. For now, the Department of Human Services plans to stick to state health officials’ guidelines that don’t recommend people without symptoms, who haven’t been exposed to the virus, get tested on a regular basis.
“Decisions are continually being reviewed,” the agency said in an email. “Exceptions may be made.”
Concerns about the outsize risk the coronavirus poses to seniors prompted Gov. Kate Brown to order that all approximately 60,000 workers and residents in Oregon’s senior care homes get at least one coronavirus test by Sept. 30. About half have already been tested.
But the mandate leaves out Oregon inspectors who visit facilities with coronavirus cases at least once a week. Those visits are “crucial,” said Williams, the agency spokeswoman, because they allow state experts to give immediate feedback if facility workers aren’t doing enough to prevent infections.
The state has taken other steps to prevent inspectors from spreading or getting infected with the coronavirus. For example, inspectors who visit care homes with outbreaks generally don’t go to facilities without outbreaks, the agency said. Meanwhile, the state has limited inspections at homes without outbreaks, except for situations when residents’ health and wellbeing is at risk.
Inspectors also avoid close or prolonged contact with residents or workers, and they get screened for symptoms or potential exposure to the disease, Williams said. They wear masks and eye protection when they are inside and put on other gear, as necessary.
Oregon’s top advocate for care home residents said inspectors pose no particular risk of spreading infections because they know how to use personal protective equipment. Everyone in the state should be tested regularly, he said, and inspectors don’t face any greater risk of catching or spreading the disease, he said.
“They’re the ones advising people” on proper protective equipment, long-term care ombudsman Fred Steele said. “They know how to wear” it.
The director of a union that represents some inspectors, as well as nearly half of all nursing home workers, said she hasn’t heard complaints about the lack of testing. The inspectors don’t pose a “unique risk” of spreading infections because they wear protective equipment, said Melissa Unger, executive director of SEIU 503.
Wasserman, the California advocate, commended the state for mandating protective equipment, saying it goes a long way toward preventing the spread of infections.
But the problem, he said, is human error. Especially as the pandemic drags into its sixth month in Oregon, people can get lax with how they put on and take off their protective gear, Wasserman said.
Testing each of Oregon’s approximately 75 inspectors weekly would amount to 0.3% of all tests Oregon has been doing a week, a volume that Wasserman said “should not be a big deal.”
One Oregon industry representative, LeadingAge Chief Executive Officer Ruth Gulyas, also said inspectors should get tested, just like the staff and caregivers in senior care homes.
“We think the policy should be consistent,” said Gulyas, whose organization represents not-for-profit senior care homes.
Spokespeople for Colorado and Washington, two states with mandates in place or in the works, said the policy creates another layer of protection.
California’s governor announced plans to test its inspectors in July, hours after an investigation by the Los Angeles Times published online.
Said Gov. Gavin Newsom: “We’re raising our standards.”
-- Fedor Zarkhin
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