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By Katarina Sostaric, Iowa Public Radio News 

The number of active COVID-19 outbreaks in Iowa nursing homes soared to a record 114 Thursday, putting thousands of vulnerable Iowans at risk of getting sick or dying of the virus.

Long-term care staff are now being tested for coronavirus frequently under federal requirements. But the extremely high rate of community spread in Iowa is making it very difficult to protect Iowans who live in nursing homes.

“What we’ve got to do as a state is control our own behavior,” said Brent Willett, president and CEO of the Iowa Health Care Association, a nursing home industry group.

Willett said as community spread increases, the number of nursing home outbreaks increases along with it. He said there won’t be a significant decline in nursing home outbreaks until Iowans take more public health precautions to slow the spread.

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“You just cannot separate the two,” Willett said. “It’s like separating smoke from a wildfire.”

Nearly one-fourth of Iowa’s approximately 445 long-term care facilities have active outbreaks. In at least two facilities, more than 100 residents and staff have been infected. At least 972 nursing home residents had died of COVID-19 as of Thursday.

The state of Iowa defines a long-term care outbreak as three or more residents testing positive for the coronavirus. Outbreaks in assisted living facilities are not included.

AARP Iowa State Director Brad Anderson echoed Willett’s call for Iowans to do their part to protect others.

“If you do care about older Iowans in this state, you will abide by these guidelines because we know that wearing a mask, social distancing, washing your hands—these measures help stop the community spread,” Anderson said. “And if we stop the community spread, that will help prevent COVID-19 from entering the doors of long-term care facilities.”

But Anderson also said the state should develop a plan to stem the outbreaks and to help alleviate staffing and PPE shortages in nursing homes.

“We have 43 percent of Iowa nursing homes across the state reporting a workforce shortage. That is well above the national average of 28 percent,” Anderson said. “And so until we deal with the workforce shortage, we’re going to have a very difficult time containing the virus.”

Anderson believes there should be a database of qualified direct care workers, and that the state should consider sending the Iowa National Guard to help nursing homes with coronavirus testing.

Willett does not support these ideas but said nursing homes have the option of asking for the guard’s assistance if conditions get worse.

Reynolds gives update on nursing home outbreaks

On Thursday, Gov. Kim Reynolds announced she is allocating $14 million of CARES Act funding to help nursing homes cover the increased costs of testing and staffing. Willett said Iowa nursing homes are spending about $2.5 million each week on testing, even with the federal and state governments providing some testing materials.

The Iowa Department of Public Health also released guidance for emergency staffing plans. It says, “as a last resort in emergency staffing situations,” nursing home staff who test positive for COVID-19 may provide direct care for residents who don’t have the virus.

Hari Sharma, an assistant professor at the University of Iowa’s health management and policy department, said nursing homes need to follow infection prevention guidance and do more testing. He said state and federal governments need to support long-term care facilities with more resources, and facilities could try to incentivize new hires.

But he said individual Iowans also need to play a role in slowing the virus’ spread.

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“Going out to eat in public, and enjoying time at the bars, they’re all fun,” Sharma said. “But when there’s a pandemic like this, it’s important from the government level to have a consistent message where we discourage people to do some of these things, and encourage people to wear a mask, social distance, follow proper hygiene.”

And with some major holidays approaching, Iowans living in nursing homes will continue to be isolated away from their families. With the high level of community spread, federal and state regulations direct nursing homes to only allow in-person indoor visits for compassionate care needs.

“It’s certainly not a situation that any facility resident or family wants to be in,” Willett said. “But again, this circles back to if we want our folks in nursing facilities to have those in-person visits, we’ve got to control the source, which is in the community.”

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IDPH guidance encourages facilities to make virtual visitation, window and outdoor visits available.

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