Coronavirus and memory care facilities; Any ideas as to how to manage and minimize risk?

Instead of relying on conspiracy theories and ignorant social media posts or TV garbage by people who have no scientific background, try reading responsible articles like this:

https://www.sciencedaily.com/releases/2020/03/200317175442.htm

Title:
COVID-19 coronavirus epidemic has a natural origin

From the article:
"The SARS-CoV-2 spike protein was so effective at binding the human cells, in fact, that the scientists concluded it was the result of natural selection and not the product of genetic engineering.

This evidence for natural evolution was supported by data on SARS-CoV-2's backbone -- its overall molecular structure. If someone were seeking to engineer a new coronavirus as a pathogen, they would have constructed it from the backbone of a virus known to cause illness. But the scientists found that the SARS-CoV-2 backbone differed substantially from those of already known coronaviruses and mostly resembled related viruses found in bats and pangolins."

NOTE: People did NOT get infected from eating bats... bats carry many viruses, including several coronaviruses, but are immune to most of them. Generally the virus spreads to another mammal (suspect in this epidemic could be pangolins.) Zoonotic transference of diseases happen, this is nothing new. When it is a virus that is new, it certainly can have a devastating effect.

See:
https://en.wikipedia.org/wiki/Bat-borne_virus

Although the true source of smallpox is unknown, speculation in scientific theories suggest "...The date of the appearance of smallpox is not settled. It most likely evolved from a terrestrial African rodent virus between 68,000 and 16,000 years ago." So, did people back then generate bioweapons? Also, if anyone REALLY wanted something deadly, there are many already deadly diseases to choose from - one doesn't need to bio-engineer a new one! Smallpox would be a possible choice, since they no longer vaccinate for it (at least by 1977, as my daughter was born then and neither she nor my son had the vaccination.)

First I will state that I have posted here before. I thought this virus was not such a big deal. It seems like I have been misinformed. The deaths do seem to be extremely low in proportion to the number of people infected. I must admit I am surprised at the government's response to this virus.

I think there are lots of theories floating around about this virus. We do not have the answers. This is President Trump's 9-11. At least we could see and combat that enemy. This now is much harder. It seems like the Chinese did what the terrorist could not accomplish. I pray to God that things improve.

My apologies. Apparently this article is a HOAX. Please disregard!

This is an excellent article on How to determine if you are infected!
Stanford hospital board internal message:
There is so much info out there but I wanted to share this.

Begin forwarded message:
Stanford hospital board internal message:
The new Coronavirus may not show sign of infection for many days. How can one know if he/she is infected?
By the time they have fever and/or cough and go to the hospital, the lung is usually 50% Fibrosis and it's too late.
Taiwan experts provide a simple self-check that we can do every morning. Take a deep breath and hold your breath for more than 10 seconds. If you complete it successfully without coughing, without discomfort, stiffness or tightness, etc., it proves there is no Fibrosis in the lungs, basically indicates no infection. In critical time, please self-check every morning in an environment with clean air.
Serious excellent advice by Japanese doctors treating COVID-19 cases: Everyone should ensure your mouth & throat are moist, never dry. Take a few sips of water every 15 minutes at least. Why? Even if the virus gets into your mouth, drinking water or other liquids will wash them down through your throat and into the stomach. Once there, your stomach acid will kill all the virus. If you don't drink enough water more regularly, the virus can enter your windpipe and into the lungs. That's very dangerous. Please send and share this with family and friends. Take care, may the world recover from this Coronavirus soon.
IMPORTANT ANNOUNCEMENT - CORONAVIRUS
1. If you have a runny nose and sputum, you have a common cold
2. Coronavirus pneumonia is a dry cough with no runny nose.
3. This new virus is not heat-resistant and will be killed by a temperature of just 26/27 degrees. It hates the Sun.
4. If someone sneezes with it, it takes about 10 feet before it drops to the ground and is no longer airborne.
5. If it drops on a metal surface it will live for at least 12 hours - so if you come into contact with any metal surface - wash your hands as soon as you can with a bacterial soap.
6. On fabric it can survive for 6-12 hours. normal laundry detergent will kill it.
7. Drinking warm water is effective for all viruses. Try not to drink liquids with ice.
8. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes, but - a lot can happen during that time - you can rub your eyes, pick your nose unwittingly and so on.
9. You should also gargle as a prevention. A simple solution of salt in warm water will suffice.
10. Can't emphasis enough - drink plenty of water!
THE SYMPTOMS
1. It will first infect the throat, so you'll have a sore throat lasting 3/4 days
2. The virus then blends into a nasal fluid that enters the trachea and then the lungs, causing pneumonia. This takes about 5/6 days further.
3. With the pneumonia comes high fever and difficulty in breathing.
4. The nasal congestion is not like the normal kind. You feel like you're drowning. It's imperative you then seek immediate attention.

I was just reading my local hospital's Facebook page and they are limiting visitors to one "designated visitor" per patient - this is somebody who has been screened to be healthy, has had no contact with anyone who is sick and hasn't travelled for more than 14 days. This seems a very measured response to me and could easily be adopted in most care facilities as well.

Staff can get sick just as easily and corporations often force staff to go to work under threat of disciplinary action even while sick...the best safety is get your LO out of the nursing home and care for them like they used to do in the old days. Nursing homes - when one patient get sick they all do.

The virus can live in the air only minimal amount of time and can travel on a sneeze approximately three feet. Distancing from people of 6 feet is advised unless providing direct care. Cough into sleeve at elbow, not into hand or contaminated hankies. Clean door knobs. Virus can live on surfaces approximately 12 hours, warmer surfaces for longer. It will spread quickly in a facility and will be a bad place to have visitors coming in and out constantly, and deliveries and so on. Workers are coming and going on all shifts, bringing in or taking out the virus. Our elderly and we ourselves if over 60 (so many of us are) are at greater risk. Keep surfaces clean. Hand washing is paramount. 20 seconds, remembering friction kills more germs than soaps does. Then turn off faucet with towel used to dry hands. Wishing us all luck in a time scary for many with elders in care facilities. You might discuss with your care facility if they are instituting any measures. But there is little to be done. For some reason there is a choice -- and I do believe at this late date it is a CHOICE --not to test. Even those exposed are not being tested at times. I do not know if this is the choice because the Government has decided that a rise in "numbers" will mean that there is a panic, or WHAT the reason is, but it was said on NPR that we are testing at the levels that a country the size of Zambia would test. Doctors and nurses have been unable to get tested. Do remember that this virus is very very unlikely to kill those who do not have pre existing immune problems or illnesses and those who are under age 60, but the fact is that those who are younger may well spread this to those who are compromised. Everyone take normal precautions and understand that the numbers of deaths from this at present are very low.

The problem with the "it's not so bad because not too many people have died here" and "It's not as bad as the flu" ideas is that this virus seems to spread before people know they are sick and the flu is most contagious after someone feels unwell. It's a big difference in how the disease will spread.

I think the CDC has suggested that only people whose family members are on hospice should be visiting senior care facilities. The virus just needs to be carried in to spread among this vulnerable population. If you do decide to visit, do not touch your loved one and wash your hands before and after your visit.

My concern is that the facility where one of our family members is living is "doing their best" when asked what protocols are being observed. I do not see signs alerting people that only essential visitors should be coming in. I don't see any guidelines for wearing masks if you have a cough and I see people hugging and kissing their loved ones. I don't even see extra Purell available. It should be available on the way in and out at the very least.

The way they are handling the people in Kirkland, Washington is sobering. One family member said they cannot get their parent tested until they meet some symptom criterion. He said 'It really feels like there has been a decision that this population is not worthy of resources." They weren't even testing the workers until they showed symptoms. That's too late.

We are staying away until this clears up a bit. I hope the other families will also at least take precautions when visiting the facility.

nevada said:
"It just seems hard to believe that a person who just happens to work in a nursing home just happened to go to this exact place in China where they have a level three or four virus testing location. They get sick and come back home to bring it to our elderly population."

Since you posted this, can you provide your "source" for this? Last I checked, they don't know who patient 0 is. Could it be a facility worker? Sure. But it could have been ANYONE, as there are many visitors, workers other than nurses, delivery people, any host of OTHER people who could have brought the virus in. Once in, with age and various medical issues, it is a given it would spread easily and be deadly.

You also said "One area that concerns me is that there is a segment of HIV in this virus." That sounds like pure unadulterated hogwash to me. Provide your source for that and state your medical background please!

If you post stuff like this, you need to back up your statements with actual real **GOOD** sources, not just junk from social media or whatever pops into your head.

nevada;
While I will still say be careful, cautious and take precautions as needed, there is no need to panic. Less than 700 people in the US have reported illness and out of the current 327 MILLION, this isn't a lot. I posted elsewhere, 40,000 people in the US die EVERY YEAR due to car accidents - you going to blame that on the car companies (aka China, as many parts come from there)?

Please stop with the conspiracy theories. If the Chinese "invented" this, they have done a very poor job since it's affecting their own citizens more than any others. You also state you think this is "...slightly stronger then the common cold..." If they want germ warfare, it will need to be a LOT stronger than a hyped up cold!

You blame the media for over-hyping, which I agree with, BUT you contribute to it by posting your "theory", multiple times.

Put this in perspective;
As of March 09, 2020, 20:55 GMT
China has almost 81000 cases, with 3120 deaths. NO other country has yet come even close! 3.8% death rate there.
Italy has the second highest infection and death rate and has initiated a lock-down. 9172 cases, 463 deaths, resulting in a 5% death rate.
S. Korea and Iran have the next highest number of cases, but Iran has a higher number of deaths. (7478, 7161 cases, 53, 237 deaths, .7% and 3.3% death rates respectively.)

IF you remove the higher stats, there are 9673 cases outside these areas - currently 108 countries/territories and a cruise ship (they haven't counted in the other cruise ship), that averages to 88 each - obviously some have more (France, Spain and Germany all over 1000 infected), some far less.

Although the "death rate**" for the US is about 3.5%, consider this:
Of the current deaths in the US, 22 of the 26 are from WA state, many or most from one facility and most of those were old and/or medically compromised.
((** The ACTUAL death rate could be much lower everywhere, because there are many who have mild symptoms, who aren't tested, hospitalized or otherwise "captured" in the statistics. If MORE cases actually exist (which is VERY likely), that reduces the death rate.))

In addition, many of those identified with the virus traveled to some of the countries that have the high rates of infection/death. It is spreading from them, but not as bad yet.

THAT also partly answers your question as to why mostly older people. They ARE more vulnerable to begin with and if they have other serious medical conditions, it is, like ANY illness, going to hit them harder. CURRENT data indicates those under 50 have a .4% OR LESS chance of death from this virus. Males seem to have almost twice the chance of dying. Did the Chinese target old men??? Various conditions increase the chance of death (high BP, heart or lung issues, diabetes, cancer, etc.) Those with no medical conditions, less than 1% chance of death. One source mentions how like SARs (also coronavirus) it attacks the lung cells, if it gets into the lungs, and can lead to pneumonia on top of the virus - THIS is a leading cause of death in the elderly!

"The other thing is that it keeps evolving."
That's what viruses do... and why there is a different flu shot every year. This is nothing new.

"Why is it just the elderly that are dying from this virus?"
It is NOT just elderly dying, however due to age and/or several medical issues, they are more likely to succumb. Percentage among those with no medical issues is less than 1%.

So, please stop with the conspiracy stuff and don't contribute to the media HYPE, please.

That’s really a tough answer, as I keep asking the same thing. I have wipes, hand sanitizer where my mom is at, and each time I visit, I wipe down her wheelchair, her bed side rails, table tray, and in the bathroom the toilet seat and sink, even though I know they’re supposed to be doing that. I have her washing her hands after being toileted and before eating,
and that’s all I can do for her and myself while there.
As for not visiting, how do you explain that to someone that can’t quite comprehend, but yet looks to see you each day.

COvid-19 is the big concern these days. I have stated a couple of times on this post that I think like Senator tom Cotton of Arkansas that the Chinese have committed germ warfare. I have also stated like President Trump and some doctors in the CDC that this is slightly stronger then the common cold and weaker then the flew. Judging by the number of answers on this posting this is a great concern and I truly understand the fear. One thing I have noticed over the years is that the media blows things up for ratings. Does that ease anyone's fears? No! It happened with Avian flu, SARS, MEARS, ZEKA, and Norwalk virus, and now COvid-19. This bug comes around every year in the form of a common cold. That is one type of corona virus. So Americans and the rest of the world want help. In one posting that I responded to someone was stating that the Chinese were handling the virus outbreak affectively. They were right if you consider putting the patients into a hospital and then that hospital just happens to collapse trapping all inside.

I understand that people in Florida and North Carolina have now come down with this virus. President Trump asked for $4 million a week or two back. Chuck Schumer retorted why not spend $10 Billion. I should have said $4 Billion earlier. President Trump stated that if he was given more money he would gladly spend it. The senate has past a bill this week for $8.5 Billion. Senator Schumer has 85% of what he wanted. Meanwhile as the United States has been working on a vaccine for this virus, that would take a year or more to come up with, an Israeli company has come up with a vaccine. It is on track to be ready in the Fall just in time for next year. One area that concerns me is that there is a segment of HIV in this virus. The other thing is that it keeps evolving. I do have one question. We have people with compromised emu systems in all age brackets. Why is it just the elderly that are dying from this virus? Is it a form of euthanasia? It just seems hard to believe that a person who just happens to work in a nursing home just happened to go to this exact place in China where they have a level three or four virus testing location. They get sick and come back home to bring it to our elderly population. Odd! Yes you can say I do not trust.

My mom's ALF has a Purell bottle in the foyer with a big sign to "sanitize" before entering building. I cautioned my mother to wash her hands often. The day I visited we had a confirmed coronavirus patient in our city. Just found out he was on one of the cruise ships that is now quarantined in SF (he got off the last cruise on Feb 21st.) We now have 40 people from that ship roaming around our town. I hope her facility doesn't have another lockdown. The last one was over the holidays for two weeks. She almost went nuts.

Beatty,
That must feel surreal, so close to home.
Stay the course.
Wash your hands.
Shelter in place.
Check in here more often, we are listening.

Coronavirus just found in NH next surburb from me. They are now in lockdown mode. No visitors. Residents isolated in their rooms.

Private hospitals preparing to cancel elective surgeries if notified by Dept Health & take public overflow patients instead.

Listening to passing ambulance siren as I type... Wish you all luck.

My mom's memory facility has strictly limited visitors. They are offering video chats & phone calls, as well as activities pictures online.
My mother doesn't know me, or miss me & she is content in her facility. I'll call to check on her of course.
We live in Washington State & the virus is heading our way. I actually worry more about my husband on dialysis, with his many medical appointments.

You need either 91% alcohol or 50/50 bleach water to kill a virus. Start carrying a packet of paper towel soaked in either solution. I prefer alcohol because bleach will ruin clothing.

wash your hands every chance you get. Sing happy birthday twice to know you washed them long enough...remember to get between fingers and around your wrist too.

use those wipes on every surface. Either right after touching anything (door knobs, counter tops, faucets, etc) or use it to handle that ... use a wipe to open doors...etc.

keep you hands off your face.

keep a 6 foot distance between you and everyone else in an enclosed space.

this is a tough change to make...but this is the vest you can do.

FYI "single-payer" healthcare is not free: it is forcefully pre-paid through taxation. And then everyone gets mediocre care, or worse. Please stop thinking of it as free. Or superior. I live in MN home of the Mayo Clinic. There's a reason why a parade of world leaders come here for their healthcare. Do you think Jimmy Carter would have received cutting edge stem-cell therapy for his brain cancer with single payer? Hmm...maybe he would have since the politicians always make sure they have better options than their constituents.

DILKimba - since you asked, here’s my reasons why it matters.... if you live in the US - which does not have single payor or universal health insurance to rely on- that means you either will have to self pay for any health care services or meet whatever deductible your health insurance first and foremost requires to be paid before policy coverage can happen. Unless you are on MediCARE or MedicAID. The average deductible in the US in 2018 was $4,328 for individual plan and $8,352 for family plans (KaiserFF).

Again $4,328 and $8,352 average deductible in US.
That’s a huge sum of $$$ to most of us.

There’s a whole lot of folks who do not have the $ to self pay or cover their deductible. So they put off getting care but are sick; they continue to work but are sick; they don’t do annual preventive type of services (which can abate or control chronic diseases like HBP or diabetes) as they can’t pay the deductible or self pay. Their kids get sick and they don’t go to the doctor as can’t afford deductible; kids get sick but don’t stay home as parent has to work so kids go off to school sick. And somebody is going to be sick this month and have Covid-19 and going to be a point of contact for community spread.

The symptoms from Covid-19 are primarily the type of things you go to a physicians office or clinic to get checked out and have swabs or labs drawn for. And those type of things fall into care that have deductibles or you have to self pay. $ 550 here, $234 there, $678 RX costs. It’s - for none critical Covid cases - exams, labs and care that does not need hospitalization.

Covid-19 isn’t existing in a vacuum only affecting the over 65 set which has Medicare coverage. It’s not limited to NH residents which majority are “duals” on MediCARE and Medicaid, so the M&Ms pay for care. It’s the 35 yr old working gig economy or 52 yr old working in the mall or 17 yr old kid in school, all who can’t possibly have $4328 to meet their deductible who are going to be get it and spread it. It’s not going to be found out early, isolated, treated and nipped in the bud to lessen community spread.

China has had all testing, case finding, followup and care for everything from temp checks, to medications & food delivery, to CT scans (hundreds per day in facilities), to the fever rooms/clinics set up in all the provinces to critical care oxygenation care (ECMO) in hospitals, all have been without cost to the individual. Folks didn’t fret for days as to how to pay for a visit to a primary care doc and then wait till beyond super ill to finally go for care. That’s what’s imho gonna happen in the US.... if it means a choice of having $900 to pay rent or childcare that’s what you spend on first before going to the doctor. Maybe you have a rarefied job w/“Cadillac” employer health insurance with little or no deductible, or your below poverty level so totally on Medicaid, so that you never worry about paying for care or meds. But that’s not the situation for the majority in the US. And that’s why a single payor / universal insurance matters.

For those interested, Google: Bruce Aylward / WHO mission report. It’s all about how China dealt with Covid-19. Just amazing. Australia and Vietnam are following China’s playbook & their #s too are reigned in.

Today WorldWide 100,330 cases.

Everybody wash you dammed hands!

I can't stress enough how important proper hand washing is to combat the disease. Avoiding touching your face. Eliminate any unnecessary air travel. The coronavirus is scary, but so is the flu. 1918 should not be forgotten. People do die from the flu too.

The  coronavirus is deadly to the elderly Not so much with younger people. I'm sorry your Mom is in that place, I know you must be worried. Unfortunately, there is no way of knowing who has it. Talk to the supervisor, and see what they are doing. Wash your hands a lot and use hand sanitizer. Do not touch your face, EVER. As soon as you get home wash your hands. Some states don't have the virus yet. Check out CDC to see if it has started spreading where you are.

I knew a woman who (I think) may have suffered from paranoia as for YEARS AND YEARS (10 - 12 years ago) washed all fruits and vegetables with vinegar. Why I brought up the possible paranoia is that she washed an unpeeled banana with vinegar.

I agree about containment and reducing contact. From the latest I have read, they really need to contain it. I suppose that means no visitors until things are under control. I really wish there would be more of that done now before it’s too late.

Nevada, if China were engaged in "germ warfare", why would it target its own people?   It's suffered a lot with the loss of life, and Xi Jinping has taken a public relations and confidence beating for his behavior in suppressing dissent as well as not responding promptly.

What would he have to gain by instituting a such a devastating plague?   How would he and the state target the victims?

Geaton777, I wash veggies and fruits with warm or hot water and soap to remove as much of the pesticides as I can, although there really isn't a foolproof  way to do that.

Many apple varieties have whitish stains which I suspect are from pesticides.  I've found no way to remove them except by peeling apples.

The dangers from pesticides aren't something we can't observe; it requires testing.

You're not incorrect in that home grown food is the only way to guarantee organicity, unless you know the grower.    Even so-called organic food sold in the stores can have some limited chemical applications.

The best way is to be your own grower.   Victory Gardens were a good idea; I'd like to see them make a comeback.

This is from the Centers for Medicare & Medicaid Services (CMS), issued yesterday.

Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes

https://www.cms.gov/files/document/qso-20-14-nhpdf.pdf

As Coronavirus Cases Grow, So Does Scrutiny Of Nursing Home Infection Plans

https://khn.org/news/as-coronavirus-cases-grow-so-does-scrutiny-of-nursing-home-infection-plans

I'm reading with interest the comments about washing fruits and vegetables with hot water (and soap). To what end? If you think you are removing germs by doing this, you are not. You are removing dirt and debris, but not germs. You are not sterilizing your food. This would require very high heat for a very long time (like when you can home-grown fruits & veggies). It may remove some surface contaminant chemicals, but mostly those are absorbed and become systemic. I rinse mine in tepid water and use a tiny bit of non-fragranced mild soap. I don't get any more or less sick during the year than my work cohorts who are all organic (not that I have anything against that, I'm just too cheap and lazy). As for the chemicals, unless you grow your own you have no idea if what you're purchasing is actually truly chemical-free (or whatever you call it). There is no vigilant accountability in that industry.

Lessen your visits to the facility.

This is the first article I read on the topic. Senate President Protempor Grassly of Iowa has been involved in classified meetings and wrote an article talking about Covid-19. https://www.grassley.senate.gov/news/news-releases/grassley-receives-classified-briefing-coronavirus I hope these articles are helping.

At this point I would probably not visit a nursing home. I'd be worried about introducing the virus as well as exposing myself. I'm not in that situation, but it seems wise. I get that it might not be possible not to visit for reasons I can't even imagine.