Well, there you go again. Two of the Republican Governors’ Leading Lights are heroically fighting the nasty little Bugger-19 by diverting Louisiana drivers (non-commercial) to the side of the road. Oh, that will surely flatten the Curve, Fellas. Good on Ya!
Texas ramped up its big play Sunday April 5, following Florida’s earlier bold move on March 27.
What an Utter Crock.
How about a little reality injection? First the Texas picture hors d’oeuvres.
What about just the gross observations? So, here we have (from the New York Times coverage) six uniformed Texas deputies interacting with two lines of passenger cars and light trucks behind a cordon of orange traffic cones. The deputies are both masked and gloved below their uniform hats. All of them carry guns, radios, and a clipboard.
To the next level of detail. Deputies are observing half social distancing, appearing to be perhaps 1-3 feet away from their subjects. Subjects not wearing any PPE. Not a thermometer in sight. No testing paraphernalia. No cameras to record driver’s license or license plate data. (to be snide, the only license plate I can make out in the picture is one from Texas. Maybe this driver is in the wrong lane).
Perhaps my eyesight is bad (I am a senior). I don’t see tablets or iPads or electronic devices for data entry and rapid transmission. It looks like good old pen and paper. If I am mistaken, I apologize. Apps are everywhere.
So, Deputies are not gathering any objective medical evidence, and any history information taken from entering drivers and passengers is suspect if the driver wants to get into Texas, and the untrained deputies are potentially each exposing themselves to hundreds of unscreened and possibly contagious people fleeing from a known infected Hot Locus into the beautiful Land of the Yellow Rose.
Now there’s a COVID-19 juicy breeding ground ready to flourish, right at the side of the road checkpoint.
Jack Ass Stupid public policy waste of precious Texas response capacity. Won’t catch a single inward case. Might make some home-grown Texas cases though.
Meanwhile, in Texas City and San Antonio, Texas has a real problem this week.
At the Resort at Texas City in Galveston County 83 residents and at least 1 staff employee at a 135-bed nursing home are infected based on 146 tests performed since March 28. Galveston County won’t break out the figures between staff and employees, because…., well, just because. I won’t name this Secret Moron, but he thinks the situation is likely the result of ‘bad luck’.
So, this elder care facility has a resident positive tested infection rate of at least 61%.
Or, how about San Antonio? At the Southeast Nursing and Rehabilitation Center, where the outbreak has infected at least 75 people so far and killed one since March 27. This nursing homes has 60 employees and about 85 residents. So far, 67 or 80% of the residents have been infected. So have 8 employees out of 60 who work there, an employee infection rate of 13%.
Now to pursue our theme that Louisiana is the Fount of Evil for poor nearby Texas, we too have had a horrific elder care facility pandemic problem. One of the very worst hit was in New Orleans, our pandemic ground zero, at Lambeth House. We made the national news. Here there were 50 test positive infections and, sadly, 13 deaths. The epidemic here seems to have crested since there are no new cases since March 31. However, the Lambeth House Independent Wing where the cases occurred has 118 units and 140 residents. So. the Lambeth House infection rate was nearly 36%.
Thus, in Louisiana our worst elder care facility attack rate was 36%, and in Texas we see right now 60-80% in similar facilities. My Grandma used to say, “Better Watch Your Own P’s & Q’s, Boy”. Isn’t there a proverb with advice about Glass Houses and Throwing Stones?
It is also true that the death rate attributed to the Lambeth House epidemic is horrible at 13 souls lost. This is a death rate of 9.3% among all the residents who live there. Texas has only reported 1 death as of the latest reports I could find, except that their epidemic didn’t start until March 27 and March 28, so it is too early to account for the ultimate expected death toll.
The first case at Lambeth House was reported on March 10 and the first death March 18. Texas has another 7-10 days of watchful waiting to learn the fate of its two facilities, that is assuming no one ese gets infected with COVID-19 in the meantime.
Semi-closed and crowded elder care, senior living, and nursing home communities are all at terrible risk everywhere. So too, to a somewhat lesser degree, are group homes, disability centers, prisons and jails, and drug and other rehabilitation centers nationwide. Have you heard about any coherent national action and prevention plan so far? I haven’t.
There is some pro forma advice, but no massive resource injection, or Federal active measures. Don’t get me started, but apparently Bill Barr’s latest brainstorm is to community release untested Federal prisoners immediately from the worst COVID-19 afflicted Federal Prisons to keep the Prisons safe.
Because flooding a bunch of poor and socially isolated prisoners upon unsuspecting hometowns is his idea of good public policy. Inmates with no jobs, no health care, no money, no unemployment, no loans, no support system. I suppose he thinks every prisoner has a loving and well supplied family home he can return to lickety split. Another Buffoon Move, unless it is a deliberate move to further deepen despair in low income, black, brown and minority communities.
However, let’s look at Texas through a bit more macro lens. The primary weapon in our public health arsenal for now and weeks to come is the availability of accurate diagnostic tests in decent quantities. And that is the greatest Federal COVID-19 failing to date, followed closely behind by those lazy Governors who haven’t shown up and done their jobs for their own state residents, test wise.
Like Texas.
Here is today’s Worldometer US State by State COVID-19 Data Summary. The data table includes the information from the 25 most affected US states by Total Cases, and then sorted by their COVID-19 testing rates in order.
The pertinent number is not how many total tests have been done. What counts is the number of tests per population unit. A top end US state testing rate is >10,000 tests per million, or more simply, 1 per 100. Not enough, but still the best we got. The US average for all 50 states is a weak but improving 5,000 tests per million.
Texas is 4th worst among all the most heavily affected states in this pandemic, number 22 out of 25. It is virtually tied with Georgia as the worst in the entre South among the seriously affected. The Texas COVID-19 testing rate is only 55% of the whole US average.
What this means is that Texas is flying half blind in the teeth of a raging epidemic. It doesn’t know where it is, where it is going, what to avoid, or how to get there. It is playing craps.
Now Louisiana has been hit hard by the Virus. But we instituted hard control measures early on, the same week the first case was found. And our testing rate is the second best in the entire country, behind New York, but ahead of Washington, Massachusetts, and New Jersey. Our testing rate is also 5 times that in Texas. Say it again. 5 times greater. That means we have better eyes on the problem, a better handle on what to do, how to distribute our limited medical and support resources, and how to protect and defend our citizens in this public health crisis.
Don’t make me laugh. Texas ought to spend whatever public safety resources it has on finding and fighting the intra-state Texas epidemic, instead of wasting time and energy on border crossings with Louisiana. The Virus has already passed through every porous Texas border, north, south, east, and west. Long since.
The reluctant Texas Governor finally agreed to a Stay At Home order as of April 2, but non-essential businesses are still open. Days late, thousands of cases short, millions of dollars in future heath and economic damage already baked in.
Do early public health measures matter? Here is the latest IHME model data from April 5, for the resource demands and likely peak dates for Texas, Louisiana, and Florida. A picture is worth….
Texas and Florida have at least two more full weeks of increasing pain and loss to come. By the models (God Willing) Louisiana has now seen the worst growth and is declining. We will still have too many more sick and dying, but our predicament is getting better.
For those interested, the IHME models all have the worst day for deaths expected 1 day after the peak medical resource use.
Texas and Florida can’t even see over the Hump.
Hard and Early, Feel the Pain. Lax and Late, Pay the Price.
For the next two weeks or so, would you rather be in Louisiana, even with our New Orleans tragedy, or in Texas waiting for the hit, that is even assuming all the Texas residents decide to abide by the Stay at Home Order?
To Be Seen, Amigos.
Like I said. A Texas Size Dose of Stupid.
Not even Willie Nelson can make this cock-up better.
Selected Sources on the Lambeth House Outbreak in New Orleans (March 2020):
https://www.nola.com/news/coronavirus/article_fed9538e-6b70-11ea-827f-db045f504c38.html
https://www.nola.com/news/coronavirus/article_eb545a58-657a-11ea-9e78-bf3b9395d66f.html
https://www.nytimes.com/2020/04/06/world/coronavirus-live-news-updates.html
From the New York Times Daily Updates on COVID-19:
Amid quarantine orders, highway checkpoints appear along some state lines.
As stay-at-home orders have spread across the United States, checkpoints have appeared along some state lines, where certain visitors are being told to quarantine for 14 days.
Governors in Rhode Island, Texas and Florida have ordered some drivers coming from out of state to be stopped at the border and reminded of the quarantine requirement. No state has blocked drivers from passing through on their way to their final destination. Some municipalities have added checkpoints and restrictions of their own.
Texas set up checkpoints on its border with Louisiana on Sunday to screen people for the coronavirus, widening the scope of a mandatory quarantine order for visitors from one of the country’s emergent hot spots, the authorities said.
Photos of the checkpoints appeared on the Facebook page of the Louisiana State Police, which advised travelers to exercise caution and remain alert for traffic congestion in a post mentioning the enforcement measures. The post said commercial traffic would not be obstructed.
The screening measures came a week after Gov. Greg Abbott of Texas expanded a mandatory 14-day self-quarantine for travelers arriving from Louisiana, as well as air travelers from a number of other states and cities. The Texas Department of Public Safety said Monday that it was increasing its presence along the Louisiana border, where troopers had set up roadway screening stations to gather required forms from road travelers.
The steps taken by the Texas authorities recalled an order last month by Gov. Gina Raimondo of Rhode Island, who ordered checkpoints in her state that singled out vehicles with New York license plates to enforce a similar quarantine.
Some two weeks after Marie Margolius, 27, drove from her apartment in Brooklyn to a family home in Middletown, R.I., to stay with her family, the National Guard dropped by.
The family cars, all with Massachusetts license plates, were parked in the front yard. The officers took notes of the family members’ names and date of arrival into town and instructed them to continue self-isolating.
“It felt surreal seeing these men in uniform, wearing masks, knocking on doors in an effort to get a handle on who’s here,” she said. “But it made me feel safe. The fact that they are attempting to really understand the situation in our community was sort of comforting.”
From Reuters on the Florida Checkpoints
True claim: Roadway checkpoints established at Florida-Georgia state line in response to coronavirus
Videos posted on social media make the claim that state troopers have set up roadway checkpoints at the Florida-Georgia state line. The posts on social media make the further claim that this was done in an effort to respond to the coronavirus.
One user who uploaded video footage of roadway traffic wrote, “apparently checkpoints to stop people from hotspot locations from coming into Florida…”
Different iterations of this claim say that the location of the checkpoint in the video is on the south-bound lanes of Interstate 95, which Reuters confirmed as plausible by geolocation (St Mary’s river and shoulders labelled “agricultural check points” off the I-95 can be seen here.
The claim is mostly accurate. On March 27, 2020 Florida’s Republican Governor Ron DeSantis issued an executive order directing the establishment of checkpoints on roadways entering the state.
A press release by the state’s Department of Transportation on the enforcement of the governor’s executive order states:
“Effective immediately, motorists who are traveling from areas with substantial community spread including Louisiana, New York, New Jersey and Connecticut, will be required to isolate for a period of 14 days upon entry to Florida or for the duration of their visit, whichever is shorter, and should be prepared for additional monitoring by DOH to help mitigate the spread of COVID-19. Executive Order 20-86 does not apply to persons performing military, emergency, health or infrastructure response, or persons involved in any commercial activity, including individuals that live in Georgia and commute to work in Florida”.
The document also states that incoming travelers will be required to complete a traveler form with contact information and trip details.
Florida’s Department of Health confirmed over 6,000 coronavirus cases statewide as of March 31, 2020.
VERDICT
True: An executive order by Florida Governor Ron DeSantis has established roadway checkpoints at state lines to combat the spread of coronavirus. Motorists coming from areas with “substantial community spread” are required to isolate for 14 days (or for the time of their visit, if shorter) and are required to give contact and trip details.
This article was produced by the Reuters Fact Check team. Read more about our fact checking work here .
From the Lambeth House website (April 6, 2020):
Our Retirement Community in New Orleans, LA
“A great place to live … like being on a cruise!” – H.C.
Lambeth House retirement community is located in Uptown New Orleans along the scenic crescent of the Mississippi River. Our 12-story main building is comprised of 118 independent living apartment homes.
Upon entering Lambeth House, on the first floor, you will find a variety of elegant spaces for use by our residents. A formal dining room, a cozy and ample library, a card room, a business office and a gracious parlor for entertaining are just a few of the many comfortable spaces for our residents.
The first floor of our new expansion reflects Lambeth House’s progressive approach to healthy aging. The Wellness Center at Lambeth House, the only one of its kind in this region has over 21,000 square feet of space dedicated to areas that promote wellness of the mind, body, and spirit. It includes a fitness center, art studio, interfaith chapel, meditation room, casual dining Café, and salt water pool natatorium.
Our retirement community campus also includes St. Anna’s at Lambeth House, which is comprised of 56 private nursing care residences. Additionally, we offer 15 secure memory care rooms and 61 beautiful assisted living apartments with a wide array of floor plan options.
In one of Nature’s crueler jokes, sometime soon, the Lambeth House IT folks might want to rethink the cruise analogy praise from H.C.
Thanks for the great reporting from the Houston Chronicle and the San Antonio Express News below.
From the Houston Chronicle:
The Texas City nursing home where more than 80 residents and employees have tested positive for the coronavirus was recently cited for failing to provide a safe and sanitary environment for its residents and the public.
At the Resort at Texas City, 83 residents have been confirmed to be infected with COVID 19 — the apparent largest cluster in the Houston region. The outbreak was traced to March 28, when an employee tested positive for the virus, leading the Galveston County Health District to test 146 residents and employees in partnership with the University of Texas Medical Branch at Galveston.
Experts said the Resort’s inspection violations, all of which were deemed “corrected” a month later, are symptomatic of a larger problem when it comes to health and sanitary practices of long-term care facilities, as well as lax regulatory oversight.
Infection control failings at nursing homes across the country are remarkably basic — such as staff not properly washing hands, which happens to be the primary way coronavirus spreads, said Richard Mollot, executive director of the Long Term Care Community Coalition, a nonprofit advocacy organization for long-term care facilities.
“Things that pretty much every 8-year old knows is what we’re talking about here,” Mollot said. “It really comes down to extremely poor enforcement of those standards. They know they can get away without following the protocols and they do. They’re sent a message by the state and the federal government that those things are OK.”
It is not yet clear how the virus was introduced at the 135-bed nursing home. The Galveston County Health District declined to give a breakdown of how many residents and employees tested positive, nor did it give an exact number of hospitalizations out of this group.
Philip Keiser, the county’s local health authority, said at a news conference Friday evening that he suspects the mass infection at the Resort came from multiple part-time employees who may have unknowingly carried the coronavirus with them from other long-term care facilities they worked at in Galveston County.
When asked if the nursing home could have prevented the coronavirus outbreak, Keiser said he believed they were largely a victim of “bad luck,” and said the health district was more focused on testing and isolating coronavirus-positive residents and employees than scanning inspection reports for red flags.
“When we did visit there, we found the staff to be on top of things, they’ve been following all of the (Centers for Disease Control and Prevention) guidelines, we found them to be professional and caring and doing everything that they could,” Keiser said.
But federal reports indicate that the Resort was falling short of health and safety standards even before the outbreak occurred. The facility recently received the second-lowest possible ratings — 2 out of 5 stars — for health and fire inspections, staffing levels and quality of resident care. Experts called the violations a symptom of what experts say is a larger problem when it comes to health and sanitary practices of long-term care facilities, as well as lax regulatory oversight.
The reports documented incidents where Resort staff failed to exercise proper sanitation and infection control measures.
A report from July cited the nursing home for failing to maintain mechanical and electrical equipment in safe operating condition, specifically noting two industrial washing machines that were not kept in proper working condition.
“This failure could place all residents who had their clothes laundered by the facility at risk of infection from not having their clothes properly cleaned and sanitized,” the report said.
In the same report, the nursing home was cited for failing to store, prepare, distribute and serve food in accordance with professional standards, as well as stained ceiling tiles and dirty air-conditioning units that “placed (residents) at risk of an unsafe environment and decreased quality of life.”
The Resort at Texas City administration has not released any public statement since the initial outbreak at the facility was first reported Wednesday. A woman who answered the phone at the facility Saturday hung up on a reporter several times before declining to comment.
Amanda Fredriksen, state director for advocacy and outreach for AARP in Austin, said Texas regulations allow facilities with violations that “cause actual harm” to residents — the violations at The Resort were deemed “minimal harm” — to correct them to avoid paying a fine. If the violation hasn’t been corrected within 2 years, the facility can charge them triple the penalty.
“I have no idea how often (penalties for failing to correct) happen, to be quite frank,” Fredriksen said. “I think it probably doesn’t happen very often because there’s always more (violations) to find.”
Nursing home staff working at multiple facilities have also proven to be vectors for coronavirus infections. In Washington state, CDC officials found that staff members who worked while sick at multiple long-term care facilities contributed to the spread of coronavirus among vulnerable elderly in the Seattle area.
“It’s a real worry. Even if you’ve got a facility that is just being as vigilant as they possibly can be, if they can’t control what happens when the staff leave their facilities, they can only control what happens when they try to come back,” Fredriksen said.
The Galveston County Health District on Friday issued a public health order requiring all long-term care facilities in the county to prohibit workers at facilities with positive coronavirus residents from working at other long-term care facilities. The county is also committing to eventually test residents and employees at all of its long-term care facilities for the coronavirus.
Across Southeast Texas, however, Galveston County’s nursing home restrictions are an outlier.
While almost all Houston-area counties are restricting nonessential visitors from accessing long-term care facilities, some of those county officials detailed a more reactive approach to battling the coronavirus in those places. Among the counties that responded to requests for comment — Harris, Liberty, Brazoria and Waller — none intends to conduct more widespread testing at nursing homes.
The Department of State Health Services, which acts as the local health authority for some counties in the state such as Waller, has not found a need for widespread testing at nursing homes in counties it oversees.
“It really is driven by the need at the time and the disease investigation,” said Chris Van Deusen, the department’s director of media relations. “That really guides what testing looks like.”
But there have already been consequences to this reactive approach. The Montgomery County judge last Monday issued a shelter-in-place order at the Conservatory of The Woodlands, a luxury retirement community, after at least 12 people tested positive for the new coronavirus. Three elderly men from that community died shortly after the order was issued.
For Larry Edrozo, whose mother, Helen, 87, is a resident at the Resort at Texas City who tested positive for the coronavirus but is asymptomatic, his biggest fear is that her condition will worsen to the point that she might die before he gets to see her again.
Yet Edrozo said he doesn’t blame Resort staff, knowing that the virus is indiscriminate, regardless of how it entered the facility.
“I feel sorry for them,” Edrozo said. “I know they must feel like they’re in a war zone and they’re doing what they can. I recognize the severity of the situation, but I’ll be very upset if I don’t get to say goodbye to Mom.”
One of the greatest tragedies for thousands of American bereaved in the days to come is that they literally won’t get a chance to say goodbye to Mom, Grandpa, Nanny, Brother, and Sister.
From the San Antonio Express News:
A nursing home stricken by a coronavirus outbreak now is at the center of investigations by local and Texas officials, who are gauging compliance with state rules and whether the employees could have spread the virus to other facilities where they also worked.
The Texas Health and Human Services Commission, which helps regulate the state’s nursing homes, is investigating potential violations at Southeast Nursing and Rehabilitation Center, where the outbreak has infected at least 75 people so far and killed one.
Danielle Pestrikoff, an HHSC spokeswoman, said a survey team was examining the nursing home’s infection control practices, screening of staff and service providers, and the use of personal protective equipment.
Local officials are working to test and trace the movements of the facility’s 60 employees, some of whom also work at other nursing homes in the area.
They consider the potential for the virus to spread in such facilities to be so dangerous that Mayor Ron Nirenberg modified his public emergency declaration to prohibit nursing home employees from working at multiple locations.
Officials stressed the outbreak further highlights the urgency of orders compelling residents to stay at home as much as possible while the novel coronavirus continues to spread.
“In case anyone in San Antonio needed a wake-up call about the seriousness of COVID-19 in our community, this is it,” Nirenberg said. “COVID-19 is alarmingly contagious and very insidious.”
At least two of the eight Southeast Nursing employees who are known to be infected might also have worked other jobs. Additional workers who have yet to be tested for the virus have been linked to at least five other facilities.
That number was expected to grow as more staffers from the facility are interviewed, officials said.
Dawn Emerick, director of the Metropolitan Health District, said her department’s staff was still conducting contact tracing from the outbreak to determine all potential exposures.
Workers at other facilities will be tested if they were in close contact with the Southeast Nursing employees, she said. Any residents or staff with symptoms of COVID-19 also will be tested.
While the infections from the nursing home residents pushed San Antonio above 300 confirmed cases of coronavirus on Thursday, Emerick said they do not represent the peak of the city’s outbreak.
“It’s going to feel that way, but that’s not what this is. This is a localized outbreak,” she said. “Because of the rapid spread of the virus among the vulnerable populations, it’s going to feel like that spike.”
The other potentially affected facilities include: Advanced Rehabilitation and Healthcare of Live Oak, the Village at Incarnate Word, Buena Vida Nursing and Rehabilitation, the Rio at Mission Trails and Floresville Residence and Rehabilitation Center.
Initially, the nursing home had told Metro Health officials that some employees had worked at Baptist Emergency Hospital-Overlook and Methodist Hospital | Specialty and Transplant. But they determined after further investigation that no employee had ever worked at the Methodist hospital, and no workers had been employed at the Baptist hospital since early March.
The coronavirus quickly swept through Southeast Nursing, where 67 residents, or about 80 percent of those in the facility’s care, were found to have the virus. One resident who was infected died earlier this week.
It’s not yet known how the virus was introduced there.
A few infected residents were transported to the hospital, and officials said the rest are being isolated from healthy residents in a separate area of the nursing home. Employees with the virus are self-isolating at home.
Across the country, deadly coronavirus outbreaks have slammed nursing homes, which house sick and elderly people who are particularly vulnerable to the respiratory virus.
Patty Ducayet, the state’s independent ombudsman for long-term-care facilities, said she was not surprised to learn of such rapid spread of the virus at a Texas home. Ducayet, who acts as an advocate for residents, said she is readying her colleagues for the worst.
“I’ve been preparing staff ombudsmen around the state that we will learn of many cases and we must brace for significant loss of life,” she said.
Operators of facilities in Texas have had a chance to learn from what has happened in other states, she said. The first major U.S. outbreak of coronavirus was at a Seattle-area nursing home, where dozens died.
Nursing homes already have been instructed to curtail visitation, equip health care workers with protective gear and observe physical distance within the building. Family members should be allowed access to a resident’s room only in end-of-life situations.
Even watchdogs like Ducayet are no longer making in-person visits, she said, “which means fewer eyes and ears are in the building to identify abuse and other problems.”
Because nursing home workers tend to have multiple jobs, she said it was critical for facilities to be aware of where else their staffers may be working.
Workers like certified nurse aides balance multiple jobs out of necessity, Ducayet said, because they often are underpaid and lack health insurance.
While the state investigation will yield more information about potential problems with how the facility responded to the outbreak, Ducayet said the high level of transmission could indicate deficiencies with surveillance and screening for disease, social distancing or infection control.
Federal regulators gave Southeast Nursing one of the lowest possible performance ratings and recently cited it for failing to observe proper infection control standards and medically neglecting a resident.
After learning of those problems, San Antonio officials launched assessments of environmental and infection control procedures at three dozen of the lowest-rated nursing homes in the area.
Toni Viesca, whose 61-year-old sister has been a resident of Southeast Nursing since 2012, was well aware of problems that have been identified at the facility. She and her niece said they have made a litany of complaints about the building’s cleanliness and the quality of care for her sister, who has early onset Alzheimer’s and multiple sclerosis.
They said their family member, who they did not want to identify to protect her privacy, has developed sores after not being regularly bathed, lacks adequate dental care and has a large hernia that has gone unaddressed for years.
A representative with Southeast Nursing did not respond to requests for comment.
Viesca first learned of coronavirus at the facility March 27, when a staff member told her a resident had tested positive for the virus after being taken to a hospital for unrelated issues.
The resident hadn’t returned, the employee said, and precautions were being taken.
On Tuesday evening, she got the call: her sister, who also is a smoker, had tested positive for the virus.
Her sister seemed fine when she called the next morning, Viesca said, but she also didn’t seem to know she was infected.
Although she was already dissatisfied with her sister’s care, Viesca said she does not know where to turn. She is unable to care for her sister, whose infection also would pose a risk to their 90-year-old mother. A transfer to another nursing home does not seem likely during a pandemic, and other facilities soon could be beset by the virus, too.
She hasn’t been able to visit in person since early March.
“I feel completely trapped and helpless, that I can’t help my sister be in a better place,” Viesca said.