Gov. Larry Hogan issued an executive order Wednesday requiring that all residents and staff members at Maryland nursing homes be tested for the coronavirus, regardless of whether they show symptoms.
The governor is also putting a National Guard official in charge of enforcing safety rules at long-term care facilities.
The order requiring what Hogan called “universal testing” was announced during a news conference Wednesday and is part of a strategy to target what Hogan called the “most acute outbreaks, clusters and hot spots of coronavirus” in the state.
“We have been and will continue to take aggressive actions to address the spread of COVID-19 in Maryland nursing homes,” Hogan said at a briefing. “Targeting and containing these outbreaks and clusters is critically important to our state’s recovery efforts.”
The governor said facilities will be prioritized for testing based on the risk of an “imminent outbreak” or what he called a “current rising threat risk.”
Outbreaks or “clusters of cases” of the coronavirus have been reported at 278 different facilities across the state, according to health department data released for the first time earlier this week.
A total of 4,011 confirmed cases are linked to nursing homes or other long-term care facilities — 19% of total cases in the state. The number of deaths linked to long-term care facilities — 471 — accounts for 46% of all deaths in the state.
Hogan also said he is tasking Col. Eric Allely, the state surgeon of the Maryland National Guard, to enforce safety rules at nursing homes. Hogan said he made the move after he grew “increasingly concerned and quite frankly outraged that a few (nursing home) operators are not complying with directives from the state.”
Under the governor’s order, all nursing home residents must be evaluated on a daily basis by a doctor, nurse practitioner, physician’s assistant or registered nurse.
Staff members who test positive will be sent home immediately and directed to isolate, and facilities are required to have “emergency surge” staffing plans in place in case large numbers of staff members are sent home sick.
“With our expanded universal testing, we should expect to see the number of positive cases significantly rise among both nursing home residents and staff,” Hogan said.
In addition, the order makes it mandatory for facilities to fully comply with “strike teams” that are deployed by the state department of health to respond to outbreaks.
The teams, which are made up of members of the National Guard, health officials, doctors and nurses, were created earlier this month and have “successfully responded to serious outbreaks and growing threats” in 84 facilities since then, Hogan said.
The state is also now rolling out “bridge teams” to help provide emergency nursing staff for facilities experiencing a crisis. Each team is made up of a registered nurse and five to seven aides with the capability of providing care for up to 100 nursing home residents per shift.
“These team members are all fully vetted and are ready to be immediately deployed statewide,” Hogan said.
Maryland to address poultry plants
Hogan announced actions to address outbreaks of the coronavirus at poultry processing plants.
Hogan said he participated in a call with the White House on Wednesday and other governors that included Delaware Gov. John Carney and Virginia Gov. Ralph Northam.
He said a virus testing site will be opened at the Perdue Stadium in Salisbury, Maryland, to test workers at the Perdue plant there and the Amick processing plant in Hurlock, Maryland.
Maryland now has 262 lab-confirmed virus cases associated with poultry workers. Hogan said state and federal resources are deploying to support the testing.
Hogan on unemployment site glitches: ‘The buck stops with me’
During the news conference, Hogan also apologized for the shaky launch of a new state website designed to handle an influx of unemployment claims from Marylanders out of work because of the coronavirus pandemic.
The BEACON One-Stop application system launched on Friday and crashed several times as it struggled to keep up with heavy volume.
“The IT contractor who developed this site and the Department of Labor have fallen short of the high standards that we have set, and the people of Maryland deserve better. And the buck stops with me,” Hogan said.
He added that the IT contractor has hired hundreds of additional staff to fix the site issues and are “working around the clock.”
“I am going to make sure that they do and that we do whatever it takes to get this straight so that every single Marylander gets every single penny of financial assistance that they deserve,” he said.
Since the launch of the site on April 24, more than 245,000 accounts have been activated, and over 100,000 new claims have been filed, Hogan said.
The site is now handling 33 new accounts every minute, and he said an average of 780 claims are successfully filed every hour.
“But while we have been able to handle this volume better than many other states in the country, it is simply not good enough,” Hogan said.
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Officials in Montgomery Co. respond to nursing home data
Earlier Wednesday, officials in Montgomery County, Maryland, responded to new data showing more than half of the deaths related to coronavirus in the county stem from outbreaks in nursing homes and other long-term care facilities, and described the steps they have taken to stop the spread of the virus.
More than a quarter of all coronavirus cases in the county — 1,043 cases out of a total 4,152 — stem from long-term care facilities, according to Maryland Department of Health data released for the first time Tuesday. About 59% of deaths in the county — 129 deaths out of 218 total — are linked to long-term care facilities.
The number of known cases in the county linked to nursing homes is the highest in the state, and is far higher than in Prince George’s County, which has a higher number of overall cases.
Speaking to reporters Wednesday during an online news briefings, Montgomery County Health Officer Dr. Travis Gayles suggested the high number of cases in the county is due to the number of long-term care facilities.
There are 303 long-term care facilities in Montgomery County, Gayles said. The new data shows there are outbreaks in 47 of them.
“When you look at the numbers stand alone, it can give the inference that we haven’t been actively engaged,” Gayles said. “That’s just not an accurate depiction.”
Gayles said most of the outbreaks in the county’s nursing homes — including the “hot spots” that involve 30 cases or more — date to late March and early April, before the state issued stricter guidance to curb the spread of the coronavirus in nursing homes.
“That was before we had more up-to-date guidance to suggest that a set of individuals who are not demonstrating symptoms can transmit coronavirus,” Gayles said. Up to then, the infection control procedures were focused on things such as directing staff members to stay home when sick and taking staff members’ temperature when they reported for work.
Among the changes that have been rolled out at the state level designed to stop the spread of the virus by asymptomatic people:
- Requiring workers to wear masks at all times inside facilities
- Directing staff to wear personal protective gear, such as gloves and gowns, when dealing with patients
- Isolating residents who test positive
- Making sure there is dedicated staff who specifically work with patients who test positive.
“Since those tougher precautions have been put into place, we haven’t seen a huge level of transmission,” Gayles said.
Last month, the county created its own local action teams, made up of disease control staff and nurses from the county’s nursing home regulatory staff, to handle a “first wave” of cases at nursing homes, Gayles said.
The state health department has also rolled out “strike teams” designed to help facilities respond to outbreaks.
“Even before the state took action in terms of creating action teams, we had those on a local level,” Gayles sad. “And we’ve continued to use those as best as we can to provide the additional support.”
A key focus of the local teams is on contact tracing new infections, Gayles said, especially since nursing home employees often work in more than one facility.
“We’re doing our due diligence now, too, as part of the contact tracing process … to go back and review to see if there were any common denominators across any of the facilities,” Gayles said.
Overall, the state “strike teams” have made nine visits to nursing homes in Montgomery County, Gayles said. Some of those visits have been at the request of the facilities, and some have been suggested by state officials reviewing data, he said.
The Associated Press contributed to this report.