As health care facilities step into the next chapter of the pandemic following last week’s declared end of the federal COVID-19 public health emergency, they’re continuing to track public health data — but with fewer resources. Despite changing reporting metrics, health officials say, the pandemic is far from over.
Although the state and Whatcom County have seen a recent downward trend in COVID-19 cases, patients in long-term care facilities remain at higher risk of infection, said Dr. Amy Harley, co-health officer with Whatcom County Health and Community Services. Long-term care patients and those over age 65 also experience disproportionately high mortality rates.
According to the Washington State Department of Health’s May 3 COVID-19 monthly long-term care report, 65,678 cases and 4,805 deaths have been associated with long-term care facilities in the state since the onset of the pandemic, representing 3% of total cases and 30% of total deaths.
“Long-term care facilities do tend to be at higher risk if they get infected, and then also at higher risk of becoming infected because [they] tend to be these congregate settings,” Harley said.
The monthly long-term care report is just one resource that’s ending along with the federal public health emergency. Health authorities will now shift from reporting all recorded COVID-19 cases to focusing specifically on deaths, hospitalizations and emergency department visits.
As of May 10, testing data is no longer available on the Washington State Department of Health COVID-19 dashboard, due to an increase in at-home testing and decrease in reported tests that make the data less useful than it was at the beginning of the pandemic.
Over the course of the pandemic, many of these now-disappearing resources have informed practices at long-term care facilities such as Alderwood Park Health and Rehabilitation of Cascadia, located in Bellingham’s Birchwood neighborhood.
When the state’s mandate on masks in health care settings ended April 3, Alderwood Park looked to Center for Medicare and Medicaid Services (CMS) for masking guidance based on county positivity rates, said Zendi Meharry, director of clinical operations at Cascadia Healthcare, Alderwood Park’s umbrella organization.
Because Alderwood Park has had no reported COVID-19 cases since the mask mandate ended, the facility has made masks optional, but continues to encourage symptomatic residents and caregivers to cover their faces. COVID-19 testing is also no longer universally enforced. As CMS guidelines and county testing data fall to the wayside, the facility will rely on other information to align itself with health jurisdictions’ recommendations.
Meharry said Alderwood Park will adapt its policies as necessary in the case of an outbreak, and will continue to track Centers for Disease Control and Prevention national trends for severe respiratory viruses, weekly COVID-19 hospital and emergency department data and voluntarily reported testing data.
Other health care providers are adjusting similarly.
PeaceHealth St. Joseph Medical Center initially dropped its mask requirement in April in accordance with state guidelines, but reinstituted masking of caregivers involved in direct patient care and of visitors in emergency department waiting rooms and patient rooms after other facilities in its network reported outbreaks, Bev Mayhew, a senior director of marketing and communications for PeaceHealth, said in an email.
PeaceHealth is also continuing to monitor CDC, state and county information for updated community COVID data.
“Our goal here is to keep patients safe, and to help them recover to their pre-hospital state or as close to that as possible,” said Cedar Anderson, nurse manager at the St. Joseph Medical Center intensive care unit. “And if we have to take added precautions in order to do that, then we’ll take added precautions to do that. I mean, that [is] what the medical field does.”
While some reporting metrics and policies are changing post public health emergency, Meharry said many of the precautions now associated with COVID-19 response were already woven into health care practices long before the pandemic. Moving forward, Alderwood Park will continue education on proper masking, physical distancing and handwashing, as well as vaccinations, which remain the best defense against COVID-19.
“For nursing homes, we have done surveillance for infection control and prevention processes forever, that’s part of our natural process,” Meharry said. “The two things that we’re left with is truly managing when to increase source control measures and, secondly, the continued education process.”
Stepping out of the public health emergency, health officials seem to agree that these continued efforts play a crucial role in the fight against COVID-19.
“Though the public health emergency is over, the pandemic is not over,” said Washington State Department of Health Chief Science Officer Tao Sheng Kwan-Gett in a media briefing earlier this month. “We have vital tools such as testing, vaccines and medications to help keep our community safe and healthy, and our challenge now is to use these tools and work together to protect the elderly and the most vulnerable in our communities.”
