How a West Baltimore nursing home has zero COVID-19 infections
https://www.baltimoresun.com/opinion/columnists/dan-rodricks/bs-md-rodricks-0619-20200618-re2obahhbzbddojazrkf65gdoq-story.html
By Dan Rodricks
Baltimore Sun |
Jun 18, 2020 | 2:00 PM
Here’s a key question for the Rev. Derrick DeWitt, director of the Maryland Baptist Aged Home in West Baltimore, a 100-year-old nursing facility that has had no coronavirus infections: What was the moment you realized the threat was real and that you had to take action to protect your residents and staff?
“Right after President Trump said we had 15 cases and it would soon be down to zero.”
I dare not put words in a Baptist minister’s mouth, but it sounds like he listened to what the President of the United States had to say, then decided just the opposite would be true.
“It does sound like that,” Reverend DeWitt agreed.
Trump, of course, has lied or made misleading statements thousands of times. So, by the fourth February since his inauguration, none but the Trumpiest would take seriously his prediction for coronavirus.
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“When you have 15 [cases], and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done,” Trump said at a White House briefing on Feb. 26.
Of course, the U.S. death toll from COVID-19 has surpassed 117,000. An analysis of state data by The Wall Street Journal puts the number of deaths in nursing homes and other long-term care facilities at close to 50,000. In Maryland, the state says there have been 12,168 cases and 1,830 deaths at elder care facilities. As the Sun reported earlier this week, that’s about one in five positive tests and nearly two-thirds of the deaths since the pandemic hit the state.
None has occurred at the Maryland Baptist Aged Home on Rayner Avenue in West Baltimore, according to the Sun’s database of nursing home cases.
That’s because, in late February, after hearing from Trump, DeWitt believed the country faced a deadly threat of unpredictable scope. He took immediate action.
“The first thing we did was eliminate all visitations,” he says. “So family, volunteers, the church people who visit were all told they could not visit. It wasn’t too popular at first, but they understood it was for the safety of the residents.”
The Maryland Baptist Aged Home, established in the segregated-by-ordinance Baltimore of 1920, is considered the oldest African American owned and operated nursing home in the state. It has 30 residents and 21 full-time and 19 part-time employees. It is governed by the United Baptist Missionary Convention. DeWitt, pastor of First Mount Calvary Baptist Church in Sandtown-Winchester, has been chief financial officer and director of the home for seven years.
His first hire after taking the job was a nurse who specialized in infection prevention and quality control. That nurse, Nioca Osbourne, established protocols for dealing with infections and trained the staff.
“So we already had procedures in place for dealing with infections,” Reverend DeWitt says. “The next thing we did was eliminate residents going out unless it was for a crucial medical procedure. All employees who were not involved in direct care were told to stay home and work from there if they could. I personally have not been [inside the nursing home] for 11 weeks.”
The home stocked up quickly on extra masks, gloves and gowns. DeWitt scheduled his janitors so that the nursing home received thorough cleanings day and night. He asked each staff member involved in the care of residents to limit travel and contact with their family members. On reporting for work, staffers had to fill out a questionnaire about their outside activities and health conditions. “And we took their temperature three times a day,” DeWitt says.
Masks were dispensed to all the residents. Community meals were eliminated, and residents ate in their rooms. Employees were provided food so they would not have to go out for lunch or dinner. Rooms with one television and two residents got a second TV to help meet social distancing.
The nursing home hired an extra activities coordinator to visit with residents, coach them through daily exercises, play board games with them or take them for walks. This was particularly important because, says DeWitt, up to half of his residents have no relatives who visit them, and he was concerned they would feel even more isolated during the pandemic.
DeWitt and his staff did all this before seeing directives from government agencies. “We didn’t wait for guidance from the Centers for Disease Control or from the Maryland Department of Health or from Baltimore City,” he says. “We did what we thought was prudent at the very beginning of the pandemic.”
He gives credit for a team effort to the nurses and their assistants, the nursing director, Josephine Mungin; the home’s administrator, Johana Walbourn; the medical director, Dr. Narender Bharaj; the janitorial staff, dietician, food staff, social worker and therapists.
DeWitt says there will be no changes any time soon, no loosening up of the restrictions he put in place in February and March. Like many of the health professionals he listens to, DeWitt thinks it’s too soon for that for his vulnerable residents.
“But we have allowed porch visits,” he says. One at a time, residents are allowed to come out on the nursing home porch and speak to relatives on the sidewalk 12 to 18 feet away.
“My own aunt, Aunt Gerri Alston, is a resident,” DeWitt says. “She came out on the porch and cried. She was happy to see us.”
