Third of Cape May County cases, most deaths, were in long-term facilities
By JACK FICHTER/Sentinel staff
CAPE MAY COURT HOUSE – The majority of Cape May County’s COVID-19 cases are residents and staff of long-term care facilities, according to county Public Health Coordinator Kevin Thomas.
The Cape May County Chamber of Commerce hosted a video town hall meeting May 22 on the county’s response to the COVID-19 pandemic.
Thomas and county Freeholder Jeffrey Pierson, who serves as liaison to the health department, fielded questions from the public.
After President Donald Trump’s March 13 declaration of a national health emergency, Pierson directed the county-owned Crest Haven Nursing Home to close to the public and not accept new residents. He said Crest Haven Nursing Home had no residents or staff with COVID-19.
Pierson said employees at Crest Haven were tested every morning and asked a series of questions. If they felt ill, they stayed home, he said.
“All of our employees work for the county of Cape May, whereas many of the long-term facilities here in the county, those people have two jobs or more,” Pierson. “They work in different industries because of the cost of living, etc. and raising families, so they bring a lot in from the outside community into the (nursing) homes and they were not being tested as they came in every day.”
He said Crest Haven was receiving support and supplies from the county Health Department and Office of Emergency Management.
Thomas said the health department tracked all the positive cases in the county and responded through contact tracing with staff nurses. Cape May County has the second smallest number of coronavirus cases in the state, he said. He answered questions submitted by email, chat and phone.
On a question of how has wearing masks, social distancing and hygiene measures enacted by the state and the county had a significant impact on the spread of the virus here, Thomas said it has been effective. As of May 24, the county had 579 cases of COVID-19 with 47 deaths with 33 percent of the cases in long-term care facilities.
“All but 10 of the deaths are in long-term care,” he said.
Thomas said if you subtracted the number of staff members in long-term care facilities that became infected from the total, the numbers are even more positive. He said the numbers were not looking as bad as they were two to three weeks ago.
Contact tracing is the key to stop the spread of the virus, Thomas said.
County Health Department Assistant Director of Nursing Mary Tighe said testing in long-term care facilities was a little slow and difficult to come by at the beginning of the pandemic but testing of residents and staff was now taking place on a weekly basis within nursing homes. She said those testing negative were continuing to be tested to identify those who are positive before they become symptomatic.
Tighe said the health department was in daily contact with the directors of nursing and staff in long-term care facilities concerning positive cases of residents and staff. She said positive staff members are questioned to determine persons they have been in contact with in the community.
Anyone in the community who tests positive is called and asked whom they have been in contact with, in particular close contact, which is considered closer than 6 feet, longer than 10 minutes in a confined area, she said. Tighe said there is minimal spread of the virus from touching surfaces.
“Just walking by someone quickly, that’s not how it’s happening,” she said. “It’s that talking, sharing utensils, someone who lives in your house, those are the people that we identify and then we give them guidance also.”
Along with the positive persons, those exposed are also being asked to stay home for 14 days to monitor themselves for symptoms and if they become symptomatic to contact the health department and their physician and get tested, Tighe said.
She said testing is available even for those not symptomatic at Cape Regional Urgent Care offices, CompleteCare and a few doctors’ offices.
On a question of if the county has enough contact tracers in the event of a spike in cases due to the increased summer population, Tighe said other nurses could be used including those of the Medical Reserve Corps, a nationwide volunteer service.
Thomas said the state was purchasing online software to manage contact tracing and assigning contact tracers to each health department.
He displayed a graph of confirmed active cases by municipality, persons under quarantine. He said Lower Township was displaying 78 cases on May 22 due the number of long-term facilities within its borders, North Cape, Victoria Manor and assisted living centers.
Coronavirus hit Cape May County on March 18 with cases in long-term care facilities on April 5, Thomas said.
“Once it gets into long-term care, it spreads like wildfire and it’s hard to put out,” he said.
A spike of the virus occurred in the county on April 19, according to Thomas. He said the county also saw an increase on April 29. The beginning of May showed a large spike which has gradually started to move out, Thomas said.
He said COVID-19 did not just affect those over the age of 65. Thomas said the county had a good portion of cases in the 41 to 65 year old age group and also ages 18 to 40. “It’s fairly evenly distributed from age 18 on up to and past 65,” he said.
Thomas said 77 percent of the county’s fatalities are in long-term care with 23 percent in the community. There has been little difference in fatalities between men and women, he said.
A question was submitted asking upon reopening of the county, how will vulnerable members of the community be protected such as people of color, the homeless, the disabled, the elderly, those with compromised immune systems and essential workers without health insurance. Thomas said the vulnerable population was the highest priority of the health department.
He said the state and the county Office of Emergency Management were working to address where to quarantine homeless persons; some have been placed in motels. Tighe said vulnerable persons were being connected with the county Department of Aging and Social Services.
Pierson said senior centers were shut down. Those who relied on the senior centers for meals were added to the Meals on Wheels program and it was opened more to the general public, he said.
On a question of if the local hospital could be expanded if cases spike in mid-to-late summer, Tighe said Cape Regional reopened a unit it had shut down a few years ago and the beds have been made negative air flow. She said hospitals in the area communicate and have the ability to divert patients to other hospitals.
“We also have the Convention Center in Atlantic City that the governor had set up with the National Guard and that has an overflow bed capacity, so if we needed that in the summer, we could certainly start diverting patients there as needed,” Tighe said.
Pierson said the county Office of Emergency Management had received close to 100,000 different supplies such as masks and gowns. He said the supplies were shared with first responders.
A business owner asked if an employee states they have had contact with someone who is presumptive of COVID-19 or tested positive, does the employee have to stay home for two weeks, can they get a test and if so, how many days after exposure, should the county be alerted and what are the businesses’ responsibilities not to create a spread in the workplace?
Tighe said as an employer, if an employee calls in and states they have been in contact with a positive case, they will need to isolate for 14 days.
“They should stay home even if they are not sick because this is where we want to stop the spread,” she said. Between six and 11 days after exposure is typically the timeframe in which a person will become positive with the virus, Tighe said. Others may take longer, thus the 14-day quarantine, she said.
“You can have them go get tested, a negative test will only tell them they are negative at that point in time,” she said. “So if they went and got tested on day six and they were negative, they could possibly start developing symptoms two days later on day eight and become positive.”
Tighe said those who isolate for 14 days are asked to monitor for symptoms including fever, cough, sore throat, gastrointestinal problems and loss of senses of smell and taste.
A participant asked how many cases of COVID-19 came from long-term facility staff. Tighe said it was similar to the old “chicken and the egg, which came first?”
She said a lot of the staff members did bring the virus in from the outside. Most of the nursing homes locked down fairly quickly to outside visitors, so it would have been the asymptomatic staff bringing in the virus, Tighe said.
“When you have residents with virus, you definitely have staff with virus,” Thomas said.
He said there was a proportional number that is constant. As the staffing virus goes down, the resident virus goes down, Thomas said.
