Gov. Jim Justice has asked all nursing homes in the state to restrict visitors to patients, except to those who are experiencing life-ending or very serious illness. He announced this Thursday afternoon during a press conference on measures the state is taking to minimize the spread of coronavirus once it arrives here.
Older residents are among the most susceptible, he said. People over 60 need to be concerned and avoid big gatherings, he said. For those 80 and up, it’s especially dangerous. Children can carry the disease and not know it, and spread it.
Along the same lines, Justice said the state is recommending that all West Virginians at the highest risk of having complications, including seniors and those with chronic health problems, avoid contact with large crowds, especially places without good ventilation.
Nursing homes
Annaliese Impink, spokeswoman for Morgantown Health and Rehabilitation Center, said they are now restricting visits to only essential vendors, suppliers and outside health care professionals. “Those individuals will have to be screened before each visit. We are allowing limited visitation for residents who are on hospice, are at the end of life, for residents or patients with significant psychosocial or clinical needs where participation by a visitor is needed, or when there is a need to complete admission paperwork or to complete medical authorizations.”
The situation has been changing rapidly, as illustrated by Sundale Rehabilitation & Long Term Care. On Wednesday, Donna Tennant, Sundale’s admissions and marketing director, said, “We’re taking precautions to keep the virus out of the facility.”
They weren’t restricting visitors but were asking them that if they had signs or symptoms of any cold or virus not to come. Sundale was having all visitors sign in and notify it of any contacts with anyone with a virus, or of travel to states or countries that have had coronavirus outbreaks. They planned to start taking the temperatures of all visitors and staff.
But on Thursday, Sundale posted this on its Facebook page (Tennant could not be reached late in the afternoon): “Per Governor Justice’s news release on Thursday, we are restricting visitors until further notice except in the event of an end-of-life-situation.”
A spokeswoman for Encompass Health Rehabilitation Hospital of Morgantown did not respond to phone messages placed Wednesday and Thursday.
Hospitals
At the hospital level, Mon Health System said it is following CDC guidelines “and the need to protect our patients. The current recommendation from the CDC is to limit visitors both in hospitals and long term care facilities to limit the risk of introducing any infectious agents into our facilities.”
Mon Health has posted signs at its facilities with several instructions. The sighs say that anyone with respiratory illness symptoms including fever, cough, shortness of breath or difficulty breathing, or who has traveled outside the country should notify registration or clinic staff.
Visitors with symptoms are asked to wear a mask, cough or sneeze into their elbow or to cover their mouth and nose with a tissue. They should wash their hands or use hand sanitizer after a cough or sneeze or blowing their nose.
WVU Medicine said Wednesday, “We are working on communications regarding visitation and other policies and will share them soon.” It did not reply to a Thursday request for an update but added Friday morning, “We do not release information until we have solidified a plan.”
WVU Health Sciences
However, Clay Marsh, WVU Health Sciences vice president and executive dean, talked in a phone interview about how the planned suspension of on-campus classes following spring break will affect medical and nursing students.
WVU and Health Sciences students have to deal with licensing agencies in their respective professions. So WVU is trying to get directions to students in clinical rotations, explaining that WVU will still welcome them to finish their rotations.
“We basically don’t want any student to interact with any person who is under investigation or is a documented person with COVID-19,” he said. WVU doesn’t want the student to be exposed.
They are working on language, Marsh said, to convey that if the student or their parents feel uncomfortable about completing rotations at this time, they will work to be able in some cases to delay the clinical experience until they know more about the virus or have a better handle on the risks and exposures.
WVU wants students to understand, he said, “If you delay or pause your clinical rotations it may delay your ability to graduate or to fulfill what the licensing groups want from people.”
WVU understands, he said, that certain groups will be leaving on spring break and coming back. In those cases, WVU will work with the county health department to identify where they’re going.
“We’re certainly advising massively against cruising; no cruising, that’s out,” he said. They are also recommending no international travel. But some people will travel abroad and they are trying to get them to register where they’re going. WVU will look at where they’re landing and what they plan to do.
If a student goes to a place with a big cluster of cases, WVU in coordination with the state health department may advise them to self-quarantine for 14 days. If they go to areas without disease clustering, WVU will give them instructions in self-monitoring and if they develop symptoms, ask them to self-quarantine and obtain appropriate testing.
The same goes for international students contemplating trips home, Marsh said. “If we have people here who stay here, we feel more secure than if they leave here and come back here,” considering the state has seen no coronavirus cases to date.
Again, the self-quarantine and testing measures apply.
Residents and fellows who see patients in the hospital and in clinics are employees and don’t take spring break, Marsh said. But do have vacation time. Again, they are trying to deter people from foreign and domestic travel, with the caveat that if they leave the country they may not be able to get back in.
One reason WVU chose to suspend on-campus classes, Marsh said, is the hazard of students bringing the disease back. That could trigger a wave of illness that exceeds the local capability of health assets. Morgantown has high-level healthcare care, but facilities are very full and the workforce is stretched.
“So if a bunch of our health workers get sick, that reduces our ability to compensate.”
Italy failed to take strong prevention measures, he said, and its health system has been overwhelmed. People are in hospital hallways, and according to some reports, some decisions are being made about who should or should not get lifesaving treatments.
So West Virginia and WVU have been doing a lot of advance work to prevent pressure on the health system.
West Virginia, like Italy has a population that leads older, sicker, more obese and smokes. All those increase susceptibility.
“We really want to control the spread … because the spread can kind of go viral if you really don’t pay attention to it.”
Tweet David Beard @dbeardtdp Email dbeard@dominionpost.com
