In one of the largest known coronavirus outbreaks in the country, 129 residents and 41 staffers at a Northwest Baltimore nursing home have tested positive for COVID-19 infection, officials with the city and the home’s operator confirmed Wednesday.
The FutureCare Lochearn facility reported its first confirmed case March 31, Baltimore Health Commissioner Dr. Letitia Dzirasa said, and as of Tuesday morning, 35 infections had been reported there, state officials said. FutureCare officials said they had been following guidance to restrict visitors and require staff to wear protective equipment.
FutureCare discovered that the outbreak had exploded through Lochearn when it decided to conduct what’s known as “widespread surveillance testing" of both symptomatic and asymptomatic residents and staff. A FutureCare spokeswoman said the company sought out the testing out of concern that the facility’s population of 200 residents was especially vulnerable because it is in an area with some of the highest numbers of COVID-19 infections in the state.
Most of the residents were not showing symptoms linked to coronavirus infection, and still are not, FutureCare spokeswoman Holly O’Shea said in a statement. But nursing home administrators “felt strongly that it was important to know who was carrying the virus, even if they didn’t present specific COVID-19 symptoms, to mitigate its spread and protect our staff and residents,” she said.
In most nursing homes and other health care settings, asymptomatic people are not being tested for the coronavirus because of a scarcity of testing materials and backups in labs.
“This type of surveillance testing is unprecedented and can save lives,” O’Shea added.
It was not immediately clear when the facility conducted the widespread testing. O’Shea did not respond to questions about the timeline of the outbreak.
With 170 total cases at FutureCare Lochearn, the cluster appears to be the second-largest in the country tied to nursing homes, behind only the Soldiers’ Home in Holyoke, Massachusetts, where 194 people have contracted the coronavirus, according to data collected by The New York Times. It is the eighth-largest known coronavirus cluster in the country, behind only outbreaks on an aircraft carrier, in jails and prisons, and at a South Dakota pork processing plant, according to the data.
It surpasses the total at Pleasant View Nursing Home in Carroll County, where 82 residents and 39 staff members have tested positive for COVID-19. Twenty-four Pleasant View residents have died.
In a statement provided by FutureCare, Dr. Morgan Jane Katz, an infectious disease specialists at Johns Hopkins Medicine and assistant professor in the Hopkins medical school, said the company is “one of the only facilities” in Maryland that proactively pursued universal testing of residents and staff, and therefore the spread of the virus at Lochearn appears more extreme than elsewhere.
"We likely do not have a sense of how widespread this infection is in many nursing homes because most are not testing asymptomatic residents,” Katz said. “If facilities do not test, their numbers will be lower. This does not mean that the COVID-19 is not there.”
COVID-19 infections have now been reported in nearly two-thirds of Maryland nursing homes — 145 of 226 facilities, according to state officials. The Times reported Tuesday that coronavirus infections have been reported in 2,500 nursing homes and long-term care facilities across the country, with 21,000 people infected and 3,800 killed.
That includes another FutureCare facility in Baltimore, its Cold Spring center in Lauraville, where at least five people tested positive for COVID-19 earlier this month. That included both residents and staff, and at least two people were hospitalized.
City health officials are assisting FutureCare, Mayor Bernard C. “Jack” Young said. And state officials said FutureCare notified them of the outbreak Tuesday night, and Wednesday morning requested a nursing home “strike team" to help manage the situation. The state sent a team to the facility that includes members of the National Guard, emergency medicine clinicians, and doctors and nurses from local hospitals, officials said.
O’Shea said FutureCare is working with partners at LifeBridge Health and Johns Hopkins Medicine, and that the company’s “highest priority continues to be the safety and well-being of our staff and residents.”
Under state and federal guidelines, patients who have tested positive for coronavirus are to be segregated from those who test negative.
Many residents of the facility share rooms. According to state data, it has 40 private rooms, 74 semi-private rooms with two beds and four rooms with three beds. O’Shea said no rooms have more than two residents.
Health workers are required to follow strict protocols when caring for infected patients, including wearing gowns, masks and face shields. Under an order Gov. Larry Hogan issued last week, all care providers must wear masks at all times in nursing homes.
That order aimed to prevent the spread of the virus through staff members who aren’t showing any symptoms of COVID-19 illness, as happened in the outbreak at Pleasant View in Carroll County.
Dzirasa said the outbreak offers a reminder of the dangers of asymptomatic transmission.
“It is safe to assume when we go places, we may come in contact with people not showing symptoms,” she said.
The nursing home is in the 21215 ZIP code, which for days has reported the highest number of cases of any ZIP code in Maryland.
It serves patients on hemodialysis and provides both short-term rehabilitation and long-term care, according to its website. It has received “average” ratings from the Centers for Medicare and Medicaid Services for health inspections and evaluations of staffing, and a five-star, “much above average” rating for quality of care.
Dr. Joshua Sharfstein, a former city and state health commissioner now on the faculty at Johns Hopkins Bloomberg School of Public Health, said the FutureCare outbreak demonstrates “the scale of the challenge” of protecting nursing home residents while work to study how the virus is spreading in those facilities remains ongoing.
“I think there will be a lot learned from this outbreak that could help with understanding the risks we may not have fully appreciated,” he said.
Baltimore Sun reporters Talia Richman and Luke Broadwater contributed to this article.