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Logistical challenges mean nursing home residents and staff aren’t getting widely tested for the coronavirus yet

Five days after Gov. Larry Hogan announced expanded coronavirus testing and other resources for Maryland nursing homes, the facilities are still waiting for the help. Logistical challenges mean residents won’t get needed tests until later this week, at the earliest.

And for staff — many of whom already may have contracted the virus and are believed to be spreading it asymptomatically — it could be an even longer wait, because nursing homes first have to figure out how to replace any workers who test positive.

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“It’s not as simple as, ‘Let’s just test everybody today,’” said Dr. Gregory Wm. Branch, the Baltimore County health officer.

For example, Branch said, not all staff work the same days or shifts, and there still aren’t enough test kits for all of them.

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A Hogan spokesman said state and local health officials are surveying nursing homes to determine where tests are needed, and how many, for residents. They also are readying teams of nurses Hogan called “bridge teams,” that will help facilities manage and tamp down COVID-19 outbreaks.

“This week, based on the survey of all facilities, that universal testing will commence,” Hogan spokesman Mike Ricci said. “Once they finish their survey of all facilities, and get the bridge teams trained, they’ll fan out.”

But it’s unclear when staff will be tested because facilities first need to develop plans to replace any workers who test positive, said Dr. Nilesh Kalyanaraman, the Anne Arundel County health officer. Many facilities are seeking help from the same staffing agencies, complicating the problems.

“The logistics to do this are not trivial,” Kalyanaraman said.

Nursing homes remain at the epicenter of the state’s coronavirus outbreak, accounting Monday for 18% of confirmed cases and 44% of deaths. There are 16,000 nursing homes residents and 36,000 staff across the state, according to the Health Facilities Association of Maryland, a trade association of more than 200 elderly care providers and related businesses.

The virus is believed to be spreading through the facilities via asymptomatic carriers, leading to at least 525 resident deaths so far.

Branch acknowledged that that spread is likely continuing as nursing homes arrange for nurses, nursing assistants and other staff to replace those who are found to be infected when testing begins.

“If I had testing right today, that would have been addressed, and we’d be testing already,” he said. “I’m not holding off testing waiting for a plan. I’m basically waiting for tests.”

But with such limited testing available so far, the nursing homes must line up new staff — or risk not having enough caregivers. Plus, before they can get to work in the facilities, those replacement staffers must be tested as well.

All workers are meanwhile required to wear protective equipment including masks and face shields, to protect residents from potential exposure.

Joe DeMattos, CEO of the Health Facilities Association, called the state’s role in increasing testing “critical.” Nursing home administrators say a lack of testing has been a major weakness in efforts to contain the coronavirus, along with struggles to maintain stocks of masks, gowns and other personal protective equipment.

Hogan unveiled the plans for broader testing a day after the state on Tuesday revealed the extent of outbreaks in nursing homes around the state. The data, which health advocates and families had been pressing the state to make public, showed that the coronavirus has spread to the majority of residents in some nursing homes.

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Hogan said the state was “going on offense against this virus, attacking it from every angle with everything we’ve got.”

He appointed Col. Eric Allely, the state surgeon of the Maryland National Guard who the governor last week tapped to serve as an emergency safety and compliance officer for nursing homes, to lead the effort to roll out the expanded testing.

The effort also involves gathering enough testing equipment — swabs that are in high demand across the globe — to collect specimens from so many people. The much celebrated tests that Hogan and his wife, Yumi Hogan, negotiated to buy from South Korea are not yet available to local health officials, but could be next week, Kalyanaraman said.

Nursing homes are waiting to learn how it will all work.

“We were told on Thursday that the state was working on a plan and there would be further guidance forthcoming,” said Kevin Heffner, CEO of LifeSpan Network, an association representing 250 senior care provider organizations in Maryland and Washington, D.C. “We don’t have any more information other than what we were told on Thursday.”

And some local health officials are also still seeking details.

“Broader testing may have indeed begun, but locally, we don’t know the criteria for choosing where/how testing teams are deployed,” said Lisa DeHernandez, a spokeswoman for the Howard County Health Department.

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