The Holly Center on Maryland’s Eastern Shore is similar to a nursing home in many respects. Most of those who live at the state-run facility for people with developmental disabilities in Salisbury are over age 60, and all of them have underlying medical conditions — a combination of factors that makes them particularly vulnerable to the coronavirus.
But as Maryland hurries to offer universal COVID-19 testing in nursing homes, the state health department is providing inadequate testing and protective equipment at its 11 mental health facilities, including the Holly Center, according to the union representing many workers at the facilities.
“In the back of our minds, we’re terrified [patients] are going to start showing symptoms,” said Marguerite Warner, a nursing assistant and the union shop steward at Holly Center. "We don’t want to watch them die.”
Maryland reported 88 cases at its state-run hospitals as of Wednesday. But due to the lack of testing and protective equipment, union President Patrick Moran said officials are under-reporting the number of cases and putting both state employees and patients at risk.
Maryland lawmakers also have raised concerns about a lack of protective gear at the state facilities.
In a letter to the state health department, House Speaker Adrienne Jones, Baltimore Del. Maggie McIntosh and Howard County Del. Shane Pendergrass wrote that “we continue to hear from essential personnel at State hospitals and the Department of Health that they do not have the proper protective gear, including gowns and masks, despite them being available in the private sector."
The American Federation of State, County and Municipal Employees Chapter 3, which represents 25,000 state workers, is demanding 50,000 tests for workers and patients in state hospitals; additional gloves, masks and other protective equipment; agency- and workplace-specific coronavirus response and prevention plans; hazard pay and other measures.
Amid a national testing shortage, Maryland is working to roll out expanded testing for “certain highly affected areas of the state, that include nursing homes and poultry-industry affected areas on the Eastern Shore,” said Ebony Wilder, a state health department spokeswoman.
The health department “plans to expand its testing efforts as the testing infrastructure improves,” Wilder said in an emailed statement.
In the meantime, she said, Maryland has instructed all health care facilities to follow guidance from the U.S. Centers for Disease Control and Prevention — including a recommendation to consider allowing workers to use masks and other personal protection “beyond a single patient contact” to conserve supplies.
In their letter to the health department, the legislators asked for specifics, including the amount of personal protective gear on hand at Maryland-run hospitals, whether the state had deployed machines to clean gear for those employees, if staffs had been asked to reuse masks and gowns, and if there were contracts in place to get more supplies.
The health department has not responded to those inquiries, a spokesman from Jones’ office said.
At the Holly Center, where concerns about the coronavirus followed a particularly nasty flu season, mask rules have been reversed in the past two months, the union says.
Workers were prohibited from wearing face masks until as recently as late March — and one employee was even sent home without pay for refusing to work without a mask, Warner said.
Wilder denied that, saying no staff member was forbidden to wear a mask or sent home without pay for refusing to remove one.
Following CDC guidance, the state implemented masking requirements on April 6, Wilder said.
Employees are now being provided surgical masks — not N95 respirators — and are required to reuse them for seven shifts in a row before supervisors will issue them a new one, Warner said.
So, after each eight-hour shift, she removes her mask, places it into a plastic bag and hands it back in.
The seven-day reuse order was based on initially limited supplies, and workers whose masks become soiled or otherwise unusable have been told they will be issued a new one, Wilder said.
Holly Center workers want to protect themselves, of course, but their bigger concern is for the vulnerable patients in their care, Warner said.
“The real thing is we don’t want to carry it in to them," she said. "They are a population that could not survive it.”
Other state-run hospital facilities have seen issues amid the pandemic, too.
Following a COVID-19 outbreak at Clifton T. Perkins, Maryland’s maximum-security psychiatric hospital in Jessup, officials stopped testing patients on three wards, presuming any patients with symptoms to have the acute respiratory disease, according to an April 7 internal bulletin obtained by The Baltimore Sun.
“There will be no further testing on 4N, 3S or 3N per Howard County Department of Health," the bulletin said. "Any symptomatic patients will be considered presumptive positive.”
The state has reported 15 staff cases and 14 patient cases at Perkins. The Howard County Health Department, which runs Perkins with the state health department, did not respond to a request for comment.
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Moran called the state health department’s coronavirus response “a total and complete failure” at its hospital facilities.
“As medical experts, they should have been leading the charge on this thing,” Moran said. “They failed on the guidelines for [personal protective equipment], they failed on providing PPE, and they have failed on protecting their own employees and the people they are responsible for that are under their care.”
Workers face a lack of communication from supervisors about the state’s strategy to keep them and their patients safe and healthy, Warner said.
“We don’t know what the plan is at the Holly Center,” she said.
The state-run hospitals aren’t AFSCME’s only concern. The union also represents corrections officers at Maryland prisons, where more than 200 cases of the new coronavirus have been confirmed, according to the Department of Public Safety and Correctional Services.
“Seventy percent are your own employees,” Moran said. “But there’s no rush to test there. No priority. No testing whatsoever. It’s all talk, and there’s no plan.”
Baltimore Sun reporter Hallie Miller contributed to this article.