Over the course of one night, the number of deaths linked to long-term care facilities jumped by 40 to 945, and yet the total count of COVID-19 fatalities in Virginia rose by only three on Thursday.
No explanation was given with the reporting data. For Martha Bryant, whose only surviving triplet son needs round-the-clock skilled nursing care, nothing about the way Virginia has handled the virus in long-term care has been clear and transparent.
Bryant, who tunes in to Gov. Ralph Northam’s virus briefings, keeps waiting for word on when all of the residents of homes will be tested and when there might be a reopening plan. Northam didn’t mention long-term care during Thursday’s briefing. He rarely has since appointing a task force in April, a month into the spread of the disease. As of Sunday, 60% of Virginia’s 1,611 deaths came from nursing homes and assisted living facilities.
"What gets me and actually makes me angry would be when [Public Safety Secretary] Brian Moran could get up there and tell you all about the prisons and they had so many cases at Buckingham and whatever, and Dr. Forlano would get up there and say, ‘Well, we can’t tell you. No we aren’t going to tell you.’ It was like night and day,” she said. Laurie Forlano heads the governor’s long-term care task force.
Bryant said she watched as testing first was scarce and then became available for prisons and then high-risk neighborhoods and meat packers.
“I told the health director at Hiram Davis, your workers are just as valuable as a poultry worker,” she said.
Bryant said she was told this week testing would be done at her son’s home at Hiram W. Davis Medical Center on June 24.
The Virginia Department of Health is expected on Friday to release a reopening plan for nursing homes. The department did not respond to questions about how the reopening would occur or whether weekly testing would be available as suggested by the Centers for Disease Control.
Angela Harvell, deputy commissioner for facility services for the Virginia Department of Behavioral Health and Developmental Services, said Thursday she has not seen the plan.
The department operates Hiram Davis Medical Center, Eastern Virginia Training Center and the state-owned psychiatric hospitals, including Catawba Hospital in Roanoke County.
Bryant hasn’t seen her 26-year-old son, Taylor, since she left Hiram Davis on March 11 following a team meeting about his care.
With news of cases of COVID-19 increasing in the U.S., Bryant said when she got in her car in Petersburg for the long ride to her home outside Lynchburg, she sensed change coming. Within a week, Hiram Davis, like other skilled nursing homes, would be on lockdown, with no visitors allowed.
Hiram Davis isn’t where she wants her son to live.
Taylor Bryant was born 11 weeks prematurely, as was his brother Tyler. Their triplet was stillborn.
The surviving boys were profoundly disabled.
They had lived at the Central Virginia Training Center in Lynchburg, not far from Bryant, until in 2017 the Department of Behavioral Health and Developmental Services moved them — over Bryant’s objections — to the Petersburg campus. The state is under a Department of Justice order to close its training centers and move residents out of institutions and into less-restrictive settings.
But for Bryant’s sons, who need a high level of care, assisted living and group homes were not an option.
Soon after the move, Tyler died and the Justice Department investigated. Bryant said one of the results is that Taylor has a licensed practical nurse or nurse’s aide with him at all times.
Taylor has a tracheostomy in order to breathe. He has spastic quadriplegia cerebral palsy and the intellect of a 9- to 15-month-old child, and he cannot use his hands to ring a call bell, nor can he ask for help.
“He does know me and my mother. He recognizes our faces and he smiles. It’s not like he misses us. He doesn’t cry. He can’t have a conversation with us. But I don’t want to drop out of being part of his life, either,” she said.
Bryant said she has received two pictures of her son during the lockdown.
She asked if Taylor could be moved to the first floor so that she could see him through a window. That couldn’t be done.
Harvell said she didn’t know about Bryant’s request but the facilities had been making accommodations for families with calls, video calls, window viewing and letters.
“I have worked closely with Hiram Davis and Southeastern Virginia Training Center and they have communicated what the options are,” she said. “When I have spoken with the facility directors, the families have been pleased with the outcomes as far as the low number of COVID positives. They are appreciative. They would rather forgo their physical visit in order to keep their individual safe.”
Bryant said she talks routinely with the staff and was told in April a patient had the virus.
She said she became concerned in May when Taylor ran a fever and had a cough. She asked for him to be tested, but was denied.
Bryant said she has called the Crater Health District numerous times, asking them to test all at the facility without success.
She became concerned when she saw the cases rise at Central State Hospital, where Hiram Davis is located, and was concerned about shared maintenance and food staff. As of Wednesday, the 13 state hospitals and homes have had 33 positive cases, mostly of staff. Some have not had any. Central State currently has 11 staff and one resident who are positive, according to the department’s weekly report.
Beginning in May, private nursing homes started reporting cases to the federal government, but assisted living facilities and group homes are under no obligation to make cases public. Virginia claims it is not permitted to identify facilities with positive cases, as state code extends them the same health privacy rights as people.
Harvell said the state facilities have had access to all the testing they have needed, and have followed the guidance offered by local health departments.
She said they would follow whatever guidance the CDC and the Health Department recommend as to who should be tested, and how often, once they reopen facilities.
Walton Mitchell, who served as director of Catawba, now is acting assistant commissioner for facility services.
“We have a recovery unit that is looking at how to safely reopen all the hospitals and to do that incrementally,” he said.
Much will depend on the facility.
“We care for folks from children and adolescents to, as you know at Catawba, we have geriatric. We have such a range of folks and such a range of vulnerabilities,” he said. “We will have to look at them as separate populations.”
Pushing for answers
Bryant said she doesn’t know what to expect with reopening. She worries about conditions at Hiram Davis and the ability to control infections.
“He’s like in a psychiatric lockdown hospital. He’s literally in a building that was built in 1977. He’s on the second floor and the little windows are these psychiatric-can’t-jump-out-the-window windows,” she said. “He doesn’t even have a sink in his room. He’s on a ward-style hall, the next to the last room. They are carrying basins of water out of those common sinks to 20 people in the hall.”
Bryant said she plans to keep pushing for answers and raising concerns.
“The only way I can put my head on the pillow at night and ever sleep is for me to know I’ve done everything I can do,” she said. “A lot of people talk about when you mourn you need to find purpose. Part of my mourning of the severe disabilities of my sons and the death of one of my sons is to find purpose as an advocate for better care. So I’ll push if it takes 10 calls to the Health Department. I’m driven to do it.”