Facing questions about the state’s handling of coronavirus outbreaks at nursing homes, Gov. J.B. Pritzker on Monday pledged to ramp up testing at all long-term care facilities, even those that have yet to report a case.
The governor also said he continues to “think hard” about requiring people to wear masks when they go to the grocery store or other public places. If he follows through, he said, it would be done in concert with other changes to his stay-at-home order, including a possible region-by-region approach to easing social distancing restrictions.
Pritzker’s directive is set to expire April 30, and he’s expected to announce changes to the rules before then. Even so, he indicated Monday that he doesn’t think Illinois has hit its peak yet when it comes to the virus.
The governor’s promise of increased testing at nursing homes came a day after the Illinois Department of Public Health released data showing that roughly a quarter of COVID-19-related deaths in the state can be tied to a long-term care facility.
Acknowledging the “terrible toll” the coronavirus pandemic has taken at nursing homes, Pritzker said the increased availability of needed supplies will allow the state to “more aggressively deploy testing” there.
Illinois had at least 1,860 cases and 286 deaths at nursing homes as of Sunday. To slow the spread of the virus before more large outbreaks occur, the state is now working to test all residents and staff at nursing homes that have yet to report a single case.
“We’re prioritizing testing at long-term care facilities that are home to our populations where COVID infection is more likely to lead to higher-severity cases, especially among black and brown communities,” Pritzker said. The idea is “to identify early the presence of COVID-19 in a facility and isolate those cases before widespread transmission.”
The state delivered testing material last weekend to Paul House and Healthcare Center in the Irving Park neighborhood and Presence Villa Scalabrini Nursing and Rehabilitation Center in west suburban Northlake, public health spokeswoman Melaney Arnold said. An additional 10 homes were scheduled to receive deliveries Monday.
For the 186 nursing homes a state website lists as having reported cases, public health officials are shifting from recommending pre-shift wellness checks to pushing for testing of all staff for the coronavirus.
This will allow public health officials “to determine who is coming in and out of an infected home, possibly asymptomatic, and should instead be home in isolation,” Pritzker said.
But there remains conflicting information about the veracity and accuracy of the state’s online numbers.
On Monday, Pritzker said his administration lists every long-term care facility with a “known presence” of COVID-19. But the website itself doesn’t go that far, listing only places with at least two cases of residents or staffers testing positive.
Other factors could leave nursing home residents, their families and staff with old information.
The state said it pulls figures from two different databases where entries are made hourly by local officials and others.
“The information that we pull out had to have been submitted,” the agency’s director, Dr. Ngozi Ezike, said Monday. “We can only report obviously what we’ve been given.”
She said the agency also releases the previous day’s data, in an effort to ensure accuracy. Regardless, she said, the agency plans to update the nursing home list once a week.
Until the state began releasing figures over the weekend, some people with family members in nursing homes didn’t know whether the facilities had reported any cases of the coronavirus.
Among them was Ken Loredo, who found out about the two dozen COVID-19 cases and seven deaths at Glenview Terrace, the north suburban long-term care facility where his mother lives.
Loredo said he talks to his mother daily. About two weeks ago, she was moved out of her room because her roommate had a fever, he said.
“I was like, ‘OK, well I haven’t heard anything from the facility so maybe they’re OK,’” he said. “Maybe this person is just sick. You know, it happens.”
But with the newly released statistics, Loredo is wondering if those residents were infected.
“If that person that was in her room passed away from that, and my mother was in that room with her, I would have at least expected them, if possible, to let us know: Your mother was in a room with somebody that was positive so we’re going to be keeping an eye on her for a couple of weeks just to make sure,” Loredo said. “But nothing.”
Allen Hollander, an administrator with Glenview Terrace, said the facility has sent out some letters about confirmed cases but not for each one. The facility has been following state and federal guidelines with testing, Hollander said, but also hopes it can get more tests with state help.
“We want to figure out who has it and who doesn’t and separate them appropriately so we know 100%,” he said.
Those comments echoed the frustration of a nursing home lobbying group.
“We’ve been frustrated by the slowness to action when it’s been known from the very beginning that nursing homes would be hit hardest by this virus,” said Pat Comstock, the Health Care Council of Illinois director of COVID response.
The prospect of information that’s out of date worries Rosemary Payne, who said she is seriously concerned that COVID-19 cases have been undercounted.
Payne said she was told by the Chateau Nursing & Rehabilitation Center in Willowbrook that her 94-year-old mother, Mary Kahler, tested negative for COVID-19 last month. Payne, a nurse, listened to her mother with a stethoscope. “She had everything that COVID-19 patients were having,” Payne said.
Rosemary Payne’s mother, Mary Kahler. She died when she was a resident at the Chateau Nursing & Rehabilitation Center in Willowbrook. (Family photo)
Her mother died March 28, but Payne is worried she isn’t counted among the state’s listing of 54 cases and 10 deaths at the facility. “I think, if my mom’s going to die from this, at least count her as a statistic. Give her that much,” she said.
Chateau administrators did not respond to requests for comment.
Increased testing is part of the state’s equation to adjust restrictions, and Pritzker and President Donald Trump continued sparring Monday over the state’s requests for help increasing its capacity.
Pritzker said that on a conference call with governors, Vice President Mike Pence insisted that states have the ability to conduct all the tests they need. But governors said they don’t have all the supplies and manpower they need to run tests around the clock.
“There’s a big difference between testing capacity and getting testing results,” Pritzker said.
At his briefing a short time later, Trump said: “Pritzker from Illinois, did not understand his capacity. Not simply ask the federal government to provide unlimited support.”
Pritzker spokeswoman Jordan Abudayyeh said the governor and his staff don’t watch the president’s briefings “because they are not a source of factual information.”
At any rate, the new information on nursing home cases is another window into how the coronavirus is spreading across the state.
Pritzker said Monday that 4,599 people in Illinois were hospitalized as of the previous day with confirmed or presumed cases of the new coronavirus. That’s a 7% increase from five days earlier.
But without the measures put in place through his stay-at-home order, Pritzker said, projections in mid-March showed the state would have exceeded its existing hospital capacity by 25,000 beds by April 6.
Pritzker provided the update on hospitalization figures on the same day state officials announced 1,151 new cases of COVID-19 and 59 additional deaths, bringing the number of known cases to 31,508 and the death toll to 1,349 since the start of the outbreak.
The number of new cases and deaths reported Monday was down significantly from the records reported in recent days, including 1,842 new cases reported Friday and 125 deaths reported both Thursday and Saturday.
As Illinois hospitals have increased the number of intensive care unit beds, the share occupied by COVID-19 patients has dropped. On April 6, such patients were in about 43% of 2,700 beds. On Sunday, they were in about 40% of 3,100 beds, Pritzker said. The percentage of ventilators being used by patients with the coronavirus has dropped from 29% on April 6 to 23% Sunday as the state has acquired more ventilators.
“We may not have reached our peak yet, but your actions are helping to keep that peak as low as possible,” Pritzker said.
In assessing when some of the restrictions can be eased, Pritzker said he’s looking at one of the suggestions from the White House Coronavirus Task Force. Among other factors, the panel recommends that states not lift stay-at-home orders until the number of cases declines steadily for 14 days.
Pritzker said a region-by-region strategy based in part on hospital availability is being considered as he ponders whether to relax social distancing in an extension of the order, which expires at the end of the month.
“If the hospital capacity in a certain area is quite large and very available, even with coronavirus in existence, then that might be a place where you could do more, right, than some other place,” he said.
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Pritzker noted that there are vast distances between people’s homes in rural areas and said the notion of ordering people there to wear face masks in public outside was different there compared with the “North Side or West Side of Chicago going outside and walking on the sidewalk with hundreds of other people.”
The governor did not give a timeline for updating his order, but he acknowledged there may be modifications.
“We want to keep people safe and also give them the ability to do as much as possible without spreading the virus. So those are the complications,” he said, noting that even medical expert opinion has changed in dealing with the virus.
Chicago Tribune’s Joe Mahr and Rick Pearson contributed.
