A third round of testing is expected to start Thursday at the Providence Transitional Care Center in Anchorage as health officials continue to try to contain Alaska’s largest coronavirus outbreak.
More than 40 of the center’s patients and caregivers have tested positive for COVID-19 so far.
One of the patients died on Sunday, Alaska’s 11th coronavirus-related death. Other patients have been hospitalized with the disease, and one was in very serious condition on Wednesday, said Dr. Michael Bernstein, chief medical officer for Providence Health & Services Alaska, the operator of the center.
“It’s humbling how transmissible this virus is,” Bernstein said in a call with reporters late Wednesday afternoon. “People were doing excellent practices.”
Bernstein said the center stopped allowing visitors at the East Anchorage health-care campus in March and enacted strict procedures, including universal masking, to try to keep the virus out after watching COVID-19 tear through long-term care facilities in other states, including Washington.
“At least a third of the deaths in the U.S. from COVID are from residents of long-term care facilities,” Bernstein said. “And particularly following the outbreak at the Life Care in Kirkland, that was really a warning cry to all of us.”
Patients usually spend weeks at the Anchorage transitional center to recover from serious illness, injury or surgery before heading home or to assisted living. The center shares a campus with Providence Extended Care, a long-term care facility that mostly serves older people who live there for years.
The coronavirus has proven particularly deadly among older people and those with underlying medical conditions. And it has shown to spread quickly in settings where people live in close quarters.
That’s why, Bernstein said, Providence locked down the campus quickly.
“Fortunately for the first two and a half months or so of the pandemic, this site was entirely clear of COVID,” he said.
Then the virus got in, he said, as the state started to open back up and record a climbing number of COVID-19 cases.
“After our reopening, with increased community spread that we’ve been seeing now for several weeks, a resident developed a fever on Thursday, May 28, and was tested. And the following day, we had a positive test,” he said.
Bernstein said he believes the patient became infected at the center. But he doesn’t know exactly how. There are about 50 patients at the center and about 145 employees.
“We know that it had to come in from the outside,” he said. “And so the two main ways that would happen would be either: One or more caregivers could have acquired it in the community and brought it in. Or, a new resident that we could have taken, could have brought it in.”
After the first confirmed case, Providence tested hundreds of caregivers, patients and residents on the campus. Bernstein said too many positive cases came back to pinpoint the source of the virus.
A recent round of testing also found a positive case in an employee from Providence Extended Care who had shown no symptoms, Bernstein said. By Wednesday, there were no positive tests among the residents there. Bernstein said thankfully those 96 residents are separated between eight cottages on the site, spreading out the population.
“They’re like individual homes that were built to create more of a family-like atmosphere,” he said. “But it’s kind of a godsend now.”
Patients at the transitional center who have tested positive are now quarantining in their rooms. They’re all in one wing of the center, Bernstein said. All other patients are also under direction to stay in their rooms.
“They’re really confined to the rooms unless there’s something they absolutely need,” Bernstein said, such as medical care.
Employees with the disease are staying at home.
That has created a staffing shortage, and prompted Providence to recently move about a half-dozen patients to its St. Elias Specialty Hospital in Midtown. That wasn’t without complications. One of those patients tested negative, but then received what Bernstein described as a “conflicting” test result that’s under investigation. That patient was moved back to the transitional center.
“They were tested by a very reliable method before being moved, and it said negative,” Bernstein said. “But then a test from the sweep raised the possibility of it being positive.”
Bernstein said Providence will continue to test patients and staff on the campus weekly until no new positive cases occur. Even after that, he said, he hopes to do periodic tests.
Reflecting on the past few weeks, Bernstein said, it’s difficult to say what Providence could have done differently. The only thing he could think of, he said, was regularly testing the campus earlier.
“But,” he said, “we really didn’t have the testing capacity.”
Now, it’s a complicated balancing act to control the virus spread in a state that’s largely reopened.
“We knew we would see more cases when we opened up. We have the capacity to take care of the very ill when those resources are appropriate,” he said.
“But, you know, we’re living within that balance and it’s hard to titrate,” he said. “We really, really want to keep the virus out of these long-term care facilities.”
Also, family of caregivers have tested positive for COVID-19. Alaska’s chief medical officer Dr. Anne Zink said Wednesday that at least nine of Alaska’s coronavirus cases are linked to close contacts of caregivers from the campus.
In a call with medical providers and others Tuesday evening, Zink said the state was in the process of testing everyone in long-term care facilities in the Kenai, Mat-Su and Anchorage areas as a preventative measure.
“As you saw,” she said, “one case quickly led to a whole lot more.”