By MICHAEL FORSTER ROTHBART • Special to www.AllOTSEGO.com
A coronavirus outbreak swept through Fox Nursing Home mid-January, sickening 97 staff and residents, and ultimately killing 12 of the residents.
“After more than 10 months with no resident cases, the outbreak occurred suddenly with half of the total cases occurring within a week of onset,” Fox Hospital spokesperson Gabrielle Argo confirmed.
The first COVID cases among residents were confirmed on Jan. 14, and the first death occurred two days later.
Among the victims were Patricia O’Brien of Oneonta, who died Jan. 24 in the nursing home’s Unit One, after living there seven years.
Another was Bernice Marlette, Mount Vision, three days later on her 99th birthday.
Charles Rizzo, a World War II Navy veteran and later a nurse in Oneonta, died Jan. 30 at age 97.
Frances Sokol, a Quaker activist from Unadilla who once met Eleanor Roosevelt, turned 100 in December. Before she died with COVID on Feb. 4, she complained to her daughter how the oxygen made her throat feel so dry.
The most recent death was this Monday, Feb. 8.
Six other residents died from COVID-19 during the same period.
►2020 A Long Year
The Fox Nursing Home is a low-slung brick building tucked behind Fox Hospital. On Tuesday, the sidewalks were covered by fresh snow, with only a few footprints across them. A large red sign, half-covered in snow, reads “STOP! Visitor Restrictions in Place.”
To the left of the entrance, every second window is covered by plywood, each with a 4-inch hole cut through it attached to a duct. These are the negative pressure rooms: inside the windows, blue and green industrial fans draw exhaust, ensuring that no air from these rooms gets into the rest of the building.
At the end of 2020, there were 123 residents living in the three units behind the hospital. The building had been closed off for most of the year, with strict restrictions on visitors.
“Last March, when everything really started to cascade into a lockdown, we suspended visitation completely, and did not resume at all until August,” Argo said during a phone interview.
In late summer, residents were allowed to visit outside with a family member, one at a time, under a tent on the front patio – as long as they stayed a safe distance and only after both the resident and visitor were screened for COVID symptoms.
It wasn’t ideal.
“You were 6 feet apart. My mom was hard of hearing so you still had to use a white board to try to talk to her, and it was very difficult,” said one relative. But it was better than nothing.
In September, the state mandated that before visitors could come on site, they needed a verified negative COVID test no older than seven days. “Understandably, that dramatically deceased the number of people coming to visit, because most people couldn’t afford or didn’t have access to a weekly COVID test,” Argo commented.
Once the temperature dropped below 55, outside visits were cancelled.
For a brief period in October, family members could schedule a 15-minute visit indoors, held in an empty classroom set up with negative-pressure ventilation, with personal contact forbidden and protective equipment required. “That quickly ended as cases started to rise again,” Argo said. Since early November visits have been cancelled indefinitely.
The restrictions were draconian but effective. Although six staff members caught COVID in 2020, no residents were infected. All residents in the nursing home have been on isolation precautions, which means there are no communal activities occurring, said Argo. Meals in the three dining halls were cancelled, with residents served in their rooms instead. Recreational activities were cancelled. Physical and occupational therapy continued, but only in their rooms. Residents who needed to leave the building for medical appointments such as dialysis could do so.
Largely confined and alone, residents continued living as best as possible. “Our residents, unfortunately, are in their rooms. But we have been working to give them individual activities besides TV every day, like puzzles, knitting, crocheting, quilting, reading, and more, when they are not engaging in FaceTime with family and friends,” Argo said.
Since families couldn’t visit, two activity coordinators were reassigned full-time to run FaceTime calls for each patient. Each unit also has cordless phones that staff use to answer calls and bring to the residents. Some families came to visit through the windows.
A friend of one woman who died last week recalled how they visited from outside: “We tried to let her know, here we are, we’re saying hello to you, and we’re waving our signs… The windows are not too high up, if they bring the person out to the front, right in front of the patio. She could see me and I went out… and I danced around and pirouetted so she could take a little delight as I was talking with her, and she was always crying that she wanted to go home.”
►VACCINES TOO LATE
Dec. 21 was Frances Sokol’s 100th birthday. Her extended family gathered online to celebrate with her remotely. Her children presented Frances with a collection of letters they had written describing favorite childhood memories. They didn’t imagine that it was the last time some of them would speak to her.
On Jan. 8, 86 residents in the nursing home received their first inoculation of the COVID-19 vaccine made by Pfizer-BioNTech. Six days later – too soon for the immunizations to take effect – the first residents fell ill after the virus was introduced into the building from an unknown source.
According to research published in December 2020, the Pfizer-BioNTech vaccine is roughly 52 percent effective after the first dose. However, the vaccine-induced immunity doesn’t take effect until Day 12 at the earliest, the Pfizer study showed. The residents in Fox Nursing Home didn’t get that much time.
“When there is significant community spread, and once the virus gets in, it can spread very easily due to how nursing homes are designed, the medical conditions of our residents, and how contagious the virus is,” said Argo. “The virus is contagious long before it can be detected.”
“Unfortunately, the nursing home population is … very vulnerable,” she wrote in a follow-up email to questions about the outbreak.
“Up to 50 percent of transmission occurs from asymptomatic people,” explained Dr. Diane Georgeson, Oneonta’s public health officer, in a phone interview. “We knew that nursing homes were going to be high risk, and we’ve known that since the pandemic began. So in that sense, it’s not surprising.”
“Even with testing, there’s going to be windows of time when people could be carrying the virus… So it could have been an asymptomatic staff member that unknowingly brought it in. We were at this peak of community transmission, really, last month, and – I don’t want to say inevitable – but even with the best practices, I can see where it could have gotten in and then met the perfect conditions for a cluster or an outbreak.”
“It’s really unfortunate, it came right after the vaccinations began to be rolled out. If the vaccinations could have come sooner, maybe it would have been less of a hit for the residents,” Georgeson said.
Bernice Marlette lived in Mount Vision for nearly a century, then spent her last three years living at Fox. In 2018, at age 96, she could no longer walk—after breaking a hip she never fully recovered her mobility, and her kids were at the age where they couldn’t physically take care of her.
Still, she was very independent in a lot of ways, her daughter said. “At 99, she still had her mind about her – very forgetful, but she knew what was going on. She was a very stubborn woman, but very loving…The staff absolutely loved her because she was just feisty. What we saw as difficult they saw in a different light.”
Marlette FaceTimed with three of her daughters every week. “Her family was everything to her,” one said. The last time she saw her family was two weeks before she died, on Jan. 9. “We would go, usually on Saturdays,” a relative said, to see her through a window. “The next Saturday, she was ill, and they weren’t sure if she had pneumonia or what. They had tested her, and I believe it was the 18th before they knew she had tested positive.”
“We didn’t see her after that. Once she got the COVID there really was no interaction… it obviously hit her pretty hard. We weren’t able to see her through the window, and she wasn’t able to FaceTime at that point. They have the fans set up in the window, so there was no way to be able to see her.” She passed away peacefully early Sunday morning, Jan. 24, according to her obituary. It was her 99th birthday.
Despite the painful circumstances, Marlette’s relatives and others interviewed raved about the compassion shown by the nursing home staff. (Family members of four residents agreed to be interviewed as long as their names not be used.) “My sister was in contact with them daily,” said one relative. “As far as the care, we couldn’t have asked for anything better, they were wonderful.”
Several family members expressed gratitude to Fox Nursing Home Administrator Jeff Emhof, saying he has been working until 11 most nights and has been writing personal emails to update family members every evening.
“The confidential letters were very open about the real situation,” said the family friend who earlier described dancing outside a window.
Although the Fox outbreak may be the worst in the region, it’s not the first, said Georgeson.
She listed other local nursing homes and eldercare residential facilities that have had clusters of coronavirus cases.
Robynwood Adult Home in Oneonta had an outbreak in December, while Robinson Terrace in Stamford and a facility in Chenango County both had significant outbreaks in the fall. In Cooperstown, both the Cooperstown Center and even the Clara Welch Thanksgiving Home had cases among patients, she said.
The county Department of Health reported last week that only three nursing home residents died from coronavirus during January. The same report stated that county-wide about 30 healthcare workers tested positive for COVID during the month.
Dr. Tommy Ibrahim, president/CEO of Bassett Healthcare Network, which includes Fox Hospital, talked in a Zoom interview about how difficult it has been for all involved – residents, staff and families. “One challenging issue has been staffing, because once staff catch COVID they need to quarantine, so we’ve been short-staffed for a long time,” he said. This month 31 staff in the Fox Nursing Home have been on sick leave after testing positive for COVID.
This week, Emhof reported that the worst of the outbreak has passed. Only three new COVID cases were identified among residents, plus one staff, during the latest round of testing last week.
Currently 12 residents remain COVID-positive, all of them isolated in negative pressure areas.
Many of the staff who had been quarantined have returned to work. “We’ve definitely turned a corner,” Gabrielle Argo said, while also noting that the outbreak has not ended. “Sadly, another death occurred yesterday,” she said.