SPRINGFIELD — Members of the state Senate Veterans Affairs Committee had pointed questions for officials with the Illinois Department of Veterans Affairs about the agency’s response to an outbreak at the LaSalle Veterans’ Home that has resulted in at least 27 resident deaths from COVID-19-related complications.
The committee called for the hearing last week, following reports of the growing outbreak since the beginning of November.
A total of 105 residents and 100 staff at LaSalle have tested positive for COVID-19 since the outbreak began. Currently, there are 40 residents and 24 staff who are actively positive for the virus.
The LaSalle home outbreak was first discovered by staff when a resident was sent to the hospital for a severe urinary tract infection on Nov. 1 and was found to be COVID-19 positive, according to Dr. Avery Hart, a U.S. Air Force veteran and physician with the Illinois Department of Public Health.
Hart, who testified during the committee, serves as a medical consultant for the department’s COVID-19 clinical response in congregate living settings.
He said test results returned from the lab on Nov. 3 showed that 22 residents and seven staff identified positive. By Nov. 8, 59 residents and 64 staff tested positive for COVID-19.
Paul Schimpf
Sen. Paul Schimpf’s line of questioning focused on the delay between the outbreak at the facility and the request for an IDPH site visit.
He questioned IDVA Director Linda Chapa LaVia, a former member of the Illinois House of Representatives.
“This is what's frustrating to me, Director (Chapa LaVia). Your legislative liaison sent an email to the senators on this committee and I appreciate the update. But that email talked about the sense of urgency in the sense of trying to do everything that could be done to ensure the safety. But the actions don't seem to match the rhetoric,” Schimpf, R-Waterloo, said.
“So, the two questions are, when was Gov. (J.B.) Pritzker notified about this, did he give any guidance and then why again was it not until Nov. 12 that we had IDPH personnel on site?”
Illinois Department of Veterans Affairs Director Linda Chapa LaVia testifies Tuesday afternoon before the state Senate Veterans Affairs Committee to answer questions about a coronavirus outbreak at the LaSalle Veterans Home.
Chapa LaVia said she personally did not speak to Pritzker but he was aware of the outbreak.
Chapa LaVia, who served as a First Lieutenant in the Illinois Army National Guard, also pushed back against the charge that the IDVA officials should have moved more quickly to respond to the LaSalle outbreak.
“But I feel that our staff moved as quickly as they could,” she said. “I feel that we've tried to move as swiftly as possible ... And we have always been in contact with IDPH with each and every step we take, to make sure we're doing the proper protocol and procedures.”
On Tuesday, IDVA also released two reports from two separate on-site visits at the LaSalle home — the first conducted by an official from the U.S. Department of Veterans Affairs on Nov. 12, and then by an official from the state Department of Public Health on Nov. 17.
The reports documented areas for immediate change, including replacing all nonalcohol-based hand sanitizers with alcohol-based sanitizers, performing COVID-19 tests for residents and staff twice weekly, rather than once per week, and requiring staff to follow strict personal protective equipment guidelines.
Sen. Laura Ellman, D-Naperville, asked about the specific examples in the U.S. VA official’s report of staff violating PPE protocols.
For instance, the report mentions staff were observed in full PPE walking through an administrative area of the home, as well as three staff members being seen in the facility’s kitchen with masks around their chins, eating, and all less than 6 feet from one another. The report also mentions staff seen wearing gloves to touch patients and multiple surfaces without changing or performing hand hygiene.
“I'm just concerned that for those veterans that are receiving treatment, some of these practices could worsen their condition, which can be quick changes. What are the things that are being done at this facility to ensure that, on the treatment side, they are getting the proper care with the proper protocol?” Ellman asked.
Hart acknowledged that breaks in protocol were observed during the site visit, and said staff within the facility now are tasked with monitoring and enforcing proper PPE guidance.
Employees failing to properly wear PPE could increase the likelihood of virus transmission between employees, but Hart said it can be difficult to pin down the precise origin when the virus is rampant in the community.
“Let's say two staff members came down with COVID within a certain period of time. You don't know if one of them is married to a frontline worker, or another one was in a bar downtown or they were just shopping for their groceries and had the bad luck to encounter the virus,” he said.
IDVA Chief of Staff Anthony Kolbeck said five employees at LaSalle continued to work at the home after being notified that they tested positive.
“In general, it was notification late at night. They were the only people there for that position. If they went home, it would create another issue and they volunteered to stay,” Kolbeck said during the hearing.
He said the five employees were working with patients who already tested positive.
The Senate hearing kicked off shortly after the IDVA announced the Acting Inspector General from the Illinois Department of Human Services will conduct an independent investigation into the outbreak at the LaSalle home and IDVA “will immediately address any findings from that investigation,” according to an agency press release.
Chapa LaVia said the investigation could take between four to six months.
“We will make sure that we reconvene, so we can go over those findings, but we want to make sure that we get to the bottom of this. I thought it very important to go above and beyond,” she said, noting the review would be independent and conducted from outside the department.
Chapa LaVia pointed to the increasing spread of the virus in LaSalle County as an explanation for the outbreak at the veterans’ home.
Beginning Oct. 23, LaSalle County’s COVID seven-day average positivity rate jumped from 7.2% to 13.1% in just one week, according to the IDPH website. By Nov. 6, the county's productivity rate reached 18.5% and, by the following week, it rose to 20.5%. As of Nov. 21, it was 16.2%.
“The people who care for our heroes in the homes live within the communities they serve,” she said. “But when community spread of this virus is high, staff can fall prey to infection, no matter how conscientious they have been about following protocols.”
Schimpf said the other veterans’ homes located in similarly affected communities have not seen cases and deaths spike, as they have in the LaSalle facility.
Specifically, he cited Adams County, where the Illinois Veterans Home at Quincy is located, and Kankakee County, where the Manteno Veterans’ Home is located.
“The reason I think that's relevant is you have COVID running rampant through places besides LaSalle, but yet the Veterans Home in a Manteno and Quincy have been able to largely avoid the type of tragedy that we've seen in LaSalle,” Schimpf said.
The Quincy home has reported one COVID-19 related resident death, and it currently has 13 positive residents and 18 positive staff.
The Manteno home has reported 17 COVID-19 related resident deaths, and it currently has zero positive residents and eight positive staff.
COVID-19 myths and misconceptions: Mayo Clinic experts weigh in
Coronavirus case increases
Experts say the rise in COVID-19 cases is not due to increased testing. The increase in percent positive tests shows that the jump in cases is due to increased community spread and contraction of the virus through close interactions.
The Coulee COVID-19 Collaborative, a partnership of the La Crosse County, Wisconsin, Health Department, Mayo Clinic Health System - La Crosse, and Gundersen Health System, notes that while cases were highest among the college age demographic in late summer, the middle-aged sector is now being hit hard, due in large part to gatherings.
Quarantine vs. isolation
While often used interchangeably, quarantine and isolation are different, with those exposed but not positive for the virus adhering to the guidelines of the former and those with symptoms or confirmed cases following the rules of the latter.
Quarantine is recommended for individuals who are determined to have been close contacts with someone who has the virus. A close contact, says Fitzgerald, is someone who was within six feet of an infected person for several or more continuous minutes, regardless of whether masks were worn, though that decreases the chances of spread.
Quarantine guidelines
Quarantine should be followed for 14 days from date of contact with an infected person or household member. A negative test, Fitzgerald notes, is not a free pass to discontinue quarantine, as it is possible to test positive a few days later as the virus can take multiple days to manifest.
“People deemed to have positive exposure want to get tested so they can continue going out, but a negative test doesn’t mean you can resume (leaving the home) ...,” says Fitzgerald. “People who are exposed want to get back to work but there’s really no way around (quarantine).”
Those infected should begin isolation the day of symptom onset or receipt of positive test result, and remain in isolation for 10 days from that date.
Fitzgerald notes it seems “counterintuitive” that infected individuals spend less time in isolation than those exposed but not necessarily positive spend in quarantine, but CDC data indicates “that persons with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset.”
However, individuals with severe to critical cases of the virus can remain infectious up to 20 days after symptom onset, so ceasing isolation after 10 days is dependent on if the person has been fever-free for at least 24 hours, without the use of fever reducing medications, and all other symptoms are absent.
Fitzgerald adds that those who test positive but are asymptomatic are not exempt from isolation. “People with a positive PCR test but are asymptomatic can find it hard to believe they have the virus,” but PCR test are very rarely inaccurate, he said.
Herd immunity
Herd immunity, which occurs when the majority of the population becomes immune to the virus, thus reducing spread and protecting the population at large, is not a realistic plan for stopping the transmission of COVID-19, experts say. Currently, it is unknown if contracting the virus gives you immunity, and even if patients do prove to become immune following infection, achieving herd immunity would be to the detriment of millions of lives lost.
It is estimated 70% of the U.S. population — over 200 million people — would need to have the virus and recover in order to stop the pandemic. This would overwhelm the healthcare system, result in millions of fatalities and have severe, long term consequences on the health and function of communities.
COVID-19 deaths
Rumors have been swirling that the death toll of the coronavirus has been exaggerated. The myth, Mayo experts say, was born from a data table from the Centers for Disease Control and Prevention which showed the majority of people who died of COVID-19 had multiple causes listed on their death certificates. This caused people to question whether the deaths were actually the result of a preexisting condition.
Health experts note that while those of older age or with serious health problems are more prone to severe cases of the coronavirus, the vast majority could have lived significantly longer had they not been infected.
Age and case severity
The elderly are especially susceptible to severe symptoms of COVID-19, but people of all ages can have cases serious enough to require hospitalization or even result in death. People of all age brackets and demographics are susceptible to the virus and related hospitalizations, and regardless of age, heart or lung conditions, immune deficiencies and obesity can increase the risk of a severe case.
Most children with COVID-19 have mild symptoms or are asymptomatic, but some have required intensive care or ventilation for the virus. Though rare, children have died from COVID-19.
Antibiotics
Taking antibiotics will not kill the coronavirus, as it is a virus rather than a bacteria. Individuals undergoing hospitalization for COVID-19 only receive antibiotics if they are simultaneously suffering from a bacterial infection of some kind.
COVID vs. flu
Social media is rife with assertions from the public that the coronavirus is no worse than the flu. While both are contagious respiratory diseases and have many of the same symptoms, the viruses manifest differently, with COVID-19 believed to be more contagious and more deadly than influenza.
While COVID-19 symptoms can take up to 14 days post exposure to surface, flu symptoms are usually apparent within four days. The health consequences of COVID-19 are generally worse than flu, including lung injury, development of blood clots and, for children, the onset of multisystem inflammatory syndrome.
According to a recent study from the Centers for Disease Control and Prevention, patients hospitalized with COVID-19 were five times more likely to die than those with the flu, and COVID-19 patients were at higher risk than flu patients for 17 types of serious health complications, including pneumonia.
Currently, there is no approved and readily available vaccine for COVID-19, though early analysis of the Pfizer and BioNTech vaccine trial shows promise. The flu shot is recommended for all individuals.
Face masks
Despite pleas from health officials, some people continue to question the efficacy of a face covering, feel the requirement infringes on their rights, or both. Masks, especially fabric versions, were not recommended at the start of the pandemic, but for months have been designated one of the three main viral spread prevention tactics, along with social distancing and hand washing.
As the virus is caused by respiratory droplets, released through talking, sneezing and coughing, a mask provides a barrier to protect both the wearer and those around them from becoming exposed to those droplets, which can enter through the mouth, nose and eyes.
smansur@capitolnewsillinois
