How one nursing home warded off the coronavirus and saved lives
COVID-19 has devastated America's nursing homes, killing more than 100,000 residents and workers over the course of the pandemic. But one small long-term care facility in Baltimore is proof the toll could have been much lower: The Maryland Baptist Aged Home has recorded zero cases of COVID-19, says its director, the Rev. Dr. Derrick DeWitt. The feat is all the more impressive because the home caters mostly to low-income people of color, who as a group have been hit disproportionately hard by the disease.
DeWitt, who is also the facility's chief financial officer, spoke with CBS MoneyWatch about what Maryland Baptist Aged Home did to protect its residents and staffers, and what can be learned from their experience. This interview had been edited for length and clarity.
CBS MoneyWatch: Tell us about the Maryland Baptist Aged Home. How many residents do you care for? How many workers do you employ?
We are a small facility with 29 residents, including my aunt, and 42 employees. We are located in a struggling, very impoverished part of Baltimore. We've had to deal with a lot of disparities and lack of services in the area, which in my estimation makes our success that much more impressive.
What were some of the first steps you took after realizing that COVID-19 was a threat?
When I heard President Trump say we only have 15 cases of COVID and that soon we'd be down to zero, I said to myself, 'We are on our own over here.' I didn't have any confidence that leadership would help us through this time. Immediately, on the 28th of February, we shut down the facility.
What does shutting down entail for a nursing home?
When we locked down there was no visitation at all. No one who didn't need to have direct contact with residents was allowed in the facility — not even myself.
But employees who interacted with residents were free to return home after their shifts. How did you ensure they didn't become infected outside of work and bring the virus into the facility?
We were extreme with our employees. We had to get buy-in from them. We had to stress and impress upon them the importance of staying safe outside the facility. We asked them, 'Are you committed, if necessary, to being separated from your spouse and to keeping a distance from your children and wearing masks at home and only interacting with family members if absolutely necessary?'
These were things we asked employees to commit to. We asked them not to go to family gatherings. We didn't want them taking public transportation, so we paid for Ubers, Lyfts and necessary things so they would not have to ride public transport and risk being exposed to other people.
Essentially, you monitored how they spent all their time away from the facility.
We asked them questions when they showed up to work. Our questionnaire is a little more intrusive than what a regular questionnaire would be. We want to know what you did every minute and hour since you left our facility. Who did you go out with or ride with. Short of asking them, 'Did you sleep with anyone last night?' it's pretty deep.
And everyone bought in. That's why all credit for us being COVID-free has to go to our employees. They bought in lock, stock and barrel into these extreme safety measures, and they have done a phenomenal job of keeping our residents safe.
I attribute our success to what I call the "Four Es." We were early, excessive, extreme, and we made sure we looked out for the emotional well-being of our residents and employees.
And it turns out these extreme measures weren't so extreme, but rather appropriate and effective. What other steps did you take?
We stockpiled personal protective equipment early on in the pandemic. And when they said to keep six-feet distance, we did 12 feet.
We also couldn't ignore the toll of isolation and separation, with no more community meals or activities. We made sure every room had a television and radio, and each resident was able to FaceTime or Zoom with their family on a weekly basis. We also brought in extra "activities staff" to make sure people had one-on-one activities and exercise.
Why have nursing homes, assisted living centers and other long-term care facilities suffered so many COVID-related deaths?
I want to underscore that some facilities could have done everything right and still ended up with COVID. I think the models that we have of long-term care facilities almost lend themselves to infection. These facilities are too large. When you talk about having 300 to 400 people and trying to control infection during a pandemic, that's going to be a lose-lose situation right there. But if your facility is smaller, you can better control and manage who is coming in and out.
How many of your staffers and residents have been vaccinated so far? Can you see light at the end of the tunnel?
It was really challenging to get people to take the vaccine at first, with misinformation and a lack of information and lack of leadership. But I took it first to try to encourage people to do it, and I assured them I had no residual effects from taking the vaccine, and more people came around after that. That went a long way in reassuring people that it was OK to take it.
So far we have vaccinated 24 of 29 residents and 33 of 42 employees. Regarding the few residents who haven't been vaccinated yet, we are waiting for approval from family members or their guardians. And with the few employees that have not yet taken it, it's just a scheduling thing.
I can see the light at the end of tunnel, but I think it's a long tunnel. We have a long way to go to getting people as a whole — not just my facility — to accept and to take this vaccine.
Have you loosened any of the measures you put in place at the beginning of the pandemic?
We are staying the course as if we're in Phase 1 of the pandemic. The only restriction we've loosened is we now allow outdoor visits with 12 or more feet of separation — so the resident is on the porch and the family is in the yard. Other than to get my two vaccinations, I haven't been inside since March 1.