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DeSantis leans toward allowing tightly controlled visits in nursing homes

Staff Writer
Walton Sun
Walton Sun

Desperate to see her husband who is hobbled by dementia, Mary Daniel got a job as a dishwasher at his memory care center to get around coronavirus-control measures that closed all nursing homes to visitors.

On Tuesday, the 57-year-old Jacksonville woman joined Gov. Ron DeSantis, his wife and top state health officials to discuss ways of relaxing the rule that has devastated families and left their elderly relatives isolated, depressed and confused.

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Daniel made it clear she wasn’t just window-dressing.

When the secretary of the Florida Department of Elder Affairs held up hand-made paper arms his grand-daughter sent him as an example of how families could safely send their love to elderly relatives, Daniel said she wasn’t interested in a “virtual hug.”

“I just want to make something very clear, I’m looking for a real hug,” she said. “I’m not looking for a virtual hug.”

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“Our goal is to get to our loved ones,” Daniel continued. “They need a hug from us. Not a picture of me on Facetime. Not me at the window. They need us.”

“My goal is to safely and as quickly as possible, with the right guidelines, get us back to our families,” she said.

Daniel found a sympathetic ear in DeSantis, who agreed that nearly six months of forced separation is too much.

Before the hour-long meeting in Jacksonville was over, DeSantis pledged to begin crafting a measure that would allow people who have tested positive for coronavirus antibodies to visit relatives in nursing homes and assisted living facilities.

Their exchange came on a day that saw the number of deaths reported in Florida rise to a near-record high but the number of new cases remain far below the rapid growth of July.

DeSantis went further and promised to find out how many of the millions of rapid-result test kits that the Trump administration has promised to send nursing homes would be headed to Florida.

Unlike the antibody tests, which show if a person has had COVID-19 and therefore may have some immunity to it, the rapid tests show if a person is currently infected.

DeSantis said he also was interested in exploring steps that have been taken in other states that have allowed families to visit loved ones.

“The ultimate vision may take a little bit of time. I don’t want to give anyone false hopes to say, ‘You know what? Next week, everyone go,’” he said.

But, he said, since he imposed the no-visitation rule to prevent an outbreak at a facility filled with frail, elderly people, he has been troubled by it.

“You can have the best of intentions, you can do the best that you can to protect people from the virus, but the actions are not cost-free. It impacts other people,” he said, nodding toward Daniel.

“We have to figure out a way to protect the vulnerable but also alleviate the stress, anxiety and emotional trauma that so many families have felt,” he said.

However, he said, solving the problem is complex.

Even with visitation banned, 3,155 residents and staff of the state’s 4,000 long-term care facilities have succumbed to COVID-19. They account for nearly 43% of the state’s roughly 7,500 deaths.

To assure visitors aren’t bringing the disease into the facilities, Daniel said she and countless others would be willing to pay for the cost of the tests that produce results within 15 minutes.

But, DeSantis said, supplies are limited and hospitals, first-responders and others throughout the state are clamoring for them.

With more than 150,000 people living in the state’s long-term care facilities, an enormous number would be needed to test what likely would be hundreds of thousands of family members, he said.

Further, if only a limited number are available, questions would arise about which facilities would get them.

Studies also have shown that about 20% of the tests produce false negatives. That would allow someone to unwittingly spread the virus in a facility filled with elderly people, who are most at risk of dying from COVID-19.

There is also some question about whether people who have antibodies are immune. The World Health Organization said the evidence is inconclusive.

“Do not only fixate on testing,” DeSantis told Daniel, Elder Affairs Secretary Steven Prudom and Mary Mayhew, secretary of the Florida Agency for Health Care Administration, who will work to find a way to let visitors back in.

Instead of testing, DeSantis suggested providing masks and other personal protective equipment to family members who have been designated as “essential caregivers.”

Such a designation is used in Minnesota and Indiana, Daniel said. Instead of opening up visitation to all family members, one person is allowed to visit their relative twice a week for an hour, Daniel said.

In some states, family members are allowed to visit their relatives outside, she said. Others have allowed indoor visits in rooms far from other residents. Some states allow touching. Others require people to stay six feet apart.

DeSantis said a restriction on touching made no sense.

“Hell, hug ‘em,” he said. “Come on. If you have PPE on and you hug and you don’t sneeze or do something on them, you’re going to be fine.”

Daniel insisted people are desperate to see their family members. She recalled how confusing it was for her husband when she was only allowed to see him through a window or during a video phone call.

“I stopped doing window visits because it was just so painful for him,” she said.

Other people are also suffering, she said. While they understand the need for the restriction, it has dragged on for too long.

“They’re seeing the complete decline of their loved ones, in their personal care, in the way they’re being bathed or not being bathed and having their hair cut and their fingernails clipped,” she said.

“We’ll do anything,” she said. “We’ll be tested every time we go. We’ll wear whatever you want us to wear. There’s just so much desperation and helplessness.”

And, she promised, any rules that are imposed would be followed.

“We’ll be the most stringent rule-followers you’ve ever seen because we understand what the risk is,” Daniel said.

The meeting in Jacksonville came shortly after the latest numbers released by the Florida Department of Health showed that deaths from COVID-19 are continuing to soar.

After a two-day lull, 257 fatalities were reported by state health officials. The deaths, including 16 in Palm Beach County and 124 non-Florida residents, is the third highest reported on a single day since the pandemic began.

The new fatalities pushed the state’s death toll to 7,526, including 876 in the county.

However, while the number of deaths soared, for the third day in a row, the number of new cases were far fewer than those reported in recent weeks.

The state reported an additional 5,446 people had been diagnosed with the highly contagious respiratory disease. Other than Monday, when the number of new cases fell sharply, it is the lowest number of new infections reported on a single day since June 29.

With 497,330 people statewide diagnosed with the disease, by Wednesday it is likely that 500,000 people in Florida will have tested positive for the coronavirus.

Only one other state, California, has surpassed a half-million cases. Only five countries, including the United States, have reported as many cases.

Palm Beach County mirrored the statewide trends. After a sharp decline on Monday, the 379 new infections reported on Tuesday is the lowest number reported in the county since July 1 when 279 new cases were reported.

Since March, 34,929 people in the county have been diagnosed with COVID-19.

Giving a regular briefing to the county commission, county health director Dr. Alina Alonso acknowledged that there are some positive signs. But, she said, the state and the county have a long way to go.

There are pockets in the county where people seems to be ignoring advice on how to contain the disease, she said.

Outbreaks continue to erupt along the Lake Worth Road corridor and in the Glades. She attributed them to large gatherings — birthday parties, weddings and barbecues in the Lake Worth area; block parties in Belle Glade and Pahokee.

“This is not the time to have parties,” she said.

The number of people hospitalized for treatment of COVID-19 has fallen in recent days, said Bill Johnson, director of emergency management for the county. On average about 86 fewer people were hospitalized with the virus in the past week compared to two weeks ago, he said.

At the same time, the number of people in intensive care units has climbed slightly, increasing from a daily average of 137 two weeks ago to 139 this week, he said.

There were 7,787 people hospitalized statewide on Tuesday afternoon for treatment of COVID-19, including 476 in the county, according to state health care regulators. While the numbers vary even throughout the day, roughly 9,500 people were hospitalized statewide and 660 in the county were hospitalized two weeks ago.

But, Alonso said, the percentage of people testing positive remains high. The positivity rate shows the prevalence of the virus in the community.

While the state has said it should be below 10%, ideally it should be below 5%, she said. Neither Florida nor the county is near those benchmarks, she said.

The Centers for Disease Control and Prevention on Monday said the disease was “at dangerous levels,” because the positivity rates remain high in communities throughout the country, she said.

With the disease spreading rapidly, there is no way to stop the spread through contact tracing, she said. By the time people are warned that they have been exposed, they have become infected and likely infected others.

The percentage of people testing positive statewide crept up to 10.88%. While it increased slightly in the county, Tuesday marked the seventh straight day it remained below 10%.

However, she said, the overall positivity rate, which is higher, is also an important gauge of the spread of the disease.

Statewide, 13.1% of the nearly 3.8 million people tested have learned they have the disease. In the county, where 265,000 tests have been conducted, 13% came back positive.

Alonso embraced an analogy that is being used by the Palm Beach County Medical Society in public service announcements to get people to follow social distancing guidelines.

In the media campaign, doctors compare the pandemic to the Titanic. If people wear masks, practice proper hygiene, avoid crowds and engage in social distancing, the ship won’t hit the iceberg and lives will be saved, they said.

“I really like the analogy of the Titanic,” Alonso said. “We’re not going to sink. We’re going to get through this.”

But, she said, everyone has to do their part.

jmusgrave@pbpost.com

@pbpcourts

For more information:

– Florida Department of Health coronavirus web page

– CDC coronavirus web page

– Florida DOH coronavirus hotline (8 a.m. to 5 p.m. Monday-Friday) is 866-779-6121 or email COVID-19@flhealth.gov