Delayed report contributed to coronavirus cluster, Arlington assisted living center says
On March 18, a resident from an assisted living facility in Arlington was sent to a local hospital with a fever and other COVID-19 related symptoms. It took six days for the facility to learn that the resident tested positive for the novel coronavirus.
It took even longer for health officials to respond.
At least a dozen people, 11 residents and one employee, from the facility have tested positive since then, according to Jason Signor, CEO of Caddis Healthcare Real Estate, which owns Heartis Arlington Assisted Living.
“We would not have known if it weren’t for the resident’s family member,” Signor said. “Six days is a long time. We could have been isolating people immediately. I wish we would have known earlier.”
The coronavirus pandemic is especially threatening to seniors and people with disabilities, who are at far greater risk of contracting COVID-19 and requiring hospitalization.
In Italy, the average age of those dying is 80, according to a study by the Italian national institute of health. In China, people 70 and older accounted for just 12 percent of all infections but more than half of all deaths, according to the Chinese Center for Disease Control and Prevention.
There are more than 80,000 residents living in assisted living facilities across Texas, according to the Texas Assisted Living Association.
Pointing fingers
When the facility’s operator, Frontier Management, learned that their resident had tested positive, they immediately called the city’s health department. Kandice Alarcon, who oversees all clinical functions, said the city thanked them and told them Medical City Arlington hospital had not flagged them on the case.
City officials were not immediately available for comment.
Hospital officials said they could not comment on specific cases due to federal privacy laws but said they have protocols in place and work in partnership with local, state and federal health departments to care for patients with infectious diseases such as COVID-19.
“Notifiable conditions considered to be a public health emergency, such as COVID-19, are reported to public health immediately for possible contact investigation tracing,” according to a statement from Medical City Healthcare.
The Texas Department of State Health Services requires reporting facilities to provide detailed information including the patient’s name, phone number and method of diagnosis along with the physician’s contact information, according to the statement.
“This information provides public health epidemiologists with crucial facts to quickly conduct and notify additional contacts, as they deem necessary,” the statement reads.
State health officials were not immediately available for comment.
Tarrant County Public Health Director Vinny Taneja said physicians who order the test are responsible for informing the patient, family and the health department.
Taneja said if the test is done through their lab the turn-around is usually a day or two. Private labs’ tests may take longer, up to seven days. Point-of-care tests, those that can be done by a hospital or a clinic in house, are becoming available and may take a matter of hours.
Taneja added that testing everyone in a facility is not the norm but in this case it was clear that there had been widespread transmission inside the facility so “almost everyone” was tested.
“What we found in the data of all of this is that asymptomatic people typically do not get a positive result,” he said. “So when you have limited capability, you don’t.”
Knowing is half the battle
All 80 Heartis Arlington residents were tested by Tarrant County and City of Arlington health officials, according to Frontier Management. Eleven residents and one staffer who came in contact with the first patient tested positive.
Of these 12 people who tested positive, nine were not showing symptoms, according to Signor, who also oversees facilities in Illinois, Wisconsin and Georgia.
“That’s what’s really scary about this disease,” Signor said. “Three-quarters of the people that tested positive were asymptomatic, so even if you train your staff and test twice a day, you have to be on high alert, even more so than with the flu.”
Most residents nationwide at assisted living facilities are in their mid 80s, according to Signor. He said residents in some of their other facilities have contracted and died from COVID-19 but it has not been above their normal rate of flu-related deaths. He also said health officials in other states have been faster at providing test results and responding.
“In Georgia it was almost instantly,” Signor said. “The hospital called us and the health department conducted contact tracing.”
Five people tested positive in that facility, but Signor said it could have been worse if it wasn’t for the swift action by officials and staff.
“Knowing is half the battle. In Arlington they didn’t tell us anything,” said Signor, who continues to blame the hospital for its inaction.
This story was originally published April 1, 2020 at 6:22 PM.
