Populations most vulnerable to COVID-19 infections and complications are older adults — especially those with preexisting conditions. In fact, the CDC reports that 8 out of 10 COVID-19 deaths reported in the U.S. have been adults 65 years or older. Because high-risk populations live closely together in nursing homes and long-term care facilities, residents are at an even higher risk of being affected by respiratory pathogens like COVID-19.
Before the first cases of COVID-19 were reported in the U.S., Spokane Veterans Home, a long-term care facility in Spokane, was at the tail end of its “upper respiratory season.” Hardish Khinda, staff development coordinator and infection control manager, was already several weeks into monitoring the spread of upper respiratory infections, quarantining infected staff members and residents, and communicating daily with Spokane’s local health department.
When COVID-19 cases were first confirmed in Washington state, Hardish’s shifts increased from 8 to 12 hours almost overnight. At one point in March, she didn’t have a day off work for 12 days straight.
“We didn’t fully know what was going on, so we just kept following what the CDC was saying about the coronavirus and were frequently checking in with our team in Olympia,” she recalls.
To protect her husband and her adult son and daughter at home, Hardish changed her routine; she began washing her clothes and taking a shower immediately upon arriving home after each shift, washed her hands often, and frequently cleaned doorknobs and other high-touch surfaces around the house.
“It’s just a cold,” her husband told her. “You’re taking it too seriously.”
In the first week of April, with the help of other nearby facilities, every resident and staff member of Spokane Veterans Home was tested for COVID-19. Despite following infection prevention guidelines to the letter, like restricting in-person guest visits for residents, screening staff members before they entered the facility and wearing full PPE when providing care to residents, some test results came back positive. In May, after another round of standard testing at the facility and despite her own best efforts, Hardish was diagnosed with COVID-19.
“I was so surprised because I wasn’t having any symptoms when I was tested,” she says. “I was a little tired and had occasional headaches, but I just thought it was because I was stressed and working so much.”
Thankfully, Hardish’s children created a care system for her while she quarantined in the family’s guest bedroom for 14 days: preparing and placing her meals outside her door, video chatting with her each day, and making sure she had everything she needed to be comfortable as she continued working from home. Even her husband jumped on board and was tested for COVID-19; he was negative.
“It made isolation a lot easier,” she says. “I feel bad for other nurses who don’t have family members to take care of them or who are single parents with children to raise while in quarantine.”
Because she has little direct interaction with residents in her role, Hardish is unsure if she became infected by a fellow staff member or another method of community spread. Today (October 2020), family members are only allowed to visit residents in person at end of life, staff are tested weekly and all vendors are tested prior to entering. Hardish also says that unlike other health care facilities in the area, Spokane Veterans Home has never experienced shortages of PPE.
But what is in short supply, she says, is energy among both staff and residents when there is no end to the pandemic in sight. With residents not being able to see their loved ones and staff feeling fatigued, Hardish says it’s even more important that nurses remain diligent in keeping patients, and each other, safe.
“I will be the first one dancing when this is all over,” she says. “But, in the meantime, wash your hands, wear your PPE and watch out for each other. Let’s work together to see this through to the end.”