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SUNDAY, JULY 19, 2020 • SANTA ROSA, CALIFORNIA • PRESSDEMOCRAT.COM
Senior homes battle outbreak
CORONAVIRUS » US challenges
reflected in deadly outbreak at
Sonoma skilled nursing facility
By MARY CALLAHAN
THE PRESS DEMOCRAT
Coronavirus had been circulating
among the residents of Sonoma County
for at least three months before it made
entry into Broadway Villa Post Acute, a
144-bed skilled nursing facility in Sonoma.
But once inside, the highly contagious
virus got a foothold, finding ready vic-
tims among the sick and infirm patients
SONOMA COUNTY » LATINO COMMUNITY
Facing difficulties
in distance learning
Silvia Zavala, her husband, Jose Leon, and their kids, Emmanuel, 12, left, Fatima, 6, and Julian, 11, gather outside Luther Burbank Elementary School
on June 21 in Santa Rosa. Many Latino families have struggled with distance learning because of difficulty accessing technology and child care.
Technology, daytime child care contributing to disproportionate impact
By KERRY BENEFIELD
THE PRESS DEMOCRAT
T
his spring, Bryan Velasco did the ma-
jority of the work for his sixth grade
class at Luther Burbank Elementary
School in Santa Rosa on his cellphone.
His sister, Ashlyn Martinez, a third
grader, worked on a school-issued Chrome-
book. Sometimes Bryan and Ashlyn had
classroom Zoom meetings the same time,
crashing their Wi-Fi hot spot, which was
provided by Santa Rosa City Schools when
it became clear the coronavirus pandemic
would extend distance learning through
the end of the school year. Then the mic on
Ashlyn’s computer stopped working, mak-
ing it impossible for her to ask her teacher,
Anne West, any questions.
“Wi-Fi is good but not that good,” Bryan
said. “It would glitch out or everything
would stop and freeze. Every time I would
talk it would freeze for me. I couldn’t hear
anything my teacher or classmates were
saying and they couldn’t hear me.”
When asked where they wanted to be
when school starts in August, both were
emphatic: They want to go back to school.
They miss their friends. They miss their
teachers. Doing schoolwork was too diffi-
cult from home.
That option is no longer on the table for
Bryan and Ashlyn or any other of Sonoma
TURN TO LEARNING » PAGE A14
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who live and rehabilitate there.
Since its first report of an asymptom-
atic COVID-positive health care worker
June 10, the facility has reported 15 con-
firmed tests among staffers and 43 infect-
ed residents, making it one of Sonoma
County’s largest connected outbreaks.
As many as eight of Broadway Vil-
la’s residents have died of COVID-relat-
ed causes, the largest share of what are
now 10 local nursing home deaths in the
last month — more than half of Sonoma
County’s 19 pandemic fatalities, according
to county and state public health records.
Two more skilled nursing facilities, both
in Petaluma, also reported patient deaths
Ross Hause pauses at his house in Santa Rosa. Hause is a sixth grade teacher at Luther Burbank
Elementary School, and like many teachers, he has continued lessons online during summer.
“I worry ‘Are my kids going to fall behind?
What is this doing for equity?’”
ROSS HAUSE, teacher who has continued to hold Zoom lessons into the summer for
students interested in talking about current events and movie recommendations
A2 Sonoma Life D1 WELDER’S ARTISTIC PURSUITS: Customers
C1 Smith A3 love Rohnert Park woman’s whimsical insects
B4 Towns T1 created from recycled discarded metals / T1
WORK ENVIRONMENT » Businesses
reexamining office space needs. D1
WINNER OF THE 2018 PULITZER PRIZE
last week amid evidence that increased vi-
ral transmission in the broader communi-
ty had begun to pierce the defenses of the
county’s 20 licensed nursing homes.
Though Broadway Villa has had the
most substantial eruption by far, 14 sites
have at some point had at least one health
care worker test positive.
Surveillance testing was initiated early
at some locations by Sonoma County Pub-
lic Health, picking up an asymptomatic
health care worker at Apple Valley Post-
Acute Rehab in Sebastopol back in April
before any residents could be infected.
A total of six facilities have reported
at least one infected patient, including
PHOTOS BY BETH SCHLANKER / THE PRESS DEMOCRAT
SANTA ROSA
High 77, Low 50
THE WEATHER, C4
three for the first time last week.
Until a facility reaches 11 coronavirus
cases or deaths the California Depart-
ment of Public Health masks the exact
number, however. If a site has fewer than
11 cases, it is not possible to know the size
of the outbreak unless a facility admin-
istrator agrees to confirm it. Most have
refused comment to The Press Democrat
or failed to return phone calls.
But EmpRes Post Acute Health and Re-
habilitation, which posted its first infect-
ed health care worker July 6, reported a
death to the state on Wednesday, as did
TURN TO SENIOR » PAGE A13
CORONAVIRUS
Mass
spread
fueling
illness
‘Superspreading’ events
triggered by people who
may be asymptomatic
By ARIANA EUNJUNG CHA
WASHINGTON POST
It wasn’t until Day 7 of her
team’s coronavirus investigation
when it dawned on Linda Vail,
the health officer for Michigan’s
Ingham County, that this was go-
ing to be a big one. It had started
with just two infections at the
college bar on June 18, not long
after the state began reopening.
But the numbers quickly jumped
to 12, then 18, then 34.
As of Friday, she was staring
at a spreadsheet with 187 infect-
ed at Harper’s Restaurant and
Brew Pub.
“The tables were 6 feet apart,
but no one stayed there,” she
said. “The DJ was playing mu-
sic so people were shouting, the
dance floor started to get crowd-
ed. We had flattened the curve
and then, boom.”
The East Lansing case is
what’s known as a superspread-
ing event — possibly the largest
so far in the United States among
the general public. Many scien-
tists say such infection bursts
— probably sparked by a single,
highly infectious individual who
may show no signs of illness and
unwittingly share an enclosed
space with many others — are
driving the pandemic. They wor-
ry these cases, rather than rou-
tine transmission between one
infected person and, say, two or
three close contacts, are propel-
ling case counts out of control.
More than 1,000 suspected clus-
ters — ranging from the single
digits to thousands — have been
logged in a database compiled
by a coder in the Netherlands. A
megachurch in South Korea. A
political rally in Madrid. An en-
gagement party in Rio de Janei-
ro. Nearly all took place indoors,
or in indoor-outdoor spaces.
Even as the Trump adminis-
tration pressures schools to re-
open this fall, the latest research
suggests that understanding
how and why these events oc-
cur — and how to prevent them
— is key to reopening safely.
In recent days, governors from
at least 18 states, including
Michigan, have backtracked on
plans to loosen restrictions due
to outbreaks.
But even those efforts may
fail if people ignore the most
common ways the virus is con-
sidered to spread. Transmis-
sion, it turns out, is far more
idiosyncratic than previously
understood. Scientists say they
believe it is dependent on such
factors as an individual’s infec-
tivity, which can vary person to
person by billions of virus par-
ticles, whether the particles are
TURN TO VIRUS » PAGE A2
©2020
The Press
Democrat
THE PRESS DEMOCRAT • SUNDAY, JULY 19, 2020 A13

SENIOR BREAKING DOWN SPREAD OF CORONAVIRUS

Sonoma County public health officials continue to urge
CONTINUED FROM A1 residents to call their doctor if they are ill, think they have
flu-like symptoms and want to learn whether they should be
Petaluma Post-Acute Re- tested for coronavirus.
hab, which recorded its first
COVID-positive staffer June
6 and now has 13 infected
1,126 19 2,121
residents.
Active cases
as of Saturday
Deaths
as of Saturday
(3%)
The data reflects a pain- Positive results
ful reality that has spread
across the nation since the
63,857 976 61,736
Tests finished Recovered
early days of the corona-
virus pandemic, when an
as of Saturday as of Saturday (97%)
outbreak at a nursing home Negative results
in Kirkland, Washington,
claimed dozens of lives as
the virus was just laying VIRUS CASES IN COUNTY BY AGE
siege to the country. Skilled
nursing home residents —
3% 12% 13%
those who require round- Under 5 5-17 18-24
the-clock medical care and KENT PORTER / THE PRESS DEMOCRAT
monitoring — are more
vulnerable to coronavirus
A man walks the grounds of Broadway Villa Post Acute on Thursday in Sonoma.
38% 13% 9%
than other populations and Villa are “doing our very control along the way. was reported to the state, 25-44 45-54 55-64
more susceptible to poor best, under exceptional cir- Sufficient nursing staff, as is mandated, and three
outcomes. cumstances, to bring dignity who are in charge of infec- days later, on June 13, a
Sonoma County Health
Officer Dr. Sundari Mase
and healing to those we love
and serve,” he said during
tion control, also is key, said
Charlene Harrington, pro-
COVID-positive resident.
The first resident death
5% 5% 0%
said such facilities are sim- an email exchange. fessor emeritus at UC San was reported June 22. 65-74 75 older Unknown
ply not structured to deal Empey, whose site holds Francisco and lead author Before last week, Sonoma
with the degree of contagion a five-star rating from the of a recent paper on the sub- County health department
posed by the coronavirus, Centers for Medicare & ject. staffers had reported seven
VIRUS CASES IN COUNTY IN PAST WEEK
making them “singularly
unable to deal with COVID.”
Medicaid Services, which
licenses skilled nursing fa- Virus exposure at home
deaths among COVID-posi-
tive patients at local skilled
53 41 48 38
“It’s that group that is get- cilities, said he is abiding by Experts say what’s hap- nursing facilities, though
New cases Friday Thursday Wednesday
Saturday
ting really sick,” she said.
A New York Times analy-
CMS guidance in trying to
mitigate the outbreak. Since
pening in long-term care
facilities also reflects ris-
Mase has refused to say at
which facilities they resid-
55 67 116
sis earlier this month found March, when visits to nurs- ing transmission in the ed. But until Wednesday, Tuesday Monday Sunday
that about 10% of the na- ing homes were prohibited, surrounding community, only one of one of the coun-
tion’s COVID-19 cases affect- he has also made it his mis- where caregivers live with ty’s skilled nursing facili- HOSPITALIZATION
ed residents of long-term sion to maintain close com- their own families, some of ties, Broadway Villa, had
Currently hospitalized: 38 confirmed cases, 17 suspected
care facilities. Their deaths munication with families, whom may be exposed to experienced any COVID-re-
cases; as of Friday
accounted for more than he said. the virus in different ways lated deaths, according to
42% of all U.S. coronavirus But “the skilled nurs- and bring it home. the California Department Total hospitalized during pandemic: 105
fatalities, the Times’ study ing environment presents The CMS and other fed- of Public Health, which
concluded. unique challenges not faced eral and state health agen- requires licensed nursing Sources: Sonoma County health department; state of California;
As a subset, residents by other senior living cen- cies have issued successive homes to report new infec- Centers for Disease Control and Prevention; Press Democrat reporting
of skilled nursing facili- ters,” he wrote, “namely, instructions throughout the tions and deaths among its
ties — medically licensed many of our residents were pandemic, prohibiting visits staff and residents within 24
sites where clients require experiencing a decline in to nursing homes by anyone hours. Health Officer Noemi Doo- several factors cited by the
close-contact care that goes health before the pandemic, beyond essential medical Then three more were han, who has been substan- California Department of
beyond the kind of help with making them more vulnera- personnel or family mem- reported last week — one tially more transparent with Public Health in its decision
bathing and dressing that ble to infection. bers saying goodbye to a each at EmpRes and Peta- specific information about earlier this month to place
might be afforded someone “In addition, there is the dying relative. Rules require luma Post-Acute, according coronavirus cases than Sonoma County on the
in an assisted living home — added challenge of resi- health care workers to be to state data. It’s not clear Mase, said 13 cases have state’s COVID watch list,
are even more susceptible dents who may have con- screened for fever, COVID where the third occurred, been detected at the facility, subjecting local business
because of underlying con- ditions of mind or memo- symptoms and exposure be- although it was likely including seven residents operations to increased
ditions and physical frailties ry that make it difficult to fore reporting to work. Broadway Villa, according — two of whom are hospi- restrictions in an effort to
that make them particularly understand or remember Each site also is required to an analysis of state and talized and the one who died bring down transmission
fragile. frequent hand-washing, so- to establish a surveillance local data. — and five employees. rates.
They also utilize shared cial distancing, and wear- testing regime and to plan Advocacy groups, like State public health of-
staff, some of whom need ing masks,” he continued. ahead for the possibility Senior deaths increase San Francisco-based Cali- ficials have subsequently
to juggle shifts at more than “Our staff works tirelessly that coronavirus might be Broadway Villa adminis- fornia Advocates for Nurs- recommended a “restruc-
one facility because of noto- to assist and promote good detected among its patients, trator Empey has declined ing Home Reform, have turing” of skilled nursing
riously low pay. Many em- infection control practices, designating a wing or a cor- to address fatalities, given been lobbying throughout to separate COVID-positive
ployees, perhaps most, do but certain of the vectors ridor that can be used to the fact that many of the the pandemic for a variety patients and those awaiting
not accrue paid sick time, are not 100% within our separate COVID-positive people in his care are declin- of steps they believe might test results from uninfect-
and advocates worry they control.” residents from those who ing, with serious or termi- help save the lives of res- ed residents, aligning with
can’t afford to take time off, People like Pat L. Mc- are not infected and giv- nal conditions even before idents at nursing homes what local health officials
even if they feel ill. Ginnis, co-founder and en separate staff. Workers coronavirus came around. and other long-term care say has been an ongoing
Moreover, skilled nurs- executive director of San treating COVID patients are The state data, however, facilities. They include daily effort to find a suitable site
ing patients are regularly Francisco-based Califor- required to wear extra pro- indicates the seven initial inspections at facilities with to relocate those who need
roomed two, three or four nia Advocates for Nurs- tective gear, as well. local fatalities were all from active COVID cases or poor continued medical care out-
to a room, typically with a ing Home Reform, say the But it isn’t truly possible Broadway Villa and the compliance records; strike side a hospital setting.
shared restroom, so those industry structure, with to pandemic-proof part of eighth likely occurred last teams where outbreaks have A hotel, which may be a
who are unknowingly in- heavy for-profit ownership a building if there are infec- week. reached crisis levels; hazard viable option for those with
fected can easily transmit and “very low staffing ra- tious patients somewhere At least three other pay to prevent staff from minimal COVID symptoms,
the virus before being sep- tios,” means patients get else in the same structure, COVID deaths in the county having to work at two sites, doesn’t work, nor does a
arated out. Outside of pan- limited hands-on time in the Mase said. involved residents of res- to avoid cross-contamina- gymnasium, like the one at
demics, those who are mo- first place. “The main issue is that idential care facilities for tion, as well as ample sick Sonoma State University
bile often dine together and During a pandemic, the everybody in the facility is the elderly — nonmedical time; and dedicated nurs- the county had access to for
use joint activity and thera- challenge is magnified, she exposed. They just aren’t institutions that include as- ing homes for COVID-posi- a time, said Mase, the coun-
peutic rooms. said. positive yet,” she said. sisted living, board and care tive patients released from ty health officer.
In California, skilled nurs- Crista Barnett Nelson, Broadway Villa was one homes and memory care acute-care hospitals. And while there are
ing patients make up about executive director of the of three skilled nursing fa- centers. The group also believes some skilled nursing fa-
5% of the state’s cumulative nonprofit Senior Advocacy cilities in the county to par- In Mendocino County, residents should be permit- cilities with single rooms
coronavirus caseload so far Services and long-term care ticipate in baseline testing a significant outbreak at ted in-person visits from a that would allow for better
and have accounted for at ombudsman coordinator for in May. More than 90% of the Sherwood Oaks Skilled protectively garbed support isolation, “they don’t want
least 2,898 deaths, almost Sonoma County, agreed. its patients, or 114 people, Nursing Facility in Fort person to prevent isolation COVID in their facilities,”
40% of the state’s overall Infection controls means and 145 personnel were test- Bragg claimed the life of a and ensure the patients are she said.
COVID-related fatalities. “you have to slow way down” ed, all coming out negative, 63-year-old man on Thurs- not being neglected. “What we need is an open,
and take more time for ev- according to county docu- day. He was that county’s “There’s no one minding unoccupied facility to trans-
Unique challenges erything — hand-washing, ments. second COVID-related the store,” Nelson said. fer people to,” Mase said.
For Broadway Villa ad- donning protective gear and But then on June 10, a death. The recent rise in nurs- “That’s what we’re seeking.
ministrator Mike Empey, ensuring other protocols positive health care worker Mendocino County ing home cases is among That’s what we need.”
it’s proven to be an exhaust- are followed. Without sig-
ing, difficult, painful time nificant staffing increases,
— one that he feels reflects that’s not possible, she said,
unfairly on his industry and and workers running from
on his place of work. Front- one person to the next are
line personnel at Broadway likely to overlook infection

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