Douglas County Coroner Jill Romann sat in her office with Lauren Stockton, one of her certified death investigators, going down the list of recent pandemic victims who came through the office. …
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Douglas County Coroner Jill Romann sat in her office with Lauren Stockton, one of her certified death investigators, going down the list of recent pandemic victims who came through the office.
“Seventy-eight, 89, 63, 92, 81, 82, 76, 79, 99, 93,” Romann said, reading off their ages.
The bulk of people from Douglas County to die of COVID-19 in recent weeks are older than 65 and coming from assisted living or specialized nursing facilities, Stockton said.
State data shows there are nine active outbreaks at assisted living, skilled nursing and similar centers in the county, with at least 36 deaths across them. The data also shows that Douglas County nursing facilities are seeing their largest outbreaks yet amid the pandemic.
“Our senior community is extraordinarily vulnerable to this disease. And I get questioned all the time, `Did they die of COVID or with COVID,'” Romann said. “It doesn't matter if they died 'of' or 'with.' They died because of COVID. Their life was shortened because of COVID and the question of 'of' or 'with' COVID is really a moot point.”
Some centers have evaded widespread death among residents despite a high number of infections, but not all.
An outbreak unfurled at the Castle Rock skilled nursing center Brookside Inn on Oct. 13, beginning with numerous infections among residents and staff but exploding in November.
As of early December, nearly 200 residents and staff have been infected. More than two dozen residents have died at the center during the outbreak.
“It was devastating,” Brookside administrator Jarom Eberhard said. “But we do see light at the end of the tunnel.”
'It's been really hard'
Eberhard hopes Brookside is nearing the end of its outbreak. A resident has not tested positive since a round of testing on Dec. 3, he said on Dec. 9.
That's relieving news for an industry in which staff can become like “a second family” to the people they care for.
Employees provide 24-hour care for people no longer able to care for themselves, he said. That not only requires getting physically close to residents but often leads to a tight bond between the health care workers and the people they serve.
“It's been really hard for our staff, obviously the residents and family members. It's been a difficult time,” he said.
The skilled nursing facility was able to trace the start of its outbreak to a new resident who tested positive for COVID-19 shortly after being admitted to Brookside, Eberhard said.
“From there it just spread to the staff and then spread to other residents,” he said. “We've seen throughout the nation regardless of your rating, or if you're a big facility, small facility, for profit, not-for-profit, it didn't really matter with COVID. If it got into your building, it is very challenging to get it out.”
The admission of an ill resident coincided with an uptick in cases throughout the community, he said. As members of the health care industry, Brookside encourages following proper social distancing within the broader community, he said.
Staff live and move throughout surrounding areas, running the risk of getting exposed and carrying COVID into their place of work, he said.
“Anything that happens in the community, we get affected,” he said.
Tri-County Health Department data shows at least 50 people died in Douglas County from COVID-19 in November. The average age of COVID-19 victims in Douglas County is 82. Nearly 79% of COVID-19 deaths are among people 75 and older.
The total number of deaths since COVID-19 reached Douglas County in March, among other statistics posted to Tri-County Health's website, is often outdated because of reporting lag times.
As of mid-afternoon Dec. 7, Romann confirmed that Tri-County Health's published data did not yet reflect an additional 10 lives lost to the pandemic. There had been 132 people from Douglas County who died because of COVID-19 by that time, she said, not the 122 published online.
Brookside is not the only facility hit by outbreaks, although others are seeing far fewer deaths, according to state data.
At assisted living facility Parker Senior Living by MorningStar, 60 residents and 33 staff have tested positive for the virus during an ongoing outbreak first declared on Nov. 5. Seven people have died.
The Brookdale Highlands Ranch assisted living facility officially became an outbreak site on Nov. 15. There, 30 residents and 13 staff members have tested positive, with two more suspected cases among staff. One person has died.
The Suites Parker, a skilled nursing center, was designated an outbreak site on Sept. 21 and remains on the state's list of active outbreaks. Among residents, at least 53 people became infected with COVID-19. One person has died. Nearly 20 staff members had tested positive.
And assisted living facility Legacy Village of Castle Pines saw at least 19 residents test positive with another probable case amid an ongoing outbreak first declared on Nov. 13. An additional 11 staff members tested positive. No one has died at the facility during the outbreak.
For several facilities, this is not the first outbreak to breach the facility during the pandemic. But none of the incidents on the state's list of resolved outbreaks at assisted living or specialized nursing facilities reached the more than 24 confirmed resident infections and no more than seven people died in an individual outbreak during the spring and summer.
Ashley Richter, the communicable disease epidemiology manager for Tri-County-Health Department, oversees contact tracing for the health agency.
Asked what the Douglas County data can tell the community — and how one location can be hit especially hard amid outbreaks while others less so — Richter said those numbers demonstrate the volatility of this health crisis.
“We have seen throughout the pandemic that some people get incredibly sick while others get what they describe as a 'minor cold.' There's no way for us to predict the severity of symptoms or how a specific individual will react to the virus,” she said via email.
It also stresses the need for vigilantly practicing precautions, she said. A person might only experience minor symptoms but can also spread COVID-19 to someone who has “a devastating outcome.”
A community can support its neighbors in congregate housing by strictly abiding by visitation guidelines, she said. Do not visit a loved one if feeling ill.
“The residents of these facilities, for the most part, aren't leaving and getting exposed outside the facility. The virus physically has to be brought in,” she said.
'It's all related'
While local facilities weather outbreaks, some Douglas County communities are criticizing level red public health restrictions and pushing to further reopen the local economy.
The Town of Castle Rock recently adopted a resolution rebuking the state for placing Douglas County under level red restrictions and closing restaurants to indoor dining. The town's resolution said it will not participate in enforcing the health order. Local business owners and elected leaders have fiercely disputed a link between indoor dining and significnant community spread.
Richter cautioned reopening communities too soon can still affect vulnerable community members.
“It's all related," Richter said. "Opening local businesses means people can become exposed, which means that those individuals can go into nursing facilities or see friends and continue to spread the virus."
Castle Rock Mayor Jason Gray said the town is kept informed of local outbreaks through Tri-County Health but does not get involved in monitoring the matters unless the business or Tri-County requests town assistance.
Gray said he was disheartened to hear about the outbreak at Brookside.
“I've long said since this started that I don't care if you're 8 years old or 80, if you have a preexisting condition or not, or if you are elderly, every life is precious,” he said. “I think it's awfully sad that that's happening.”
Gray said the town is responding to strong and often polar opposite opinions among community members regarding how best to handle the pandemic.
“There are a lot of people who have come to me and are upset that they feel like the town or the county is not taking that as seriously as we should, and we also have a lot of people who think that we are taking it too seriously and that businesses need to be open,” he said.
He would tell community members critical of the town's calls to reopen businesses that local leaders are trying to balance caring for residents' health and their livelihoods.
“I don't think that should be a choice we make, about who we are more compassionate too,” he said.
Gray is an advocate for variance programs allowing restaurants that meet certain requirements to resume indoor dining, something now prohibited under the county's level red status.
“I don't want to lose anybody else, but the fact is we are going to, so if we can mitigate that as much as possible and start the reopening process of our businesses, I would like to,” Gray said.
Douglas County commissioners are leading efforts to establish a variance program for local restaurants and have written letters to the state urging further reopening of Douglas County's businesses.
A spokeswoman said Douglas County is not involved in responding to local outbreaks, but commissioners are regularly briefed on the pandemic's status by Tri-County Health. The county does operate work groups to facilitate connecting older adults with resources they need during the pandemic, particularly assisting those isolated by the crisis.
Commissioners did not offer comment regarding the status of outbreaks at county nursing centers.
Romann, the county coroner, is begging the community to wear masks and continue taking pandemic precautions — and not only because she sees the pandemic's deadly toll through her line of work.
In October, Romann's 75-year-old husband was hospitalized for eight days because of COVID-19 while she battled the virus at home. He lost 28 pounds but recovered.
“While I was sick, I was worried sick about him,” she said.
Romann, 64, still can't taste food. And she remembers the anxiety of being separated from her husband, unable to visit him at the hospital or easily speak with him while he relied on an oxygen mask.
She wants people to stop asking if elderly pandemic victims died “of” or “with” COVID-19, and she wants people to wear masks.
“We are not out of this,” she said.
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