The Lufkin State Supported Living Center has at least three confirmed positive cases of COVID-19, coronavirus and more suspected cases waiting for test results.
However, state-provided information is not lining up with information provided by health care professionals, employees and families of residents.
By May 6, the center had three confirmed positive cases of the virus in employees and residents, according to Sharon Shaw, executive director of the Angelina County & Cities Health District. She also said additional tests are being administered but would not give a number.
The Lufkin State Supported Living Center (SSLC) administration deferred comment to the Texas Health and Human Services Commission (HHSC) when asked for additional details.
Christine Mann, chief press officer for the commission, only confirmed one case and would not confirm any information on the number of residents being tested.
“(The Lufkin State Supported Living Center) are following public health advice, and they’re doing a great job of monitoring their employees and their residents, and we’ve been working with them since the beginning of COVID-19,” Shaw said.
Mann said nothing is more important than the health and safety of residents, staff and the local community. The center began travel-screening staff on March 5, asking whether they had recently visited a country identified by the Centers for Disease Control and Prevention as high risk or whether they had contact with someone who had, Mann said.
On March 13, visitation restrictions to centers were implemented, and all employees began to be screened for fever and respiratory illness.
Mann said the HHSC was made aware of one resident at the Lufkin center who tested positive on April 18.
One resident’s guardian, who requested to remain anonymous to protect her relative from retaliation, received word via letter that a resident tested positive for the virus on April 18.
The letter stated all staff were wearing masks at all times and using additional personal protective equipment (PPE) like gloves, gowns and face shields.
“At that time, the center’s COVID-19 response plan, developed based upon CDC and DSHC guidance, was implemented,” she said. “All staff were issued commercial surgical/procedure masks. Staff working at a home designated for people with COVID-19 were issued additional PPE, including N95 masks, eye protection, gowns and gloves.”
The woman said she normally visits her relative frequently, even spending weekends together out of the facility. However, she hasn’t been able to do that since visitation was suspended, and she worries about what’s going on — has her relative been exposed, are they being tested, how many cases are on campus?
The letter also stated:
“We can provide you with this information because a guardian consented to us notifying you of the presence of COVID-19 on campus. Privacy laws prevent us from providing you detailed information in most cases, but we will make sure you have all the information we can give you. We won’t be able to notify you about every single case going forward.”
The Texas Tribune, a nonprofit media organization headquartered in Austin, released a story on April 22 reporting that the state of Texas is not releasing information about coronavirus clusters at state-run homes for Texans with disabilities.
“Residents' families, restricted from visiting in an effort to stop the spread, are pleading for information. Even they aren’t being told how severe the outbreaks are where their loved ones live,” according to the Texas Tribune story.
If the guardian of the resident who tested positive on April 18 had opted not to release information, would anyone even know about the outbreak, the woman asked.
“That just about scared the life out of me; I was like, oh, Lord, here we go,” she said. “The lady that called me told me they wouldn’t be calling me back to update about any cases unless it was your client personally. … I want to know that (my relative) is OK, if anybody in (their) dorm is one of the ones broken out with the virus or was it an employee that’s been removed from the job, how are they quarantining anybody out there that does have it?”
Surely they would have let them know, she said.
None of Texas’ 13 state supported living centers that house about 3,000 Texans and employ 13,000 staff members provided case counts to The Texas Tribune. The story said the local health department in Denton County stood out as the lone agency providing daily updates about the cluster of cases at the Denton home.
The Lufkin SSLC opted to move residents who tested positive to a home that served only them, and they will remain in that home until they recover fully from any illness, Mann said.
“Even if asymptomatic, they will remain in the isolation home until they have two negative test results, taken at least 24 hours apart,” she said. “Infection control procedures include sanitizing areas with disinfectants in accordance with CDC guidelines. Additionally, Lufkin SSLC uses UV lights, purchased using community donations, as part of its infection control procedures. Any residents who had contact with a person who tests positive for COVID-19 are also tested.”
The action to quarantine suspected positives is typical in infection-control situations, Shaw said. If someone was close to a positive or in contact with a positive, you remove that person from general circulation.
However, an employee who wishes to remain anonymous to protect their position from retaliation said proper PPE was not issued for all employees or several employees who were tasked with moving the possessions of suspected positive cases.
“The people working on the home where they knew they had COVID were issued PPE, but general staff was not even issued a mask until (April 27),” the employee said. “There was a full week of no protection whatsoever. … The maintenance guys moving stuff in and out didn’t have PPE. They were just vulnerable. They even called a maintenance guy in to work on the home this past weekend (May 2-3), and he had no PPE whatsoever.”
The employees who were assisting that move should be wearing proper personal protective equipment (PPE) during the process. In fact, they should be wearing proper PPE all day, regardless of if they come in contact with a positive, Shaw said.
“We’re closely monitoring it; they’re doing a great job,” Shaw said. “They have had to move a few residents around so they can get them into a more of a quarantined area so they can keep a good eye on them and they don’t run the risk of infecting anybody else if they were symptomatic.”
The CDC has outlined guidance regarding contact with potential positives. In a chart at bit.ly/3cek1No, the CDC says that if a health care professional with no PPE has prolonged close contact with a patient with COVID-19 (beginning 48 hours before symptom onset) who was not wearing a cloth face covering or facemask, that health care professional is in a high-exposure category to the virus, and the CDC recommends that the health care professional be excluded from work for 14 days after last exposure.
However, an email sent to center employees by Scott Schalchlin, associate commissioner of state supported living centers for the Health and Specialty Care System, reads: “The SSLC guidelines, based on recommendations from the CDC and in consultation with the Texas DSHS, require an employee who has had primary or secondary exposure to COVID-19 but has no symptoms (no cough, shortness of breath or sore throat) to:
Immediately notify your supervisor so any potential developing symptoms can be tracked and monitored.
Practice required precautions at all times.
If you have had primary exposure contact while the person is symptomatic or if you had exposure up to 72 hours before the person became symptomatic or tested positive for COVID-19, wear a mask for 14 days after exposure.
Monitor your temperature before you come to work and self-monitor for any symptoms (even if mild) such as fever and respiratory symptoms (coughing, sore throat, shortness of breath).
Ensure you have no fever or symptoms before leaving home and reporting for work.
Report to work if you don’t have fever or respiratory symptoms.”
The email stated employees who have had primary or secondary exposure to COVID-19 who have no symptoms were still expected to report to work because “CDC and DSHS guidance doesn’t require self-isolation after potential exposure to COVID-19 if you don’t have symptoms.”
“Guidance from a local health department or a health care provider to self-quarantine based on a potential exposure to COVID-19 isn’t consistent with CDC and DSHS recommendations unless the health care provider indicates that an employee has COVID-19 or is particularly vulnerable to COVID-19. As essential care workers, it is vital that staff report to work as scheduled unless symptoms appear,” Schalchlin’s email stated.
On April 29, the center began allowing staff who had no contact with residents to return to wearing homemade masks to “preserve our PPE resources,” Mann said.
“At all times, staff in areas with residents must wear commercial masks,” Mann said. “All usage of PPE is consistent with CDC guidelines and Department of State Health Services guidelines.”
Residents who had potential exposure are separated from residents who have not while the school waits for the test results, Mann said.
“In accordance with the CDC guidelines for health care workers, staff with direct or potential contact are still allowed to come to work as long as they are not symptomatic and wear a commercial mask for at least 14 days following the exposure,” she said. “At Lufkin SSLC, nearly all staff are wearing commercial masks already, with the exception of staff who have no contact with residents. Should one of those staff have potential exposure, they are required to wear a commercial mask for 14 days regardless of whether or not they are in resident areas.”
The employee said that no guidelines had been set out until March 17 or March 18, when a travel ban was implemented by the state, restricting governmental agencies from traveling between counties. However, the next day, the Lufkin SSLC had a “campus full of inspectors from Austin” who were there for a yearly inspection.
The inspectors were sent back to Austin by noon when Schalchlin found out they were there, but they had been allowed on campus for a half a day, the employee said.
Additionally, the employee said that while masks have now been provided, employees are not required to wear them.