IMPORTANT INFORMATION AS OF May 21, 2020
Dear Cedar Sinai Park Colleagues, Residents, Families, and Friends,
Last Saturday night we were to gather together at Pure Space for the “Birthday Bash of the Century,” celebrating Cedar Sinai Park’s 100th Anniversary. Please join me in giving a BIG virtual hug to our Chair, Marcy Tonkin, Steering Committee Members Michelle Eastern Gradow, Eddy Schuldman, Karen Blauer, Liz Lippoff and each member of our Anniversary and Events Committees for their hard work and effort in bringing life and passion to all events to date. A significant part of our 100th year is the newly launched “Our Stories” project. Next time you “see” Eddy Schuldman or Karen Blauer, give them an air high five to thank them for their vision in bringing Portland authors together to capture the heart and soul of our rich history.
While we were not able to celebrate in person, I am humbled and inspired by our communities’ outpouring of love, well wishes and financial support. Our fundraising efforts are more important than ever as we seek to meet the needs of those who are depending on us during this challenging time.
Staff Update: Our dedicated staff member who tested positive for COVID-19 retested negative and is happy to be back working with our residents.
Resident Update: We continue to rigorously monitor all residents each shift and encourage appropriate distancing and the use of masks during care and when in common areas.
Regulatory Update: There is much in the news about reopening long-term care. Until there is clear guidance, process, support and supplies from our state and federal partners, Cedar Sinai Park will continue to exercise an abundance of caution and maintain our current protocols.
On that note, this week I’m honored to share my weekly column with Dr. Kirsten Carr, Cedar Sinai Park’s Medical Director:
Testing in the Age of COVID-19
We have now been in the world of the COVID-19 for over two months here in the state of Oregon. My family has been mostly homebound with the occasional nature walks. I have been grateful that this pandemic occurred in the Spring. The rebirth of nature, with the flowers and trees coming back into bloom, has given a daily reminder that our world is capable of regrowth and beauty even when things are not as we planned.
We have learned much about this new virus and how it works. However, effective treatment and a vaccine remain months away as scientists and physicians test and treat patients throughout the world. We know that we will need effective treatments, testing, and tracking before we can return to a more normal state of being. Because testing is something that is available at this time, some have asked the question, “Why not test everyone at this point so we know where we are here on our campus at Cedar Sinai Park?” The reality is, at this point in time, testing is not the best way to keep Cedar Sinai Park safe from infection.
Testing kits are not widely available yet. Although the state and federal governments are trying to secure more testing kits for long term care communities, there is still a significant shortage of available testing kits. We are fortunate to have a stock of testing kits on our campus that would allow one-time testing of residents only. This would not, however, allow for testing of staff nor would it allow for retesting on a regular basis.
Testing for active disease is not 100% accurate. At this time, the testing that we have that is the most accurate for detecting the presence of the disease is a swab of nasal or throat mucous. This test has less than ideal sensitivity (true positive) with a false negative rate of up to 35%. The test is also not completely specific (true negative) with a false positive rate of up to 5%. This means if we tested 200 people on campus, we could potentially tell 70 folks they were negative when they weren’t and they could go to dinner each night and get everyone else sick or on the flip side tell 10 folks that they were positive and move them to a COVID facility in error. The best way to increase accuracy of testing is to test only those with clear symptoms (fever, cough, shortness of breath, etc.) or a known exposure to a known COVID positive person for long periods of time (household contacts).
There is also antibody testing available. Rather than testing for active disease, this test reports if you have had the disease in the past. Antibody testing has the same challenges with accuracy and the FDA has warned that many of these tests have not gone through enough rigorous testing yet to be considered valid. We are also unsure, although we suspect, if having had the disease prevents you from being able to contract it again. We are still waiting for data to support this and to help us understand if this is a lifelong protection or a short-lived protection.
There may come a time when the State or Federal government requires testing. The White House has already suggested nation-wide testing of all nursing home facility residents. This would most likely be one-time testing for the entire campus of residents and ongoing periodic testing of the staff. Each state will decide if this makes sense based on medical evidence as outlined above. If we move to this sort of testing, however, it will not take the place of current infection control measures for the reasons listed. I want to prepare you for these sorts of mandates and the potential downside of them including false reassurance that nobody on campus has COVID. This sort of testing will also not likely change any of the current guidelines related to visitation or congregating in public for long term care facilities.
The most important tools that we have now for preventing spread of this disease are the same ones we have been using for the last two months: hygiene, social distancing, good infection control practices in the community (cleaning), wearing masks, and vigilance. It remains very important to not come within 6-12 feet of another person with whom you don’t share a living space, especially indoors. Please wear at least a cloth mask whenever you leave your room/home to protect your neighbors (and if they wear them, they are protecting you). Wash your hands with soap and water for at least 20 seconds regularly and in particular after returning to your room from the community or outdoors. We ask that you avoid using public restrooms if possible. Please follow the “one mensch to a bench” guidelines inside and outside.
These are challenging times. Change is hard. But we are a community that is capable of dealing with hard times. There is creativity and ingenuity and a sense of togetherness despite the different look of the world.
“Happiness can be found, even in the darkest of times, if only one remembers to turn on the light.”
As always, if you have any questions, please feel free to contact the campus administrators or me. We will assist you in any way possible.
RSM: Vivian Villegas: 1-360-936-2694
HSCL/RJHC: Krista Mattox: 503-320-0807
With love, honor, and respect,
Kimberly Fuson Kirsten Carr, MD
Chief Executive Officer Medical Director