老夫子传媒

Four days after Celine started working as a nursing assistant in the COVID-19 unit at a Placerville nursing home, she tested positive for the virus. She was fatigued, weak and had a dry cough 鈥� but she kept working. She said she has worked 13 days in the last two weeks, frequently taking care of more than a dozen patients at a time or working a double shift when asked.

鈥淚鈥檇 have to sit down at least 10 minutes because I just get tired, and I鈥檓 still tired honestly,鈥� said Celine, who asked not to be fully identified because she fears losing her job.

Severe worker shortages 鈥� worsened by the omicron surge 鈥� have forced some of 颁补濒颈蹿辞谤苍颈补鈥檚 long-term care facilities to rely on COVID-positive staff for patient care. , 11,500 long-term care center workers are currently infected with COVID 鈥� even though 93% are fully vaccinated. Although only 8% of the workforce is infected today, it鈥檚 48 times more than at the beginning of December, .

The California Department of Public Health earlier this month quietly issued controversial allowing infected health care employees with no symptoms to continue working. And at facilities with the most severe staffing shortages, symptomatic staff are allowed to work with COVID patients.

Since the emergence of omicron, Celine said she鈥檚 worked more overtime and cared for more patients than usual at the Pines at Placerville Healthcare Center.

鈥淭here really wasn鈥檛 a lot of staff at the beginning to work the COVID unit, so that鈥檚 why I continue to work,鈥� she said. 鈥淚t鈥檚 really hard to get staff in the building because a lot of people are afraid. If (workers) did not feel well enough, they didn鈥檛 force anybody to work.鈥�

So many workers are sick that the company installed a portable potty in the parking lot for them to use away from the nursing home鈥檚 residents, she said. Water pumped in for handwashing freezes at night and some colleagues go home or to a nearby McDonalds to use the restroom, she said.

The Pines at Placerville did not respond to multiple requests for comment.

Miguel Gutierrez Jr.

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CalMatters

At another facility in Mountain View, a certified nursing assistant said she was asked to return to work five days after contracting COVID-19. State and federal health guidelines have okayed five-day quarantines or shorter at facilities with critical staffing shortages, but her lingering cough and body aches convinced her to say no.

Now, three weeks later, she is back at work, surrounded by colleagues who tell her they are COVID-19-positive, she said.

Health workers who test positive for COVID-19 are required to wear N95 masks, but the infection is still sweeping through staff and residents at the Grant Cuesta Sub-Acute and Rehabilitation Center in Mountain View.

鈥淚t鈥檚 been like one coworker after another, after another, everyone getting sick,鈥� said the certified nursing assistant, who asked to remain unidentified to protect her job.

Nine residents also have the virus, and the facility has set up an isolation ward.

鈥淣o matter how much you protect yourself, we鈥檙e still eating in the same dining room. You know, we鈥檙e still sharing the same restroom. So what鈥檚 the whole point?鈥� she said. 鈥淚t鈥檚 almost like they don鈥檛 care about us getting sick.鈥�

Grant Cuesta did not respond to multiple requests for comment.

颁补濒颈蹿辞谤苍颈补鈥檚 , home to more than 400,000 people, have been the since the beginning of the pandemic. Their residents and workers accounted for nearly 70% of outbreaks among all health care settings in the state last year.

While vaccination and testing requirements have helped bring those numbers down, the omicron surge is now hampering facilities鈥� ability to prevent infection from spreading through their often elderly and vulnerable residents.

鈥淔or me, I think this wave was a shocker only because it swept through boosted and vaccinated people,鈥� said Christina Lockyer-White, a certified nursing assistant at Kingston Healthcare Center in Bakersfield.

Staff members there are required to wear full protective equipment including face shields, gowns, gloves and N95 masks throughout the facility, but several have tested positive regardless, Lockyer-White said.

鈥淲e didn鈥檛 think we鈥檇 be in this position, and here we are,鈥� Lockyer-White said. 鈥淚t鈥檚 like reliving a nightmare.鈥�

鈥楬elp wanted鈥�: Long-term shortage of workers

Workplace shortages have plagued nursing homes, memory care and assisted living centers for years, driven by an aging population, stagnant wages and dwindling training programs.

鈥淚鈥檝e been a nurse in long-term care for over 25 years, and there鈥檚 never been a time where we haven鈥檛 had a 鈥榟elp wanted鈥� sign out in some form,鈥� said Claire Enright, workforce specialist at the California Association of Health Facilities, which represents skilled nursing facilities.

鈥淔ive to six years ago, there were over 600 training programs for (certified nursing assistants) in the state. We鈥檙e down to around 300,鈥� Enright said.

Skilled nursing facilities provide 24-hour medical care for sick residents who require constant monitoring or rehabilitation. Other long-term care facilities, such as assisted living, memory care and some retirement homes, are for residents who need help with some daily activities.

Most long-term care facilities struggle to hire enough staff like certified nursing assistants and registered nurses, and the pandemic has brought these chronic issues to a breaking point. Nationwide nursing homes and assisted living facilities have lost approximately 259,000 workers since 2019, more than any other health care sector, according to the .

State officials do not track data on workforce losses in long-term health care, Enright said, but nursing homes are operating at lower capacity than usual, in part because there isn鈥檛 enough staff to open more beds. Before the pandemic, most nursing homes operated at about 88% capacity. Now that鈥檚 down to 70 to 75%.

Enright said the association has heard of some long-term care facilities relying on COVID-19-positive employees during this surge, but she said there鈥檚 no way of telling how many of the 11,500 sick workers are caring for patients.

Families worry more about staff shortages than sick workers

Omicron has been a nightmare for families of residents, too.

Two weeks ago, Miriam Raftery鈥檚 91-year-old mother Mary contracted COVID-19 in her La Mesa memory care facility. She鈥檚 in an isolation room by herself, and Raftery said she isn鈥檛 allowed to visit.

鈥淚t is scary. They say dry cough, but who knows. At 91, she鈥檚 very frail. It鈥檚 frightening,鈥� Raftery said.

What frightens Raftery even more, however, is Mary being left alone in isolation. During last winter鈥檚 surge, most long-term care facilities implemented strict lockdown measures.

鈥淲hen she was in that first place, she would just cry. They鈥檇 let me have window visits. She couldn鈥檛 really hear me very well, but she would just cry and plead with me to take her home. She didn鈥檛 understand what was happening,鈥� Raftery said.

Now, with Mary in the isolation room, Raftery is concerned she will get depressed again or fall if left unattended.

Courtesy of Miriam Raftery

Raftery said Mary has dementia and is a high-fall risk 鈥� she forgets that she can鈥檛 walk unassisted. Without constant supervision of her mother in the isolation room, Raftery was so concerned about her falling that she hired a private caregiver to sit with her for eight hours a day.

鈥淚 felt like I had no choice,鈥� Raftery said. 鈥淚t鈥檚 costing me $5,500 to do this for her, but given her history of serious falls and winding up in hospital multiple times from falling out of bed at these other places, you know, when she was left unattended during the day.鈥�

Raftery said Mary already has experienced the consequences of understaffed facilities. She鈥檚 been in four homes in the San Diego area since February, moving each time Raftery discovered possible signs of neglect. When Raftery questioned the places about why no one was monitoring her mother, she said she was told there wasn鈥檛 enough staff.

鈥淭he facilities she鈥檚 been in, they were all losing people because certain people didn鈥檛 want to get vaccinated or they were just fed up,鈥� Raftery said.

Families and advocates say staffing shortages caused by the omicron wave are a Catch-22: Sick workers risk spreading the disease to elderly and vulnerable residents but understaffing leads to neglect and inadequate care.

鈥淚 get why (the state health department) has opened the doors to asymptomatic workers, but it鈥檚 still , whether we鈥檙e asymptomatic or not, whether we鈥檙e vaccinated or not, right? So it鈥檚 a scary proposition,鈥� said Maitely Weismann, co-founder of the Essential Caregivers Coalition.

Courtesy of Maitely Weismann

Weismann鈥檚 79-year-old mother Celia lives in an assisted living facility in the Los Angeles area. There was an outbreak in her facility last year that her mother narrowly avoided during an unrelated hospital stay. Now she鈥檚 worried Celia will catch COVID this time around.

Even though her mother is vaccinated and boosted, Weismann said she hears about people with similar conditions and disabilities dying from COVID-19.

The state health department for insufficient oversight of nursing homes where families allege residents died of COVID-19 after sick staff were forced to work.

But for some, having reliable, COVID-positive staff available to care for their relatives is better than no one at all.

鈥淧ersonally, if someone鈥檚 positive and comes in, I鈥檓 OK with that because I would rather my mom have the care that she needs than have her be neglected,鈥� said San Diego resident Angela Trivonovich. 鈥淚鈥檝e seen the results of neglect and not a lot of care in a nursing home. I would rather her not get severe diaper rash. I鈥檇 rather her not get a bed sore.鈥�

At the nursing home where her 84-year old mother Rae lives, patients鈥� families were notified that 22 workers have tested positive in two weeks, Trivonovich said.

鈥淚f people feel good and they come in positive, I don鈥檛 know if that鈥檚 going to spread it any more than it does already. And I think the residents need all the care they can get,鈥� she said. 鈥淭hey鈥檙e desperate.鈥�

CalMatters reporter Alejandro Lazo contributed to this report. 

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