News continues to be positive out of the Tri-County Care Center in Vandalia after a reported outbreak of COVID-19 among staff and residents last week.

Initial reporting had 42 active cases at the nursing facility, with 18 staff and 24 residents affected. Cases connected to the nursing facility are at 32, as of Wednesday, according to an Audrain County Health Department news release.

A majority of the staff and residents will be considered recovered by Sept. 15-16, Health Administrator Sandra Hewlett said in a weekly teleconference Wednesday with business, government, education and health leaders. She is working with a disaster medical assistance team commander to implement the recovery protocols for Tri-County.

“I was able to go over some of the clinical issues with [the commander], what they found when they first got there versus what they are seeing now,” Hewlett said.

The medical assistance team provides basic continuity of care. This includes things such as bed baths, vitals checks, laundry, cleaning and room care.

“It is task based. There is no treatment they can do,” Hewlett said. “They are there for continuity of operations. They cannot replace nurses. Nursing homes would have to pull from Missouri Veterans Homes or pull from Pin Oaks resources.”

Aiding Hewlett and the medical assistance team was the Audrain County Emergency Management Agency. The fight is not over, but Tri-County is back to a level where it can provide the best care for its residents and employees, Director Nick Tietsort said.

There is no one person to blame for the outbreak, Hewlett said. It was a matter of community transmission where a person or people infected did not know how they were exposed to COVID-19 or were not showing symptoms when they were at work.

“[Tri-County’s] infectious disease process is good and they have done everything possible to work collegially with the [medical assistance team],” she said.

All Audrain County nursing homes and other long-term care facilities received interim guidance through the health department that was released Aug. 31, reopening guidelines and the nursing home testing algorithm, among others.

Nursing homes also received guidance from the Centers for Medicaid and Medicare Services related to testing in the facilities versus county positive test rates.

The medical assistance team has supplemented Tri-County’s supply of personal protective equipment, Hewlett said.

“Now it is just a matter of getting people recovered and reinforcing the social distancing, staying home if sick, staying away from people who are sick and wearing a mask,” she said. “They are having to understand what they do after work on the weekends and holidays is a direct reflection on what can happen out there.”

All nursing facilities in the county have plans in place in case there is an outbreak among staff and residents, she said.

There are 329 total cases of COVID-19 in Audrain County, with 57 active. Four people are hospitalized, Hewlett said. There were no new cases reported on Wednesday.

The region is experiencing a surge in COVID-19 cases, though, Hewlett said. This is only expected to increase now that the Labor Day holiday has passed, she said. Similar case increases occurred after Mother’s Day, Father’s Day, Memorial Day and July 4, she said.

“We don’t anticipate that Labor Day is going to be very much different,” Hewlett said. “We average between 24-37 cases after every one of those holidays. We are bracing for what the next week is going to do.”

OTHER REPORTS

The Audrain County Emergency Management Agency recently held a county stakeholder meeting that discussed the need for bus drivers. Tietsort also referenced the need for substitute teachers. The state’s education department recently changed substitute teacher certification requirements to address the growing need.

Mexico School District spokesperson Marci Minor mirrored some of what Tietsort said. The school district is using health department data and two other metrics to report district response levels. Generally, the four response levels — green, yellow, orange, red — refer to activity and event participation. If the district reaches the red level, that is when a likely temporary school shut down would happen. A big reason for a temporary closure would be due to limited staff and bus drivers who are out in isolation or quarantine.

Pin Oaks continues to hold outdoor visits. Testing among staff and residents was to start Friday based on county positive test rates. If the rate is less than 5%, testing is done monthly, between 5-10% it is conducted weekly, more than 10% is twice per week testing.

Missouri Veterans Home and Kings Daughters are closed to visitors, Hewlett said.

Every visitor to SSM Urgent Care are now required to weak a mask when inside the facility. Simon McKeown, urgent care physician, also is working closely with the Mexico School District and the Missouri State High School Activities Association in relation to student-athletes that test positive for COVID-19. An enlarged heart has been noted in a few cases, he said, so isolation times are extended slightly for student-athletes as part of return-to-play protocol. McKeown still wants residents to report any instances of receiving nonstandard advice related to COVID-19 from medical professionals, so he can discuss that advice with that professional.