Conditions at San Francisco nursing home deteriorate rapidly amid coronavirus outbreak

MILLBRAE, Calif. —  Conditions are deteriorating at Laguna Honda Hospital and Rehabilitation Center, a skilled nursing and rehabilitation center facility in San Francisco, amid a coronavirus outbreak there, city officials said Monday.

Mayor London Breed said nine employees of the large facility had tested positive as well as two patients. Infection control nurses from the state and infectious disease physicians and epidemiologists from the U.S. Centers for Disease Control and Prevention have been sent to San Francisco to help deal with the outbreak, officials said.

“I am saddened to report to the San Francisco community the Laguna Honda hospital has a growing outbreak of coronavirus,” said Dr. Grant Colfax, director of public health for San Francisco. Because long-term-care facilities around the world have been at greater risk in the COVID-19 pandemic, “we expect the situation to unfortunately get worse,” Colfax said.

Laguna Honda is operated by the San Francisco Department of Public Health and is a skilled nursing and rehabilitation center with space for about 780 residents.

“The situation will escalate in Laguna Honda,” Breed said at a news conference Monday, adding, “It escalate here in San Francisco.”

The nine Laguna Honda workers and two patients infected with the coronavirus are in good condition, Colfax said Monday. Since March 26, 158 workers and 54 patients were tested for the virus. Of the patients, 51 tested negative and one result is still pending. Among staff, 156 have tested negative and 25 tests are underway.

Colfax said he expected for infections to be reported in both staff and the residents. Managers are working to train staff on proper wearing of personal protective equipment and thorough cleaning of resident rooms and common spaces.

The two units where coronavirus cases have been diagnosed are under an extensive quarantine order; each unit houses about 60 residents. Doors have been secured and sheriff’s deputies are monitoring the exits to prevent residents from leaving, and are only allowing appropriate staff to enter. Residents are being monitored for illness during every shift, and staff are screened twice for symptoms at every shift.

Laguna Honda is also setting up a field care clinic as a precaution in case there’s a need to separate groups of patients, Colfax said.

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Breed said that more people in the city seemed to be adhering to a shelter-in-place order over the weekend. There are 374 confirmed cases of COVID-19 in San Francisco, and six people have died.

There are still challenges San Francisco is facing. The city still doesn’t have a good estimate what percentage of San Francisco residents likely have the coronavirus, Colfax said. They also are short of testing swabs. “We are struggling to get swabs in order to test,” Colfax said. There are multiple items that are in short supply — from items needed to capture a specimen to test to the chemicals needing to process the tests.

The situation at Laguna Honda underscores larger concerns about hospitals in California in general as coronavirus cases spike.

Hospitals risk being overwhelmed by a growing number of sick patients.

The number of COVID-19 patients in California’s intensive-care beds doubled overnight, from 200 on Friday to 410 on Saturday, Gov. Gavin Newsom said. And the number of hospitalized patients testing positive for COVID-19, the respiratory disease caused by the coronavirus, rose by 38.6% — from 746 on Friday to 1,034 on Saturday, he said.

“We’re blessed that we’re just at 410, devastating for the individuals there and their family members and loved ones,” Newsom said at a news conference in Sunnyvale on Saturday. “But by comparison and contrast to other parts of this country, that number seems relatively modest.”

To prepare for a surge in coronavirus patients, medical cots and equipment are being delivered to the San Mateo Event Center in the Bay Area.

Deliveries began Sunday, and the National Guard is expected be at the center through Tuesday to set up the equipment. The federal treatment site can house 250 patients with mild symptoms.

“The latest projections estimate that a medical surge could push the hospitals in our county to capacity and we’ll need another location to house patients requiring particular levels of care,” County Manager Mike Callagy said. “We can’t just wait to see if this will happen.”