How COVID-19 vaccinations were done at this congregate living facility

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Editor’s note: Cambridge Hills, an assisted living facility in Pittsboro, last week provided 139 COVID-19 vaccinations to its residents. Executive Director Mike Walters spoke about the preparation and execution of that process with the News + Record.

Cambridge Hills completed its first round of COVID-19 vaccinations Thursday. Before we get to that, can you talk about any changes in operations and procedures you’ve had since our last discussion, and how you’ve managed to prevent COVID infections at Cambridge?

Since we last spoke things had remained somewhat the same. We maintained a consistent posture of temperature checks at the start and end of employee shifts and daily checks of our residents. We resumed allowing our therapy providers into the building, as well. In fact, we had gotten to a point where we were able to allow socially distanced outdoor visits between family and residents. It was great, for morale, for everyone.

As the weather began to shift to cooler temperatures, we moved those visits into our lobby. Our families have been phenomenal in being compliant with our procedures to wear masks and use sanitizer.

Unfortunately, in mid-December we experienced our first resident with COVID-19. It was alarming, to say the least. We had managed to go so long without this happening that it really felt awful. With that, we stopped all visitation and increased our safety protocols to have staff wearing shields, in addition to being masked at all times in the halls. We elected to test all staff and residents for three consecutive weeks. Doing so led to the discovery of five positive staff members. In each instance we worked directly with the Chatham County Health Department to provide them as much information as we can to assist with contact tracing.

As difficult as the entire year has been, I think that three or four week period was the hardest. Knowing that our residents are so vulnerable, the last thing in the world I wanted to see was that one of them had contracted COVID.

The silver lining, in all of this, was that we didn’t have any additional residents exposed and all staff have fully recovered.

What kind of preparations did you have to make before the vaccinations were actually administered, and who was involved?

We enrolled through N.C. DHHS (Dept. of Health and Human Services) to be included in the vaccine program once vaccines were being approved. We were notified on Nov. 24th that Walgreens would be our immunizer. They also conduct our annual flu clinic so we have a great working relationship with them, locally.

We received some basic information about the clinic and Walgreens, a webinar to watch and Vaccination Administration Records (VAR) to complete for each resident and staff member. With that, we had to obtain permission from residents or their authorized representative to enroll them.

Our next contact was on Dec. 16th from the area coordinator whom I understood was coordinating the clinics for upwards of 50 communities. At that time, she mentioned that their goal was to get vaccines to skilled nursing facilities and assisted living communities by the end of the year. Unfortunately, the Moderna vaccine wasn’t approved until Dec. 18 so that timeline slid to the right. Ultimately, we were scheduled for Jan. 14.

The day prior to the vaccine day I had to upload a spreadsheet of information pertaining to each person receiving the vaccine. I believe that’s what is ultimately being uploaded to DHHS and the CDC to track vaccine distribution and other demographic information.

It’s been a few days now — how’s everyone feeling?

The only reports that I had were a small number of folks with a little bit of soreness on their arms and three or four who had a small increase in temperature. By the next day everything was fine. With guidance from Callie Stegall, our medical provider, we were checking temperatures regularly throughout the couple of days after the vaccine.

The follow-up vaccine is scheduled for Feb. 11. How are you monitoring your residents and staff?

We’re back to our routine again. From what I understand it takes about a week for the first vaccine to really take effect. I’ve read that the Moderna vaccine can reach up to 80% efficacy with the first shot and up to 95% with the second.

Can you talk about how you’re handling visits from family members to your residents, and any changes in those procedures you’ve made or anticipate making?

Currently we allow residents to have 30-minute visits with up to two people. This is in compliance with what DHHS allows. With the colder temperatures we’re conducting those visits in our lobby. Residents and visitors are about 10 feet apart with a plexiglass divider in between and everyone wearing masks. We conduct a health pre-screening of the visitors prior to allowing them into the building for the visit. At this time, we don’t allow any physical contact with residents and visitors.

Throughout this year we’ve had the ability to allow in-room visits for someone who may be near the end of life. We refer to those as compassionate care visits. We recognize how hard this has been to not be able to openly spend time together so we try hard to accommodate visits during the weekdays.

I’m required, by regulation, to cease visitation if we are in a COVID testing condition (when we’re testing staff and/or residents due to a possible exposure) and if the county positivity rate is at or above 10%.

What are things like inside, among the residents, as the pandemic stretches on? Is there a light at the end of the tunnel?

I believe the residents feel safe and know that our No. 1 goal is to keep them safe. Our activities team have done an amazing job at keeping our building lively and as “normal” as possible. I’m very proud of our nursing staff who haven’t wavered in their efforts; even when we had a few staff that got COVID our team stayed on course. I believe that our persistent efforts to protect our building and make it a safe place have helped; that, and some good fortune too.

We recognize that getting the vaccine doesn’t guarantee our safety but it certainly is a huge step in the right direction. As more and more people receive the vaccine I’m hopeful that we will see a steady decline in the spread of the virus and the opportunity to open our doors up to families again.

2020 was exhausting. I feel hopeful now. I feel like there is a light at the end of the tunnel but we’re not letting our guard down. One day, hopefully soon, we’ll be talking about the year that was ...

Mike Walters joined the Cambridge Hills Assisted Living management team as the executive director in October 2017 after more than 20 years in management in the consumer goods/HVAC industry. He’s the senior member of the management team at Cambridge Hills and also has oversight of its sister company, Twin Rivers Independent Living, in Pittsboro.

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