A local nursing home has had to create a special unit and bring back employees who are confirmed positive as it continues to battle an outbreak of COVID-19, its nursing director said Monday.

Wade Menefee, director of nursing at Limestone Health Facility in Athens, said 70 patients and 21 employees have tested positive for the virus. That’s more than double the number of employees and triple the number of patients who were positive three weeks ago.

To prevent further spread, patients are being kept in a designated COVID-19 unit, away from other staff and patients. However, having 21 employees unable to work would be detrimental for most facilities or businesses, and LHF is no different.

So, Menefee said, they looked to the Centers for Disease Control and Prevention as well as the Alabama Department of Public Health for guidance on bringing employees back to work — even if they haven’t tested negative yet.

“There is guidance from the CDC and ADPH about allowing positive employees to return to work if they meet certain criteria to work with positive COVID patients,” he said. “We follow those strategies to allow that.”

According to the CDC, a test-based strategy — in which a health care employee has two negative tests before they return to work — is no longer recommended, “except for rare situations.” Instead, a symptom-based strategy is used.

This strategy requires a general improvement in symptoms, including at least 24 hours without a fever. If the employee is not severely immunocompromised, had mild to moderate illness and/or were asymptomatic when tested, they can return to work 10 days after their first positive test or the onset of symptoms, the CDC says.

If they were symptomatic, are severely immunocompromised and/or had severe to critical illness, the CDC recommends 20 days before the employee can return.

Even then, they can only work with COVID-positive patients, Menefee said. At LHF, the designated area of the facility for COVID-positive patients is arranged in such a way that Menefee said employees and patients do not have to come in contact with anyone who hasn’t tested positive, and employees continue to wear personal protective equipment during their shift.

Nothing like it

Menefee said in all of his career, nothing he’s dealt with has come even remotely close to what they’re dealing with during the pandemic. Two patients have recovered, but three have died.

In the past, patients who have died might have been surrounded by a room filled with loved ones. Now, they get visits through the window or the screen of an electronic device.

If they’re lucky, two family members at a time can get through the symptom screening station and don the full PPE required to visit the patient one last time.

“To go from a room full of people surrounding a patient to ‘we only allow two people at a time to prevent transmission,’ it’s very different,” Menefee said. “I think most health care people will tell you right now that dealing with this is something we’ve never dealt with before.”

As the people inside the facility work to reduce the spread and help patients recover from the novel coronavirus, he asked those outside the facility to do their part, too, by washing their hands and following statewide guidance.

“You can’t stress that kind of stuff enough,” he said. “Stopping the spread not just here but out in the community is what helps health care facilities, hospitals, clinics — there’s a mass group of people that can help.”

Menefee said the health care industry is tough to begin with, with staff working extremely hard, long hours. Adding a pandemic on top of it all has been draining, he said, adding, “Outside people don’t really have an inside look at what goes on a daily basis.

“And then you throw this in the mix.”

Monday’s numbers

As of Monday, more than 3,000 long-term care residents and nearly 2,000 long-term care employees had tested positive for COVID-19 in Alabama, according to a cumulative total by the Alabama Department of Public Health dating back to March 13. There have been 4,704 health care workers total to test positive.

As predicted by Dr. Scott Harris during a media conference last week, the positive test rate for the virus had jumped to 16.6% for the week ending July 11, up from 14.4% during the week ending July 4 and 11.9% during the week ending June 27.

Hospitalizations are also continuing to rise, with ADPH reporting 1,465 confirmed positive patients in Alabama hospitals as of Sunday, up 302 from the previous Sunday.

At the local level, Limestone County has reported 879 lab-confirmed cases of the novel coronavirus since March 13, adding 188 of those cases in the last five days. There have been five deaths reported, with a sixth marked “probable.”

The positive test rate in the county has risen to 13.7% for the two-week period ending Monday. Previously, The News Courier reported 12.8% for the two-week period ending July 14 and 11.9% for the two-week period ending July 8, based on data from ADPH.