WARREN — Deaths of 23 people at one long-term care facility in Warren are one reason for the huge spike in COVID-19 deaths in Trumbull County in December, city Deputy Health Commissioner John May said.

“We did experience an overwhelming number of deaths in December. We had a couple outbreaks at several long-term care facilities,” he said. “There was an overwhelming spread in one particular facility. This facility had 23 deaths in the month of December alone.”

May did not identify the facility, nor did the Ohio Department of Health.

He added that the facility had one death in January so far.

May said the facility also did not report the deaths to the Warren Board of Health and is alleged to have not followed certain CDC guidelines regarding employees coming to work after testing positive for the virus.

“We addressed that,” May said of the issues. “There was a lack of communication with the reporting of deaths to this office, the local health district.”

He said the facility “was at the cusp of a crisis situation, so we’re still investigating this a little further.”

CDC guidelines allow nursing home workers who have tested positive for the virus to still work in COVID-19 wings of such facilities under certain situations, May said. “They shouldn’t be at work at all if they are COVID positive and symptomatic,” he said.

The Ohio Department of Health has alleged that the facility made some mistakes, but May did not discuss the alleged violations in more detail.

He said the alleged reporting-to-work violations were discovered in December “during the outbreak.” He said he doesn’t know if the violations were a factor in any of the deaths.

“There’s been improvements. We’ve made recommendations, and some of those recommendations were implemented with regard to policy changes,” May said regarding when employees can come to work and when they should not.

COVID-19 STATISTICS

During December, Trumbull County had 57 nursing home deaths, raising the total to 137, an increase of 71 percent over the 80 deaths that had occurred during the first eight months of the pandemic through November.

In nursing facilities and among the general public, Trumbull County had 114 deaths related to COVID-19 in December, according to the Ohio Department of Health. The county had 150 COVID-19 deaths during the first eight months of the pandemic, but that number rose 76 percent with December’s deaths.

May said he did not know how many COVID-19 deaths occurred in Warren facilities in December.

May and the health director for Trumbull County, Frank Migliozzi, agree that Warren nursing homes were a factor in December’s death surge, but there were other reasons.

The number of people diagosed with the virus also spiked December, Migliozzi noted. An increase in infections typically leads to an increase in deaths. In the early part of December, Trumbull County recorded about 1,100 new virus cases per week, Migliozzi said. That dropped to 642 the third week, 519 the fourth week and 614 to start January.

“You see a surge in cases, and a few days later you are seeing the deaths increase,” Migliozzi said. “A lot of those (deaths) were in Warren city facilities.”

Based on ODH statistics, the number of people in Trumbull County who contracted COVID-19 in December was 4,591, an increase of 73 percent over the 6,252 who had contracted the virus during the first eight months of the pandemic.

The Warren facility with 23 deaths accounted for 40 percent of the county’s total nursing home deaths in December and about 17 percent of the nursing home deaths since the pandemic started.

May said long-term care facilities in Warren have had 59 deaths since the pandemic began, and that includes the 24 at the one facility. The facility in December did not report the deaths to authorities, May said. But the Warren City Board of Health was able to find out about them from local hospitals and with help from the Trumbull County Combined Health District.

OHIO DEPARTMENT OF HEALTH

The Ohio Department of Health, meanwhile, conducted an investigation of one Warren long-term care facility and found that some employees were reporting to work while displaying symptoms of COVID-19, such as losing their sense of taste and or smell.

This newspaper has not been able to determine whether this is the same facility as the one that had the 24 deaths.

The ODH recently reported that “based on observation, interview, record review, policy review and review of CDC guidance,” one Warren nursing home recently “failed to ensure symptomatic COVID-19 positive employees did not work on the COVID-19 unit.”

An ODH document states that the facility’s administrator said staff members who tested positive for COVID-19 returned to work in the COVID-19 unit with symptoms such as loss of taste and smell and nasal congestion.

The administrator said they allowed this because more than 50 percent of the facility’s staff “had tested positive, and they were at crisis staffing capacity.”

The facility staffed its employees in such a way that certain people only worked in the COVID-19 unit to avoid cross contamination to the other unit, the administrator said in the document.

According to the ODH document, at the time of the visit to the facility Dec. 10, six employees had COVID-19 symptoms after having tested positive for the virus and were still working. Two employees said they had “slight stuffiness.” Two said they had “no taste and smell.” One had a mild cough that she’d been having all winter and lost her sense of taste. One had no sense of smell.

The document states the positive tests had occurred as far back as eight days earlier and as recently as the same day as the ODH visit.

TWO SIDES

The facility’s administrator told an ODH investigator that the Warren Health Department was “aware of the facility utilizing staff that had mild symptoms (of COVID-19) as over 50 percent of their staff had tested positive, and they were at crisis capacity.”

A staff member at the Warren Board of Health told the ODH investigator that the facility’s director of nursing notified him that it was “having staffing issues” and would quarantine staff members who tested positive for COVID-19 who were showing mild symptoms if the facility was able to get more staffing. The facility requested four nurses and four state-tested nursing assistants.

The Warren Board of Health staff member said he doesn’t know if the facility received any additional staffing, but he “never gave approval to have symptomatic staff work on the COVID-19 unit.”

In the “plan of correction” section of the document, a facility official stated that “we do not necessarily agree with the citations with which we were cited.”

The facility stated that as of early this month, it was complying with all regulations. It had assessed all employees who had tested positive for COVID-19 and all staff “were (found) to meet CDC guidelines to return to work.”

It also stated the facility had “followed CDC guidance in its implementation of its Crisis Capacity Staffing Plan” during the time of its alleged violations.

The facility revised its Crisis Capacity Staffing policy in late December “to address how to determine when crisis capacity was reached and include the need to consult with the local health department and / or state department when making a determination of Crisis Capacity Staffing and the use of COVID-19 positive staff to care for residents,” the facility stated in the ODH document.

The facility trained its employee on the policy changes Dec. 24. Part of the training was not to come to work if he or she is COVID-19 positive and having any of a list of symptoms, including a new loss of taste or smell, congestion or runny nose.

erunyan@tribtoday.com