A COVID-19 outbreak at the Watsonville Post Acute Center has resulted in the deaths of 16 residents.
A COVID-19 outbreak at the Watsonville Post Acute Center over the summer resulted in the deaths of 16 residents.
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COVID 2022

Nursing homes account for 72% of deaths in Santa Cruz County: Data reveals surprising trends

LOOKOUT EXCLUSIVE: A breakdown of the COVID-19 fatalities in Santa Cruz County shows nursing homes accounting for far more deaths than in other parts of the state. “The virus does not give you a break,” one health official says.

Seventy-two percent of all COVID-19 deaths in Santa Cruz County have been residents of skilled nursing or assisted living facilities, a Lookout analysis of data provided by county health officials has found.

This is in stark contrast to state of California and national figures, in which nursing home deaths make up about 35% of the total.

The numbers are especially striking because COVID-19 started spreading relatively late in Santa Cruz County, as compared to other parts of the state, so these long-term care facilities had more time to implement and perfect safety procedures.

“To be honest we’re just kind of frustrated about it,” emergency medical services director Dr. David Ghilarducci said in a press conference Thursday when asked what could have been done differently. “We had a lot of time to prepare.”

Ghilarducci said county health officials have met weekly, and sometimes twice weekly, with each of the skilled nursing and assisted living facilities in the county since the beginning of the pandemic.

But, he said, “As the amount of virus in the community went up, the likelihood of a staffer walking into work with an unknown infection went up also.” Constantly practicing vigilance, and donning and doffing PPE, “is tiring,” he said. “I think frankly people got tired. And the virus does not give you a break.”

Santa Cruz County has a total of seven skilled nursing facilities and 28 assisted living facilities. Four skilled nursing and two assisted-living facilities have experienced COVID-19 fatalities.

County Health Officer Dr. Gail Newel pointed out that professionals in skilled nursing and residential care facilities provide very intimate care for their patients, often feeding, dressing, and bathing them, so their risk of both catching and transmitting the virus between caretaker and patient is very high. She urged people not to blame these workers for what has happened.

The overall per capita death rate in Santa Cruz County is very low compared to most counties in the state, at just 23 deaths per 100,000, compared to the state value of 55. That’s similar to many of the counties that have avoided the worst of the pandemic such as San Francisco, which is at 20.

But, Ghilarducci said, “The virus has pretty much spread through all our skilled nursing facilities.” He thought this might now be providing some protection in the form of increased immunity in the population. A recent outbreak at the Santa Cruz Post Acute nursing home, for example, has “stabilized.”

Rusty Greiner is the administrator of Santa Cruz Post Acute, where 16 residents have died — a quarter of all the deaths in the county. The death toll, he said, occurred despite his staff’s absolute best efforts. “Everything we’ve done, we have been either following CDC, CDPH guidelines — or taking it a step higher,” he said.

“When CDPH and the County of Santa Cruz came to our building, they saw that we were doing a lot of preventative measures that other facilities weren’t doing,” Greiner said. All employees were tested weekly, and the facility even banned bringing in food from outside vendors.

Everything we’ve done, we have been either following CDC, CDPH guidelines — or taking it a step higher.

— Rusty Greiner, Santa Cruz County Post Acute administrator

Greiner said it has been draining to constantly enforce these policies while trying to keep morale up.

But it was working for a time. Santa Cruz Post Acute hadn’t suffered any outbreaks — until November, when Halloween and other gatherings set off a surge in cases throughout the county and the nation.

“I truly believe our health care employees were trained and constantly reminded of the importance of following policies and procedures,” Greiner said, “but I also truly believe it’s so easy to live in the same household as a loved one who could be an asymptomatic carrier. And what do you do at that point? How do you stop it?”

Santa Cruz County has now confirmed 64 deaths due to COVID-19. As recently as December 2 there were only 32. Half of these deaths have been recorded just this month, and the month is far from over.

Most of the victims in Santa Cruz County, about 70%, were over 80, and most, about 73%, had underlying health conditions. Nationally, the CDC breaks up age groups somewhat differently, but according to their data COVID-19 deaths in people older than 85 account for about 32% of deaths. Including people between the ages of 75-85 brings the number to 59%.

The higher proportion of deaths among the elderly in Santa Cruz is most likely because of the higher-than-national proportion of deaths in skilled nursing/assisted living facilities.

The California Department of Public Health keeps less granular age data, but statewide deaths in people over age 65 make up 74% of all deaths.

About 35% of the deaths among Santa Cruz residents were in people of Latinx ethnicity. This is approximately proportionate with their share of the population, but the burden on the Latinx community is clearly visible in the number of known cases; that population has suffered almost 60% of the total COVID-19 cases in the county, despite accounting for just a third of the population. This is a group of people who work many of the essential jobs countywide, and aren’t able to stay home and avoid exposure, and are also more likely to live in larger households.

The trends among the Latinx community in Santa Cruz County are similar to what’s observed statewide, where they account for 39% of the population but 48% of the deaths.