IOWA, USA — As of Wednesday morning, just six long-term care facilities in Iowa are experiencing a COVID-19 outbreak.
During the November surge, the highest peak in outbreaks, there were 167 facilities battling the virus.
These facilities are home to one of the most vulnerable populations and the state immediately utilized targeted mitigation strategies to keep these folks safe.
According to the Iowa Department of Public Health, the state has a total of 432 long-term care facilities. Of those, 337 have experienced at least one outbreak.
Residents have battled more than one invisible enemy — loneliness and isolation have also been at the forefront of leaders' minds.
Local 5 is diving into how these facilities managed throughout the pandemic, highlighting how safe havens turned into battlegrounds.
Watch "How Iowa's virus battle began | COVID Cause & Effect, Ep. 1" here
Watch "The education transformation | COVID Cause & Effect, Ep. 2" here
Watch "Those we have lost | COVID Cause & Effect, Ep. 3" here
Battling the invisible enemy: Safe haven for older Iowans adapts to outbreaks
In the middle of the pandemic, Karen Stubbe went from being a full-time caretaker for her father Bennie to having to make the tough choice of admitting him to long-term care at Grand Jivante in Hardin County.
"I'm handing him over at the door, giving him his last hug. Not knowing if I'm gonna be able to see him and I'm getting able to visit him," Karen said.
Then in October, a COVID outbreak occurred in the Grand Jivante building, leaving Karen worried about the likelihood of her father contracting the deadly virus.
"Is he gonna get it today? Tomorrow? Or is he going to be one of the lucky ones that don't?" Karen questioned.
The outbreak was eventually contained, but Bennie did end up contracting COVID.
"Many days laying in my bed crying, feeling like I let him down," Karen said about her dad's diagnosis.
There are many instances around the state of communities and families getting creative during COVID — Grand Jivante saw parades, multiple signs, even food dropped off daily.
Gail Willms is a resident at Grand Jivante who struggled with the regulations in place during the height of the pandemic.
"We all just got real...when we're quarantined all the time, it got to be tough on everybody. And I... then I finally got to realize it was a big real thing," Gail said.
A big realization for Gail was when she found out her own mother was dying of COVID in the hospital. She didn't get her chance to say goodbye.
Now that restrictions are being lifted, residents can eat together once again and do activities. Gail said she is looking forward to getting back outside in the garden to plant tulips in honor of her mother.
"I told my kids, 'Grandma lived until she died.' She did. She lived every minute of it. That's good," Gail said.
A year now into COVID and working with CDC regulations, Grand Jivante allows supervised in-person visits. They are able to see one another in a regulated room, and Karen couldn't be happier to spend time with her father once again.
"We want you to see your families, we want you to be able to hug them," said Shasta Smith, director of nursing at the facility. "It really does come down to patience. We are following guidelines, we are following them, the minute they come out, we just gotta wait for him to come out."
Contact tracing and the Iowa National Guard
Contact tracing is just one of the terms Iowans have become very familiar with during the first few months of the pandemic.
At first, county public health departments and the state were making the calls to Iowans who tested positive, gathering their information.
Then, the Iowa National Guard stepped in to carry some of the load.
Dave Letexier is a senior master sergeant in the Air National Guard stationed in western Iowa. At the start of the pandemic, he focused his efforts on logistics such as moving supplies from one part of the state to another.
Like many others during the pandemic, his role shifted to a daunting task that turned out to be one of the most rewarding experiences of his career — setting up a system for contact tracing.
"I've been in a long time. I'm fairly gray and thin in [my] hair. I've never seen anything like this, and you throw 50 people into a room and you just go through from there," Letexier said. "We came together very quickly. I knew that the Army and Airforce could do anything together."
Both the Army and Air National Guard made thousands of phone calls.
"We would make these calls and we would be filling out a spreadsheet, trying to not be a robot and we wanted to be [a] real human. And so that was a big part of our job," Letexier said.
One call, in particular, stands out to Letexier. It involved a Spanish-speaking Iowa woman who was having a hard time.
"Our member talked to the interpreter to make sure she was OK, and she wasn't. We ended up calling 911 and out to another county, and she was about to have a heart attack," Letexier said.
Letexier saw the whole process come full circle, too — visiting a TestIowa site where some of the folks he called would get tested.
"Going out there and seeing our members do whatever it takes in whatever weather, that was really nice to see," he said.
For the last year, Letexier managed to stay positive and calm while continuing to look on the bright side.
"It might get ugly, but people are going to get closer and then we're gonna have to get along, too, in confined spaces, which I think overall helps us as humanity," he said.
Master Sgt. Letexier doesn't work at the call center or TestIowa sites anymore. He is now back to coordinating troops and goods throughout the world.
Local lessons learned
I think the biggest thing that I have learned and it's been so rewarding has been how willing everyone in our community has been to step up and to help. This is not something that just a single local public health department with 42 employees can do by itself. It really is a community-wide effort. And we are so thankful for everyone's willingness to step up and serve.
I think the biggest thing that I would change maybe would be the misinformation that's out there. How do we get people to trusted sources, the right information, not some of the myths and misinformation that we see on social media?
— Helen Eddy, Polk County Public Health Director
Visits at long-term care facilities continue through the glass, for now
On June 9th 2020, three months past Iowa's first identified COVID case, it was decided that Good Morning Iowa's Jackie Schmillen's grandmother needed a higher level of assistance in long-term care, including hospice, and she was admitted to Accura Healthcare of Aurelia in northwest Iowa.
"From the moment she entered the building, she was put into quarantine and we couldn't see her because they were already in lockdown and we struggled to explain to her that this was her new home," Jackie said.
Jackie's grandmother turned 103 years old in December, and because of her age she doesn't hear very well. She's also from the generation where technology, like a cell phone or iPad, just doesn't make sense.
"We've quickly learned that when words don't work, posters and smiles are enough to do the trick for now," Jackie said. "The staff at Accura Healthcare have gone above and beyond making sure she is safe and always guiding her to the large front window so we can say, 'Hi.'"
Recently, Accura Healthcare has allowed one visitor to make contact with Jackie's grandmother, and that is her dog Jack-Jack. Like other facilities in the state, Accura Healthcare is now scheduling supervised visits.
However, visitors aren't able to get physically close to their loved ones.
"And with my grandmother's hearing issues and confusion of the current situation, we continue, at this time, to make our visits through the glass."
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