Long-Term Care Data
The Illinois Department of Public Health (IDPH) recognized the potential for long-term care facilities (LTC) to be heavily impacted by COVID-19 early in the pandemic. As soon as the first few cases of COVID-19 were identified in the state, the department issued LTC guidance, restricted visitors, canceled group activities and implemented screening of staff and residents for illness. Weekly COVID-19 infection and prevention educational sessions for LTC administrators and staff began on March 9, 2020, in conjunction with Governor J.B. Pritzker’s Disaster Proclamation.
The first case of COVID-19 in an Illinois LTC facility was diagnosed on March 11, and a large outbreak ensued. A joint investigation with IDPH, DuPage County Health Department, the University of Illinois at Chicago Department of Medicine, Illinois Emergency Management Agency, Centers for Disease Control and Prevention (CDC), and Rush University Medical Center, confirmed that unrecognized asymptomatic spread of the virus had contributed to the outbreak. This finding was published in June 2020 adding to the national discussion on appropriate COVID-19 control measures for LTC facilities.
During the weeks that followed this first outbreak, the number of COVID-19 cases and deaths surged in the community and at LTC facilities, peaking in May. The IDPH LTC response focused on increasing testing capacity, providing personal protective equipment, and working with facilities and local health departments to ensure that the core principals of infection prevention were put into practice. IDPH contracted with healthcare organizations to perform onsite LTC infection prevention evaluations and COVID-19 testing. Emergency Rules were issued requiring LTC facilities to perform testing during outbreaks at the end of May 2020.
By summer 2020, the number of cases had decreased substantially. Anticipating that there would likely be another surge in cases, the U.S. Department of Health and Human Services sent newly developed point-of-care antigen tests to LTC facilities across the nation. IDPH ensured that all LTC facilities had adequate supplies of the tests and, following the Centers for Medicaid and Medicare Services lead, required routine testing of all staff. When a second wave of COVID-19 cases hit Illinois in the fall, this LTC staff testing helped to identify infected asymptomatic individuals who could inadvertently spread the virus to residents and co-workers.
After months of intense effort, COVID-19 vaccinations became available in December 2020, and CDC launched a massive national program to vaccinate the residents and staff of all LTC facilities in the United States. In Illinois 46% of all deaths from COVID-19 have been in LTC, and facilities were urged to participate in the program. Nearly 1500 LTC facilities, 99% of the total number licensed in the state, were enrolled. IDPH worked together with Walgreens, CVS and PharmScript to hold three vaccination clinics at each facility over a three-month period; 4500 clinic sessions in total. In March 2021, with COVID-19 cases in decline, and evidence of the effectiveness of vaccinations, IDPH released LTC guidance for the safe resumption of visitation and activities.