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As COVID-19 cases rise in Philly, doctors help care homes and addiction rehabs navigate outbreaks

People in care facilities are particularly vulnerable to COVID-19, both because of their communal living setting and medical conditions that might make them more subsceptible to the virus.

The Kirkbride Center located on 111 N 49th St., is shown on Monday, October 26, 2020.
The Kirkbride Center located on 111 N 49th St., is shown on Monday, October 26, 2020.Read moreJOSE F. MORENO / Staff Photographer

When COVID-19 cases spiraled in the early days of the pandemic, doctors at Penn Medicine offered help to some of the most vulnerable places in the city: nursing homes, long-term care facilities and addiction rehabs, where the virus can spread like wildfire among medically fragile residents.

Now, with cases surging again, Penn and Temple University providers are leading a more formal, state-sponsored effort. The Regional Response Health Collaboration Program, started in July, has helped nearly 50 facilities in the city deal with COVID-19 outbreaks, providing PPE, testing, and temporary replacements for quarantining staffers.

Those facilities now include the Kirkbride Center, one of the city’s biggest addiction treatment programs, which in the last two weeks has seen about 80 cases of COVID-19 among patients and staff. Kirkbride has 270 beds.

It’s the center’s second outbreak since the pandemic began, and comes after Kirkbride patients and staff went five months without a positive COVID-19 test.

During Kirkbride’s first outbreak in the spring, though testing and PPE were still scarce, Penn doctors stepped up to test and quarantine patients. This time, the process has been “better and faster," said Nina O’Connor, the chief medical officer for Penn Medicine at Home, who has been directing Penn’s efforts at Kirkbride.

The Collaboration Program helps nursing homes and other care facilities prepare for an outbreak, but it also has teams ready to respond when an outbreak hits. The initiative helps conduct tests on an entire building, provides PPE and infection prevention education for staff, and offers physicians for consultations.

“All those things, in the middle of an outbreak, that might be harder to pull together on their own,” O’Connor said.

People in facilities like Kirkbride are particularly vulnerable because they live close to others, and may have medical conditions that make them more susceptible to the virus.

At Kirkbride, most patients and staff at the facility were asymptomatic, and those who fell ill had manageable symptoms. No one at the facility has died or been hospitalized.

The facility has halted new admissions, and the remaining employees and residents are being tested for the virus weekly. In the spring, the center had to send COVID-positive residents to the city’s quarantine hotel in Center City. Now, patients are quarantining on a separate COVID-19 unit within Kirkbride that had sat empty for months as cases decreased over the summer.

“What’s challenging at Kirkbride is that that [the population] is at a higher risk of COVID than other patients,” O’Connor said; people with substance use disorder, studies have shown, are more likely to contract the disease. “But they have younger patients, many of whom don’t often have symptoms, and there’s that potential for multiple people to be positive before that first person has symptoms.”

In addition, she said, patients at Kirkbride are in group treatment for substance use disorder, and move around the facility, unlike nursing home patients who are more often confined to their rooms.

“Once Kirkbride recognized this was happening, they took really dramatic measures to try to contain it,” O’Connor said. “They have done everything right with a lot of support.”

O’Connor said that with cases rising again in the region, it’s difficult to deploy teams quickly to address such outbreaks. But, she said, she believes the collaboration program has “built the infrastructure to do that."

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“It’s certainly hard to see it happen, and anytime there’s an outbreak in a facility, it causes a lot of anxiety and suffering for residents and staff,” she said. “Outbreaks are expected... It’s not a failure of any facility to have a second outbreak — but what I like to see is in the second outbreak, they respond more quickly, know who to call for help, and leverage resources in their region.”