Tulare County demands action after coronavirus outbreak kills 15 at one nursing home

One of the state’s worst outbreaks of COVID-19 at a skilled nursing facility has driven up the death toll in rural Tulare County, accounting for more than half of the county’s reported cases despite early action by local officials to guard against the spread of the coronavirus.

In February, organizers for a three-day international agriculture show set in the city of Tulare stopped China-based companies from sending representatives after the federal travel ban. Health officials prepared to expand testing at the county public health lab, which serves five other counties in the San Joaquin Valley, purchasing new equipment days after the first few cases were discovered.

But their efforts weren’t enough to stop an outbreak at a skilled nursing facility in Visalia, the rural county’s most populous city. As some parts of the country consider reopening communities, local health officials are trying to figure out how to stop the spread at the facility, where more than 100 patients have been infected. As of Tuesday, the county reported 436 confirmed cases. While 62 people have recovered, 22 have died.

Fifteen were patients at Redwood Springs Healthcare Center, David Oates, a spokesman for the facility, said Tuesday. So far, 109 patients and 55 staff members have tested positive for COVID-19, he said.

About 60% of Redwood Springs residents are over 65, according to administrator Anita Hubbard. It is one of the worst outbreaks at a nursing home in the state, and last week, the county announced a second outbreak at a skilled nursing facility in Lindsay, where 11 residents have tested positive.

Tulare County Supervisor Kuyler Crocker, whose district includes Redwood Springs, has called for more resources from the state, which regulates skilled nursing homes, and an investigation into how the virus spread so quickly at the facility, which has a history of violating state regulations.

“We raised the flag that we have an extreme personnel shortage at Redwood Springs,� Crocker said, with more than 50 employees testing positive. “The bigger question that I have is, why did it spread to so many people?�

In the past three years, the facility’s citations by the state have totaled about $150,000 in penalties for a range of violations, including for what the state said was a failure by staff to supervise a patient who was fatally injured and failure to report allegations of physical and sexual abuse. Oates declined to comment because he said the fines happened under previous management.

To assist with the outbreak, nearly two dozen nurses from a nearby hospital have signed up to assist at the facility, and staff from other hospitals have arrived to help as well. Nursing homes have become hot spots for outbreaks because the elderly are among the most vulnerable to the virus, and many of them have from underlying conditions.

But before the outbreak at Redwood Springs, the county seemed to be taking steps to get ahead of the spread.

Before the World Ag Expo took place on Feb. 11, organizers spoke with state and local health officials about how to prevent a spread at the event and discussed the possibility of canceling, said Jennifer Fawkes, a spokeswoman for the expo. Annually, the event averages 100,000 people from 70 countries.

With guidance from the public health officials, organizers went on with the event and instead asked nine China-based companies to send U.S. representatives who had not traveled recently, or be refunded, Fawkes said. Ultimately, six companies did not attend, and other attendees arriving from abroad were vetted as well, she said. Extra hand-washing stations were placed around the event space.

When county officials announced the first confirmed case on March 11, Dr. Karen Haught, the county public health officer, issued a local health emergency. Six days later, the county Board of Supervisors approved funding for equipment to expand testing for the region, which had already begun on Feb. 27, Weyker-Adkins said.

School districts in the country began closing campuses on March 16, but one school in Farmersville remains open, Crocker said. The Outside Creek School District, which has one school, Outside Creek Elementary, remains open because many of the parents are farmworkers, Crocker said, and closing the school could create an extra burden on the families. Only about 40 of the 90 students attend classes in person, he said, allowing for small class sizes and social distancing.

Supervisor Amy Shuklian, who oversees part of Visalia, noted that the facility makes up more than half of the rising number of cases in the city, where 244 are located, as the reason for the inflated numbers.

While there were some skeptics about the virus, most residents have come around and have followed the statewide directive to shelter in place, she said, but there was some pushback to the governor’s directive simply because of the conservative lean of the community. In the largely agricultural and rural communities that run along the foothills of the Sequoia National Park, some residents don’t see the need to social distance, she said.

The county does not have a local order mandating residents to shelter in place and does not have a system in place to cite nonessential businesses that don’t close their doors, she said. But the Visalia City Council is considering taking action against businesses that do not comply with the governor’s orders.

As recently as last week, she has gotten calls from residents asking that the county reopen golf courses, with many claiming they can follow social distancing measures while out on the green, she said. A golfer herself, Shuklian said she recognizes the desire to return to a semblance of their lives before, but is asking that residents remain hunkered down.

“I understand the frustration,� she said, “but I like to err on the side of caution.�

Times staff writer Anita Chabria contributed to this report.