Some of the first deaths from COVID-19 in the United States were in a nursing home, in Washington State. In the two months since, more than 3,000 nursing home residents in 36 other states have died of the virus.

Brown County Health & Living Community has, so far, been spared.

“I am pleased to report there have been no positive or presumed cases of COVID-19 at Brown County Health & Living to date,” said Administrator Kim Povinelli on April 17.

That was still holding true as of April 23, said Dr. Norman Oestrike, Brown County’s health officer. The local health department is in touch with BCH&L daily, he said.

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The center has a plan in case the virus does appear among its 102 residents or 112 staff members.

No visitors have been allowed inside the building since mid-March except in end-of-life situations or when medically necessary.

All staff continue to be screened for fever and signs of respiratory illness prior to every shift, and residents are monitored daily, Povinelli said. Any staff member who shows any symptoms “is sent home and guided to be tested immediately,” she said.

It is known that people can show no symptoms and still be carrying the virus. To help protect residents, “every associate within the community wears a surgical mask at all times while at work and has a DIY mask to wear outside of work,” she said.

The center’s outpatient rehabilitation services have been temporarily discontinued, so as not to bring more people in and out of the building. Any residents needing therapy are seen individually in their rooms, Povinelli said.

If anyone were to test positive in the building, “we have a robust plan in place with isolation and quarantine protocols to help stop or limit the spread of the virus,” Povinelli said. “We are closely following steps recommended by the Centers for Disease Control (CDC), Centers for Medicare and Medicaid Services (CMS) and the Indiana State Department of Health (ISDH) to ensure a safe and healthy environment.”

In Indiana, as of April 21, 199 long-term care facilities had a total of 1,568 cases of COVID-19, and 74 of those facilities reported 162 deaths.

The state’s Family and Social Services Administration office has assembled “strike teams” to visit nursing homes and give guidance. Strike teams will visit when a facility has reported a suspected or positive case of the virus. They can administer testing to residents and staff, advise centers on their plans and protocols, and help them access more personal protective equipment if they need it, explained Dr. Dan Rusyniak of the FSSA during an April 8 news conference. Strike teams often make multiple visits to facilities until they have infections under control, and may even recommend moving patients to different facilities to separate those who have become ill from those who have not.

BCH&L has not been visited by a strike team since it has had no positive cases, the facility reported.

However, nurse surveyors from the Indiana State Department of Health have visited every long-term care and freestanding facility in the state to provide guidance about how to handle COVID-19 patients in their facilities, the state’s Joint Information Center reported on April 16.

Long-term care facilities are required to report to their local health department, to the state and to residents’ families when they have positive cases and/or confirmed or suspected deaths from the virus within 24 hours, said State Health Commissioner Dr. Kristina Box.

Brown County Public Health Preparedness Coordinator Corey Frost is in contact with BCH&L daily, Oestrike said.

“They actually have done it all by the book as far as I know,” Oestrike said. “They’ve had patients with fever and quarantined them, and one had to go to the hospital because they were sick, and tested negative. They’ve got it all by the book. They seem to be fine.”

The newspaper received an anonymous tip in late March that some BCH&L staff were using trash bags or tablecloths as protective gowns.

BCH&L reported on April 17 that the facility “made handmade gowns as an alternative option until our supply was up, so that we didn’t deplete our actual gowns in the event of a positive case.”

The local health department is able to help get supplies, Oestrike said.

The facility now has “ample personal protective equipment, and families can rest assured that surgical masks are work by all staff members,” Povinelli said. “Any staff member who is working in an isolation area would be provided an N95,” the mask most recommended for virus control, she added.

Donations of safety equipment would be welcome, she said. Georg Utz Inc., a plastic packaging company in Edinburgh, donated 50 face shields to BCH&L, she added. Anyone else interested in donating can call Povinelli at 812-988-6666.

While they cannot visit with family and friends — even those inside the facility, as group activities, such as meals, have been suspended — “residents are adjusting well,” Povinelli said.

Staff have been setting up phone and video calls between residents and their loved ones. They’ve also been able to participate in “window visits,” and family members can still bring items to BCH&L to be given to residents, Povinelli said.