Henrico County manager: Canterbury’s reaction to early offer of help was “not positive”

Canterbury Rehabilitation & Healthcare Center was slow to accept Henrico County’s help at the start of the COVID-19 outbreak that has left 16 residents dead and 108 people positive at the facility, Henrico County Manager John Vithoulkas said during a news conference Thursday evening.

“We have respected their autonomy and offered them support,” said Henrico County Manager John Vithoulkas. “There is a real lesson to be learned from this example going forward. … We knocked on the door initially, and the reaction was not positive at Canterbury. That changed in a matter of days.”

If Canterbury had responded more quickly to the county’s initial offers of support, it might have been possible to understand more quickly how serious the situation was, Vithoulkas suggested. “We actually offered to have testing done quicker, sooner. Had that been done, I think that perhaps we would have had results sooner.”

In a statement released Thursday night, Canterbury Rehabilitation & Healthcare Center Administrator Jeremiah Davis said, “Upon discovery of COVID-19, skilled nursing facilities must notify the Department of Health, ensure appropriate PPEs, educate staff, review policies and procedures, isolate impacted residents, initiate treatment plans, and reach out to residents’ loved ones. From the moment of the first COVID-19 diagnosis involving a Canterbury resident, our clinical and operational teams have been working in lockstep with the Henrico County Health Department. In fact, the Health Department team was onsite touring the facility with us on the day Mr. Vithoulkas initially reached out, and Dr. Danny Avula was instrumental in connecting our team with his. Since then, we have been in regular contact with a group of thought leaders, including Mr. Vithoulkas and Dr. Avula, who have provided significant support. These partnerships have been, and remain, invaluable.”

Accompanied at the news conference by Dr. Danny Avula, the director of the Richmond and Henrico health districts, Vithoulkas said the county now plans to contact all 41 long-term care facilities in Henrico on Friday to ask them what they need in terms of personal protective equipment (PPE), COVID-19 tests and staffing. The county’s emergency services department also can assist centers with action plans, he added.

“When we knock on your door, let us in,” Vithoulkas said. “When we call, pick up the phone. We are here, ladies and gentlemen, to help.”

Across the county, 205 people have confirmed cases, including 108 at Canterbury, as of noon Thursday, and one more Henrico resident has died in the past day, Avula said, although he is waiting to confirm that the person tested positive for COVID-19.

Seven nursing facilities in the city and county now have clusters of people who have tested positive for COVID-19, Avula said. One home in the city of Richmond has seven residents and a staff member who tested positive; a second nursing home in the East End of Henrico has five residents and one staff member who are positive; a third facility has four residents who are positive, Avula said.

Avula said he has been in close contact with about 10 long-term care centers in Richmond and Henrico, including Canterbury, where his staff has been on-site daily for more than two weeks. The health department has dropped off PPE deliveries and assisted in testing everyone at Canterbury in the past week, including people who haven’t shown symptoms.

“We’re dealing with an enemy here in COVID-19 that is extremely difficult to identify, extremely difficult to control,” Avula said, “and despite the best efforts of the medical staff, of the testing community, of everybody involved, we’re still seeing really significant spread.”

Among the most disturbing details, according to Avula, is that 53 people who tested positive at Canterbury are asymptomatic carriers. Also, staff members at some nursing homes — not the ones Avula has been in contact with, but possibly others — may be working at more than one facility in quick succession and potentially contributing to the spread of the virus.

Avula suggested that the state government may need to order all health-care workers who are at a nursing home to remain at their current facilities and not work at another one until the crisis has subsided.

Until very recently, people have not been quarantined or tested until they started feeling sick and showing symptoms like fever and cough, Avula said, and that likely led to early spread of the virus at Canterbury and elsewhere. But now, the Centers for Disease Control and Prevention and local officials are considering how to contain “asymptomatic spread” of the virus.

PPE is still in shortage at Canterbury, where staff members use N95 masks longer than a day at a time and try to lengthen their use by protecting the masks with cloth covers, Avula said. “Face shields and gowns — we’re starting to move more to permanent things that can be disinfected in between uses. We’re having to adapt these crisis-time solutions.”