JOHNSON

MARQUETTE — Staff at Norlite Nursing Center had an unenviable task — or maybe enviable, depending if you look at it from the standpoint of providing compassion — at the beginning of the COVID-19 pandemic.

The Marquette facility was the site of a COVID-19 outbreak that resulted in eight deaths, although it is now coronavirus-free.

Testing was — and is — key, but in the beginning, Norlite staff faced a huge challenge.

Not only did staff have to keep from getting the disease itself, it had to tend to residents who were unable to meet with their loved ones in person at a time they were most needed.

“We represented daughters, sons, grandkids, spouses, the family who wanted to be there but couldn’t,” said Cory Miller, a registered nurse who left her position on March 29 as director of admissions to work the COVID unit until the last resident was moved out. “We had the privilege of holding their loved one’s hands, or saying a prayer, being a cheerleader or their family’s voice. We stood in their place the best we could.”

Norlite Administrator Wayne Johnson said Miller signed up immediately to work the front line of the COVID-19 hall, putting in 12- and 16-hour shifts for about 2¢ months.

“She had the experience of a hospice nurse as well, so was really a perfect individual to put in that realm and have just a strong RN on that unit at all times,” Johnson said.

Norlite hasn’t had it easy during the ongoing pandemic, to say the least. Johnson said the facility experienced 26 total resident cases of COVID-19, with eight deaths recorded. Eight staff members also were diagnosed with the virus.

Norlite now is free of COVID-19, not having had a new case since April 30, he said.

That’s not to say their worries are over.

“Any nursing home or assisted living facility is like tinder for a match,” Johnson said. “It’s going to take off. We’re not well designed for this type of thing, but we do have infection-control practices that we put into place immediately.”

He acknowledged the biggest problem at the onset of the pandemic was that the facility didn’t have a way to test.

“We had to wait until people were sick — had a cough or a fever — before we were given authorization to test,” Johnson said.

Judging from numerous Facebook comments, the community has been supportive for the most part.

However, Johnson acknowledged there were “worriers” who didn’t understand the situation, specifically the facility’s inability to test at first because of the lack of supplies in the medical community.

Now testing is readily accessible.

“They’re removing the veil,” Johnson said. “We weren’t able to do that until the late part of April.”

Johnson stressed that at the onset of the pandemic, national attention was focused on hospitals and the need for them to conserve their supplies and tests.

“All the while, we’re experiencing what has proven to be really the most dangerous location, which would be any kind of congregate-care facility like a prison or skilled nursing facility or an assisted living facility, and we were just being told no,” Johnson said.

After testing opportunities opened up, new asymptomatic cases were discovered, said Johnson, who noted that with testing of staff and residents, it can be determined who is positive but spreading COVID-19 without symptoms despite wearing personal protective equipment.

“That was the part that really turned the tide, because by April 30, no new cases,” Johnson said.

In March, the advice from the Centers for Disease Control and Prevention as well as the Centers for Medicare & Medicaid Services was to conserve PPE.

“I would say as far as what we went through, the examples of the changing guidance and how it impacted us, is a perfect example of why all the guidance is the way it is now,” Johnson said. “When we were told before, ‘No, don’t test everybody. What’s that going to tell you? It’s going to tell you one point in time whether somebody was positive or negative,’ and my response was always, ‘But we’re removing the veil.'”

Norlite, he said, was shocked to find out that one of its ‘ambulatory-type residents’ who walked up the hall all day long and never showed symptoms, tested positive and potentially spread it to others.

“It’s scary in our setting,” Johnson said.

Constant monitoring in place

Kristi Tarkowski is Norlite’s infection preventionist — a position with a lot of responsibility, if ever there was one.

“She always has been the guru of making sure that any kind of outbreak we have at the facility is contained, proper actions are put into place, and all reporting goes through her,” Johnson said.

Her job was tough, with continuous monitoring paramount to stopping the spread of the coronavirus.

“You took every opportunity you had to prevent another case,” Tarkowski said.

Miller had praise for Tarkowski, who she called a “captain.”

“She was the one that really helped provide our armor against this enemy to allow us that protection,” Miller said.

Tarkowski said the faster people can be identified and isolated before they show symptoms, the more effective it is to prevent the spread of COVID-19.

“If you can identify them before that, you’re so much better off,” she said.

Holding steady

Johnson said Norlite currently is taking admissions, with new residents being quarantined and fully isolated for 14 days with PPE such as N-95 masks, face shields and other items.

Still, one thing stands out.

“Testing makes the difference,” Johnson said. “It really does.”

He believes the community drives, such as the ones the National Guard recently put on at the Superior Dome at Northern Michigan University, need to continue further testing.

However, Johnson pointed out that people still need to wear a mask and protect others.

This could be another challenge considering the apparent resistance of many people across Michigan and the United States who still balk at the idea of wearing masks.

“They’ve never watched somebody die from it,” said Miller, who believes ignorance is at the root of the problem.

“They’ve never experienced it, so they can’t appreciate it,” Miller said. “So they don’t respect it. When you’ve seen it, you respect it.”

Fortunately, she said many people at Norlite stepped up, including the nurses who tried to become extensions of the residents’ families.

At Norlite, staff is required to be tested on a weekly basis, Johnson said.

“A couple of them roll their eyes or groan, but most of them are very supportive of that,” Johnson said. “They want to know. They want us to test every single week. They’re excited about it.”

In fact, he said they want to stop COVID-19 “at the door,” because not knowing who had it affected Norlite in March when a staff member worked two straight days — not knowing she was sick — and spread the disease.

“If we could go back to March and the testing was available, it would be a complete difference,” Johnson said.

Of course, challenges remain. For instance, the World Health Organization recently indicated the possibility of the coronavirus being airborne.

“Everything changes so much, day to day,” Tarkowski said.

Johnson stressed that communication is essential with staff as well as the public since things can even change hour by hour. Guidance protocols issued in the morning, for example, could be obsolete by 5 p.m.

Daily staff meetings, a public Facebook page that has been remarkably transparent during the pandemic and a Norlite staff Facebook page have been part of the facility’s communications, he said.

Then there’s the community support in the form of things such as paper hearts in windows, meals delivered to Norlite and a sign along U.S. 41 that said “Norlite Rocks,” Miller said.

However, the effort to battle COVID-19 was exhausting.

“We didn’t hug our families for a couple months,” she said. “We showered twice.”

It was worth it.

“I’m proud of the fact that we kept it out of the community and out of our homes,” Miller said. “Not one of us on that hall contracted COVID, which is a testimony to Kristi and a testimony to staff properly respecting the PPE.”