- Associated Press - Wednesday, September 23, 2020

HILO, Hawaii (AP) - Reports on the activities at a Hawaii nursing home with a fatal coronavirus outbreak found various problems, including what one investigation called a culture of complacency among staff.

The COVID-19 outbreak at the Yukio Okutsu State Veterans Home in Hilo has claimed the lives of 25 veterans and infected another 79 residents and staff as of Tuesday.

Assessments were conducted separately by the U.S. Department of Veterans Affairs, Hawaii Emergency Management Agency and the state Department of Health Office of Health Care Assurance.

A Hawaii Emergency Management Agency report said staff members at the Big Island facility were reluctant to force residents to do anything against their will.

Long-term care specialist and geriatrician Albert Yazawa reported he found multiple potential sources of infections at the home, which is operated by Avalon Health Care Group under contract to the state.



The assessment said potential outbreak causes included patient movement between units, wandering residents and staff gatherings at work. Staff likely contracted the virus because of a lack of personal prevention practices such as wearing masks, Yazawa said.

The VA released a report saying there was very little evidence of proactive preparation or planning for the coronavirus at the home.

“A basic understanding of segregation and work flow seemed to be lacking even approximately three weeks after (the) first positive case,” the VA report said, based on its Sept. 11 site visit.

Avalon Health Care said the company and facility consistently followed the frequently changing rules and guidance from the U.S. Centers for Disease Control, U.S. Centers for Medicaid and Medicare Services and the Hawaii health department.

“Many of the recommendations contained in the assessment are above and beyond CDC, CMS and state COVID-19 rules and guidance and are not common practice in long-term care facilities, even during a COVID-19 outbreak,” Avalon said in its own summary of the VA report.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some - especially older adults and people with existing health problems - it can cause more severe illness, including pneumonia, and death.

The number of infections is thought to be far higher because many people have not been tested, and studies suggest people can be infected with the virus without feeling sick.

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