A Tuesday-morning press release from Church Hill Health Care and Rehab Center confirmed that 13 employees and 19 residents have tested positive for COVID-19.

On Wednesday morning, CHHCRC reported that one of the residents who tested positive for COVID-19 has passed away.

This cluster of cases contributed to the largest spike in new COVID-19 cases in Hawkins County over a four-day period since the pandemic crisis began in March.

Just between Friday and Monday, 62 new cases were reported in the county. 13 were reported on Friday, 12 on Saturday, 24 on Sunday, 13 on Monday, 18 on Tuesday, and 12 on Wednesday.

As of Wednesday, the county had a total of 254 cases confirmed and probable since March; 300 positive tests; 4,551 negative tests; 174 active cases; 77 recovered; and three deaths.

COVID-19 related death

“We are heart-broken to report a resident of Church Hill Health Care peacefully passed away Sunday at our facility,” Administrator Gina Harris said in a Thursday morning press release. “The resident had several underlying medical conditions and was recently being treated. As part of this treatment, a COVID test was performed. We were notified on Tuesday, after the resident’s death, the results of the COVID test were positive. No additional personal information or details will be released about the individual. The Hawkins County Health Department will report this incident as required by the State of Tennessee.”

She added, “Our thoughts and prayers go out to the family. I request that you please respect the family’s privacy and our Church Hill Health Care family by allowing the residents and staff time to grieve.”

On Wednesday morning, the Review spoke with Dr. David Kirschke, who is the Medical Director for the Northeast Tennessee Regional Health Department.

“The death certificate is not finalized, so we haven’t seen what they have listed as the cause of death,” Kirschke said. “The office of the state medical examiner is involved in reviewing death certificates where coronavirus is listed, so they may weigh in as well.”

32 positive tests

Harris also told the Review that the Tennessee Department of Health notified CHHCRC over the weekend that these aforementioned 32 tests had come back positive.

“In an effort to diminish risk to our residents and healthcare workers and in accordance with executive orders issued by our Governor, we have continued to conduct weekly COVID-19 testing of our employees,” she said. “In addition, we screen all employees upon arrival to work and mid — shift to ensure a healthy work environment. Any COVID positive lab results are promptly reported to the Department of Health to ensure appropriate actions are taken to safeguard both our employees and residents.”

Mass COVID-19 testing

Last week’s mass testing tested over 100 employees and nearly all 90 residents.

“These employees (who tested positive) reported mild or no symptoms of illness prior to testing,” reads the release. “The affected staff members are currently off work and will return according to guidance received by the Department of Health and the Center for Disease Control.”

In regards to the residents who tested positive, the release noted that, “The residents affected have been quarantined since the first symptoms were observed, and we are happy to share all residents are doing well. We continue to conduct frequent monitoring and screening of our residents.”

The release also noted that the facility will continue regularly testing employees and residents.

Kirschke told the Review that “there are active cases there (at CHHCRC) now.”

Handling asymptomatic cases

CHHC’s press release noted that several of the employees who tested positive for COVID-19 had shown little to no symptoms prior to testing.

Though Kirschke told the Review that he could not talk specifically about the COVID-19 outbreak at CHHC, he explained the role his office plays in general when a nursing home experiences an illness outbreak.

“The governor, several weeks ago, had ordered all nursing homes to do weekly testing of all of their staff, so that has been going on at all nursing homes across the state,” Kirschke said. “We definitely recommend testing anyone who has symptoms. We tell any nursing home to screen their employees every day. Anyone who has symptoms, they send them home and test them. They also should be screening their residents. Any resident who develops symptoms compatible with coronavirus should be tested.”

However, Kirschke has also noted in published reports that people with asymptomatic cases can spread COVID-19 without realizing that they have it.

“With the weekly testing of workers, and most of these people being asymptomatic, the nursing home assures us they’ve been screening people — all the employees when they’re coming in,” he has said in published reports. “A lot of these people who have tested positive have been asymptomatic, and there’s not really any way to detect that except for this weekly testing which they have done and are now excluding those positive people from the nursing home. In the community we have a lot of people in workplaces, also in other healthcare (services), that don’t have symptoms. Everyone can spread coronavirus two days before they have any symptoms. One of the biggest challenges with coronavirus is that it can spread before people show symptoms and are aware they have it.”

He also told the Review, “Anytime someone is positive for COVID-19, whether they are symptomatic or asymptomatic, we advise them to stay home in isolation for 10 days,” he added. “That goes for pretty much any work setting.”

TDH handling nursing home outbreaks

“Whenever we hear about a case within a nursing home, we will contact that nursing home and have a discussion about how to deal with the positive cases and their contacts,” Kirschke said. “We’ll often have the state health department infection control experts talk with the nursing home staff about preventing spread.”

He also added, “particularly our state infection control from the state health department will go into a nursing home to assist if they have a large number of cases.”

Kirschke noted that he and his staff have not personally visited CHHCRC in relation to this outbreak, but added that “that may occur.”

Controlling the outbreak

“Any time there is a positive case in a nursing home, the actual cases—anyone who is positive—has to be isolated,” Kirschke said. “If it is staff, they have to stay home for 10 days. If it is patients, they have to be isolated away from other non-positive patients for at least 10 days. Then, at least 24 hours after they feel better.”

“We have worked diligently to safeguard our facility”

“We have worked diligently the last several months to safeguard our facility,” the CHHCRC press release read. “We believe testing the residents and employees will assist us in identifying any asymptomatic cases; helping limit the risk to our residents.”

It added, “Thank you for your prayers, encouragement and support during this difficult time. We are grateful to all the Healthcare Heroes at Church Hill Health Care who have worked tirelessly and bravely providing care for all our residents. Please continue to pray for the residents and employees of our facility and others across the nation as we work to provide loving care for the most vulnerable entrusted to us. In an effort to relay accurate information within the community and answer any questions or concerns, please contact the facility Administrator directly. Our mission is to keep the residents, families, staff and community informed.”

This story will be regularly updated as more information becomes available.

COVID-19 clusters in long term care facilities are regularly updated on TDH’s website. As of Wednesday evening, the CHHCRC cluster had not yet been added, though the COVID-19 related death had been added.

The CHHCRC is located at 701 W. Main Blvd. in Church Hill. For more information, contact Administrator Gina Harris at 423-357-7178.