The South Dakota Department of Health found no deficiencies when it conducted a COVID-19 focus infection control survey at Bethel Lutheran Home on July 21. This indicates the nursing home was doing everything right.

The survey, conducted after a staff member was exposed to the virus, was the second conducted in two months. On June 9, the DOH also found Bethel in compliance.

"We passed with no deficiencies," said Chuck Johnson, Bethel CEO and administrator.

Still, by July 28, Bethel had 11 residents who tested positive for COVID-19, seven staff who did so and one death attributed to the virus. The goal now is to mitigate the spread and care for the residents, according to Johnson.

"We're doing everything we're instructed to do and following the Department of Health and CDC guidelines," he explained. "The staff is very capable and doing everything they can to make sure the residents are receiving good care."

The outbreak at Bethel comes at a time when the number of people testing positive in Lake County is steadily increasing. On July 1, the county had 21 positive tests with four active cases. By July 28, that number had increased to 69 with 18 active cases.

The first reported case in the county was on April 2. By early June, that number had crawled up to 12, not topping five until after mid-May. Since the beginning of the month, increases have been seen almost daily with an increase of six seen in a single day over the weekend.

In March, Johnson reported that Bethel was taking a number of measures to maintain resident safety and health. Employees were screened when they entered the building. The doors were closed to visitors. Activities were conducted in shifts to allow social distancing.

The goal was to maintain, as much as possible, normal routines while at the same time keeping safe distances. Johnson indicated at the time that they did not want to isolate the residents, especially from friends and family members, and were providing computer tablets so residents could maintain relationships through Skype and FaceTime.

At present, the source of the coronavirus is unknown. Johnson said it's possible that an asymptomatic carrier brought it into the nursing home.

"We're working with the Department of Health with contact tracing with our employees and staff," he said.

Bethel is also communicating with the DOH about any new symptoms which are observed, about staffing issues and about issues related to personal protective equipment (PPE). At the same time, staff is focused on resident care.

"I am convinced I am blessed with a very good staff, a very capable staff. They go above and beyond in caring for our residents," Johnson said.

Currently, those who have tested positive are isolated in certain areas of the building, he indicated. While this would be protocol, circumstances are such that residents have been able to stay in their own rooms because those affected live in identified areas.

To mitigate the spread, staff is closely monitoring other residents.

"The people are screened throughout the day," Johnson said. "Anyone with COVID-19 symptoms is tested."

Family members are immediately notified if a resident tests positive.

"If family has not been contacted by Bethel, their family member is not positive," Johnson stated, hoping to allay fears that loved ones may be affected.

Some minor changes have been made to mitigate the spread within the nursing home. Small group activities have been suspended, according to Johnson. Outdoor visits with friends and family members, which began in June, have also been suspended.

Activities are offered on a one-to-one basis in resident rooms, and visitors may continue to communicate with their loved ones through closed windows. They can also use technology to visit via Zoom or FaceTime, Johnson noted.

While the situation is stressful, Johnson indicated the staff maintains a good attitude.

"They're very committed to these residents. They continue to do everything they can for them. The staff are heroes," Johnson said.

Employees continue to be screened when they enter the building. Those who are ill do not report to work. They are asked to call their supervisor and are referred to their primary care physician who will determine whether testing is necessary.

Johnson is very grateful to the Madison community for its support and wants to assure community members that Bethel is following CDC and DOH guidelines to mitigate the spread while caring for the residents.

"We are doing everything we can to keep them safe and well cared for," he said.