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Michigan care facilities still struggle with a lack of personal protective equipment and COVID-19 testing capacity as they prepare for a possible resurgence of the virus, health leaders said during a Thursday discussion with a top federal health official. 

Representatives of more than 20 Michigan nursing homes, hospitals and advocacy groups attended the session, which was focused on how last spring's surge of cases in Metro Detroit affected seniors across the region.  

The online discussion was hosted by Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, who wanted to hear about the experiences of Metro Detroit health care providers during the region was a national hot spot early in the pandemic.

"I realize that what we learn from the front lines is critical," Verma said in her opening remarks. "We really wanted to come and talk to you because Michigan has been dealing with this.

"Michigan was hit really hard and hopefully that remains behind you, and we wanted to focus today's discussions on best practices, what has worked." 

Thursday's meeting took place as The Detroit News reported Thursday that workers inside some of the state’s hardest hit nursing homes rationed protective gear, went without COVID-19 tests and struggled to isolate seniors who potentially carried a deadly virus as the virus slammed Metro Detroit in mid-March. 

Out of the 45 nursing homes in Michigan that have reported the most deaths linked to COVID-19, nearly half — 22 — have been cited by inspectors in the last four months for failing to follow infection control, isolation or staffing policies, according to a News review of hundreds of pages of state records.

As of Sunday, the Michigan Department of Health and Human Services had tracked 1,988 COVID-19 deaths linked to the facilities, 33% of the statewide death toll.

"We were on fire in Southeast Michigan," said Melissa Samuel, president and CEO of the Health Care Association of Michigan, about the speed and severity of the outbreak that hit Michigan in mid-March. "And early on, our challenges with PPE and testing did have a significant impact on our facilities Southeast Michigan, and it was considerable."

Samuel said her group's members are working with the state of Michigan to increase testing capacity and find alternatives to nasopharyngeal COVID-19 tests that are difficult for many patients at nursing homes to undergo. 

Several participants said access to testing and PPE has improved, but is still insufficient.

"About a week ago, CDC came up with guideline to have N-95 (face masks) changed on every shift — right now we’re using them for five days," said Mohammed Qazi, president and CEO of Ciena Healthcare.  "We are still not able to access these N-95 masks from 3M distributors.

"They are available overseas and in China but we would prefer to receive them from the U.S.," Qazi said, adding that he worries about the quality of masks obtained from outside the country.

"If that’s a possibility, if you could somehow get these N-95 from 3M or other U.S. manufacturers, right now we’re only getting them from overseas." 

Frank Wronski of NexCare Health Systems and WellBridge Group, which owns multiple skilled nursing and rehabilitation facilities in Metro Detroit, urged the federal government to make nursing homes the priority in their COVID-19 response.

"This blew us out of the water because we just didn’t know enough about it, did not have enough PPE and certainly didn’t have testing at that moment in time," Wronski said. "In the search for PPE, (nursing homes) had such low status that it really became a dangerous situation.

"We are the priority because of the danger points that occur in our settings."

Verma, the CMS administrator, responded that "At the federal level, we always see nursing homes as the top priority."

"Nursing homes are the front line," Verma said. "As we go forward, we need to continue to double down on nursing homes and support them because then you are avoiding hospitalizations, that way we support our hospitals if we're supporting our nursing homes." 

Michigan reported 11 new coronavirus deaths Wednesday and confirmed 610 new cases — the highest single-day case count in seven weeks. 

The Michigan Department of Health and Human Services had tracked 67,237 cases of COVID-19 and 6,015 deaths through Wednesday.

When probable cases are added, Michigan's case total reaches 74,551, and the death toll is 6,262,including one new probable death reported Wednesday.  

Michigan recorded its first cases of COVID-19 on March 10, and by the first week in April the state was tallying about 1,500 cases and 100 deaths per day "and it became clear the state’s nursing facilities were facing immense challenges," said Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services. 

To respond to those concerns and provide essential protections to both residents and staff in nursing facilities, the state of Michigan took several steps, Sutfin said. 

The state created regional hubs to care for COVID-19 positive nursing residents who do not require acute care provided in a hospital, or who have gone to the hospital, been medically stabilized, and determined ready for discharge.

The state also required nursing facilities with the ability to provide adequate infection control to have separate units for residents who tested positive for COVID-19 or who were experiencing symptoms.

Michigan lawmakers have criticized these policies of Gov. Gretchen Whitmer's administration.

MDHHS also required facilities to report COVID cases, deaths, PPE and other information to the state, Sutfin noted.

Wednesday's 610 confirmed cases was the largest single-day tally since May 20 when the state confirmed 659 cases. 

Michigan has seen a rise in cases in the last three weeks but nothing approaching the record spikes reported in states such as Florida, Arizona and Texas. 

The United States on Wednesday hit 3 million known cases of COVID-19, which has killed nearly 132,000 across the country, according to tracking by Johns Hopkins University.

Staff Writer Craig Mauger contributed

Kbouffard@detroitnews.com

Twitter: @kbouffardDN

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