AMADORA, Portugal (AP) – Tears well in Diana Correia’s eyes as she reminisces about the day in October when 24 of the 55 residents of her nursing home in Portugal tested positive for COVID-19.
The stunning discovery sparked a struggle to execute the home’s emergency plan and tighten security procedures. While some staff were sent into isolation, others worked double shifts of up to 16 hours with full protective gear, leaving them tired in a sweat and bone. Some of the residents of the house, suddenly locked in their room or on their floor, were baffled and shocked by restrictions, even as they tried to take the elevator and escape the confinement.
“Times were tough,” says Correia, trying her best to keep her cool. “Very difficult times.”
As a resurgence of the fall pandemic threatened to overwhelm Portuguese nursing homes such as Correia, and the country’s public health service struggled to cope, the government mobilized whatever resources it could. That included deploying military units.
The soldiers’ mission: fan out across the country to visit hundreds of nursing homes and strengthen their defenses against the pandemic.
Long-term care facilities have emerged globally vulnerable during the pandemic. The age of their residents, their physical proximity to what is essentially a large house, and the residents’ underlying health problems put them at risk. In addition, nursing home staff in Portugal often work in different care homes and travel among themselves by public transport.
Noting that international data on deaths in nursing homes COVID-19 are “ imperfect and limited, ” a study of 21 countries by the London-based International Long-term Care Policy Network, which includes scientific researchers, found in October that the average share of those homes of the deaths from the coronavirus was about 46%.
The European Center for Disease Control, an EU agency that monitors 31 countries, said the same month that up to 66% of all fatal COVID-19 cases were among nursing home residents.
That way, Portugal has not fared badly. Nursing home deaths through Dec. 14 accounted for 30% of COVID-19 fatalities in the country, the Directorate General for Health told The Associated Press.
On Friday, the total number of deaths in Portugal reached nearly 6,000.
Fearing disaster, the Portuguese government sent an emergency call to its army at the end of September. In addition to helping track contacts, disinfect buildings, and provide beds to hundreds of virus patients in military hospitals, the armed forces have now been asked to support the protection of nursing homes.
Dr. Maria Salazar, a doctor and colonel in the Portuguese Air Force, quickly devised a nationwide program to train nursing home staff in their workplace. The program also ensures that staff receive the specific medical advice they need in almost daily online question and answer sessions with doctors, nurses and pharmacists.
The program was launched within a week, coordinated from CECOM’s military operations command center near Lisbon.
About 140 teams of one to three people from the Portuguese Army, Navy and Air Force have traveled across the country since the beginning of October. They have already been in more than half of the targeted 2,770 care homes.
Salazar, a 49-year-old gastroenterologist, says the military presence is reassuring to nursing home workers and residents who were shocked by the virus threat and desperately short of medical knowledge.
“Suddenly all these employees … felt they didn’t know what they were doing and that they were terrified,” says Salazar.
Fear was simply the basis of muddled decision-making. “We identified that very clearly,” she says.
In a first phase, troops go personally to the nursing homes and give talks with slideshows that go through the rudimentary rules of cooking, washing, cleaning and social distance. It’s COVID-19101.
Correia, the technical director of a nursing home at an AFID charity in Amadora, just north of Lisbon, acknowledges that it’s nothing her staff haven’t heard so often. The difference is who the instructions come from.
“It’s an outside voice, a military voice with all the weight we carry,” she says.
During a recent afternoon session at the AFID house, 10 Correia employees listened intently to Sgt. Ari Silva, from No. 2 Lancers Regiment, whose barracks is nearby. Silva wore military clothes, a beret and an olive green face mask and asked his audience how often they had washed their hands that day. A man in the front said four.
Silva was not impressed: “Friend, at least I did double that,” he said.
The benefits of the military presence are both psychological and practical, 38-year-old Correia says.
“We feel like someone out here is concerned about us,” she said. “It’s not just us who worry.”
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