In tiny California county, 13 have died of COVID-19 in past week, 12 at one nursing home

©The Sacramento Bee

Rural Amador County, California, has quickly become a hotbed for coronavirus activity, with health officials and the state reporting a rapid spike in new cases and a flood of more than a dozen deaths in the past week. - Nancy Daley/Dreamstime/TNS

SACRAMENTO, Calif. — Sacramento’s smallest neighboring county, rural Amador, has quickly become a hotbed for coronavirus activity, with health officials and the state reporting a rapid spike in new cases and a flood of more than a dozen deaths in the past week — nearly all of the fatalities at one nursing facility.

Amador County, which has a population of about 38,500, on Aug. 7 reported its first two resident deaths from complications of COVID-19. Both were in their 80s and had existing health conditions, according to a news release.

Then in an update this Tuesday, Amador’s County public health office confirmed seven more deaths from the virus.

By Thursday, the county’s listed death toll grew again, to 11. One week earlier, it had been zero.

The county’s official death toll stood at 11 as of a Friday evening update from its health office, but state data attribute at least 13 coronavirus fatalities in Amador to senior living facilities — 12 of them at one nursing home.

Kit Carson Nursing and Rehabilitation Center, a skilled nursing facility in the city of Jackson, in an update to the front page of its website reported that 10 of its residents had died of the virus as of Wednesday, with another 39 positive for COVID-19 at that point. The facility has 199 beds, according to its website.

A California Department of Public Health dashboard showing COVID-19 activity at the state’s skilled nursing facilities lists 12 resident deaths at Kit Carson among 48 cumulative positive cases in residents, 39 of them considered active as of Friday afternoon. There’s an unexplained discrepancy in those numbers, though, because the infection totals indicate only nine inactive cases. That’s smaller than the death toll of 12, all of which should be considered not active.

Additionally, the Kit Carson website shows 34 employees at the facility had contracted the virus as of Wednesday, seven of them active and 27 recovered. None have died. The state dashboard on Friday showed only 19 total employee positive cases.

Also on Friday, the California Department of Social Services updated its list of licensed assisted living facilities with confirmed COVID-19 activity. It added a lone entry for Amador County: the Amador Residential Care Facility in Jackson. That facility, which according to its website has a capacity of 49 residents, didn’t appear on Thursday’s list but showed up Friday with at least one resident death. Assisted living facilities provide long-term residence but a lower level of medical care than skilled nursing facilities.

The database for COVID-19 activity at assisted living facilities obscures exact numbers below certain thresholds as a privacy measure. For that reason, it specifies only that Amador Residential Care Facility has reported at least one, but fewer than 11, resident deaths. It’s had fewer than 11 positive cases among residents and fewer than 11 among staff, and no staff deaths.

A news release and coronavirus update sent Friday evening by Amador County public health officer Diana Evensen did not mention either Kit Carson or Amador Residential Care, but noted the county’s most recently reported death came in a another Jackson resident with underlying health conditions, this one in their 70s.

The county’s official statements and data updates have not referred to the facilities by name, but a rough progression of the Jackson outbreaks can be traced via twice-weekly COVID-19 news releases the county going back to late July.

First, on July 21, the county noted it had confirmed two cases “linked to a congregate setting within a skilled nursing facility.” By the next update July 24, the county said congregate settings accounted for five cases in Amador County, “including employees in one skilled nursing facility and one state correctional facility.”

A July 28 news release made no mention of congregate care facilities. But on July 31 and again Aug. 4, the county noted that its overall COVID-19 case counts “include an outbreak within a skilled nursing facility,” with no specific infection total given for that outbreak.

Finally, in statements Tuesday and Friday, the county referenced “outbreaks” — plural — “within skilled nursing and long-term care facilities.”

The county has yet to publicly announce that the vast majority — or, as it appears, the entirety — of its deaths have come in a skilled nursing setting, though officials did indicate all who have died have been in their 60s or older and had existing health complications.

Twelve deaths already ranks Kit Carson among the deadliest outbreaks in a Northern California nursing home during the pandemic, and it’s still ongoing with more than three dozen active cases.

Amador’s infection total has also soared, increasing 230% in 16 days: from 89 confirmed cases in a July 28 update to 208 as of Friday. Cases considered active across Amador County have swelled from 29 as of late July to as many as 52 this week, but were down to 48 in Friday’s update.

Jackson, the seat of Amador County where fewer than 5,000 people live, had 100 tallied total COVID-19 cases as of Thursday’s update — at least 67 of them coming since July 28.

That means more than one out of every 50 Jackson residents has tested positive for COVID-19 since the pandemic started, with more than one out of every 75 of those residents testing positive in just the past two-and-a-half weeks.

The seven deaths disclosed Tuesday “were residents of Jackson and Pine Grove, in their 60s, 80s, and 90s and each had underlying conditions placing them at higher risk,” Amador County said in a news release, which didn’t further specify how many of the deceased lived in Jackson as opposed to Pine Grove. The county Board of Supervisors held a moment of silence during that day’s meeting to honor the memory of those who’ve died.

Eight patients are currently hospitalized in Amador County, and one Amador resident is hospitalized out of the county.

Amador County’s 13 fatalities now outnumber the coronavirus death tolls for numerous larger counties in Northern California and the Bay Area, including Shasta (10 dead as of Friday morning), Butte (eight), Santa Cruz (six), Humboldt (four) and El Dorado (two). Those counties’ populations range from 100,000 to 250,000 — between triple and seven times as many residents as Amador.

In a news release earlier this week, Amador County public health officials said the three main “pathways of spread” in the region are congregate living homes, which include skilled nursing and assisted-living facilities; family or workplace transmission; and “community transmission,” which the county doesn’t define but typically refers to people contracting the virus out in public, from a source not specifically known.

Increasing spread “may likely place Amador County on the State Data Monitoring Watch List when the State resumes Watch List activity,” the county’s Tuesday news release announced. That’ll mean the mandatory closure — or, in limited cases, the potential transition to outdoor operations — of gyms, places of worship, nail salons, barbershops and other personal care businesses, which are currently allowed open in Amador County.

Indeed, watchlist placement is almost guaranteed. A recent Bee analysis of per capita COVID-19 data determined Amador is among eight counties that have surpassed the threshold for new cases set by the California Department of Public Health since the agency froze changes to that list last week, because of a widespread data problem acknowledged earlier this month.

Amador County, as of state data updated Thursday, more than tripled the watchlist criteria of 100 cases per 100,000 residents over the past 14 days, with its rate of 304 per 100,000.

What the watchlist won’t change is the status of Jackson Rancheria, the tribal casino a few miles north of Jackson representing the county’s main draw for visitors and a large local employer.

California’s tribal casinos are considered sovereign, and therefore aren’t subject to shutdown orders from Gov. Gavin Newsom or the state. Some health experts, such as infectious disease specialist Dr. Peter Chin-Hong of University of California, San Francisco, continue to express great concern about casinos, which he called an “extremely high risk” environment for virus spread, The Sacramento Bee reported earlier this month.

Most tribal casinos statewide agreed to close down in the earlier weeks of the pandemic, but nearly all that did so have been back open since late May or early June, implementing modifications to their business operations.

The Amador County casino, owned and operated by the Jackson Rancheria Band of Miwuk Indians, reopened from its pandemic closure on June 8. It remains open as of Friday with mandatory masks, temperature screening at entry, social distancing requirements and plexiglass barriers, according to its website.

Amador’s official COVID-19 infection numbers don’t include inmates incarcerated at Mule Creek State Prison in Ione, the county says. But those figures are available from the California Department of Corrections of Rehabilitation. As of Friday morning, the CDCR prison COVID-19 tracker showed 28 currently active infections at Mule Creek, plus 10 recovered cases and one inmate who was released while still infected.

CDCR also reports 13 employees at Mule Creek have tested positive over the course of the pandemic. Four of them have returned to work.

———

(The Sacramento Bee’s Dale Kasler contributed to this report.)

———

©2020 The Sacramento Bee (Sacramento, Calif.)