Alexandria Health Department Reports More Than Half of COVID-19 Deaths Associated with Long-Term Care Facilities

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Alexandria Health Department Reports More Than Half of COVID-19 Deaths Associated with Long-Term Care Facilities

­­For Immediate Release: May 2, 2020

As of May 2, the Alexandria Health Department reports that 58% of Alexandria residents who are known to have died from COVID-19 (15 of 26 fatalities) lived in long-term care facilities (LTCFs) such as skilled nursing and assisted living facilities. High rates of COVID-19 fatalities in LTCFs are a problem throughout the region and across the country. According to the Virginia Department of Health’s (VDH) data dashboard, 54% of Virginia COVID-19 deaths have been associated with long-term care facilities. COVID-19 is still spreading throughout the community, so residents must vigilantly practice the “Six Steps to Stop the Spread” regardless of whether they are in an LTCF.

Why LTCF Residents are at Higher Risk

There are five skilled nursing and four assisted living facilities in Alexandria. Both types of facilities house elderly residents, many of whom have underlying health conditions, such as heart and lung disease, diabetes, kidney disease, etc. While everyone is at risk of contracting COVID-19, people over age 65 and people with underlying medical conditions are at much greater risk of severe disease that may require hospitalization, intensive care treatment including mechanical ventilator support, and even death.

The LTCF workforce is primarily engaged in tasks requiring close proximity and prolonged contact with residents. Nationally, these workers are disproportionately lower-income and often without benefits such as paid sick leave that would allow them to stay home when ill. Analysis from the Kaiser Family Foundation notes that 58% of LTCF workers in the United States earn under $30,000 a year. The analysis also shows that the majority of these workers are women, and a disproportionate share are people of color. These frontline, essential workers have a higher risk of exposure to the COVID-19 virus with their close-contact job duties in congregate settings, and could unintentionally bring illness home to their families. The higher rates of low-income and people of color working in these high-risk settings magnify existing inequities in COVID-19 cases and hospitalizations in Alexandria, and across the United States.

A COVID-19 Report from the U.S. Centers for Disease Control and Prevention (CDC) highlighted many conditions that led to 129 cases of COVID-19 in a long-term residential care facility in Washington state in late February to early March 2020, of which 23 patients died. These conditions included staff members working while ill, staff members working in more than one facility, inadequate familiarity and adherence to infection control practices, difficulties in acquiring personal protective equipment and hand sanitizer, and delayed recognition of signs and symptoms of potential COVID-19 infections.

What AHD is Doing to Support LTCFs

AHD has longstanding, close relationships with all LTCFs in Alexandria, and routinely provides them guidance and recommendations on infection control and mitigation. Since early 2020, AHD has been working with the LTCFs to help them prepare for COVID-19. Throughout the COVID-19 pandemic, AHD has synthesized and distributed the latest CDC and VDH guidance to all facilities. AHD has also developed a comprehensive response system that includes assessing and training facilities for best practices in infection prevention and control; helping to equip facilities with personal protective equipment (PPE) by assessing needs; and coordinating deliveries from multiple sources (such as VDH, the Strategic National Stockpile, the Regional Hospital Coordinating Center, and the Virginia Department of Social Services) depending on the facility type and its associations.

AHD has created a dedicated team of staff members and Medical Reserve Corps (MRC) volunteers who conduct assessments and provide intensive one-on-one coaching and guidance to facilities and their staff in infection control prevention training, as well as for a rapid response when an outbreak occurs to mitigate the risk of disease spread.

To reduce the likelihood of LTCF workers unintentionally spreading illness, AHD has advocated for enhanced business models in Alexandria LTCFs, to include providing all staff a livable wage, benefits including paid sick leave, enhanced training, and guaranteed full-time employment, so that staff do not need to work at multiple facilities to support their families.

AHD has also notified Alexandria LTCFs of COVID-19 outbreaks in other LTCFs in northern Virginia, so Alexandria facilities can exclude workers from the other facilities until they complete their quarantine periods. To protect patient and facility confidentiality, AHD does not publicly disclose the names of facilities experiencing outbreaks. 

What You Can Do For Your Loved One

If you have a loved one in an Alexandria LTCF, here are some actions you can take.

  • Use AHD’s 14 questions to ask your loved one's LTCF to find out what steps they are taking to protect their residents and staff.

  • Stay connected with your loved one. Although you are not able to visit in person, stay in touch via phone, video chat, email or letters and cards to check on and boost their physical and mental health.

  • Visit to learn more about how every resident can take steps to stop the spread of COVID-19.

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This news release is available at

Note: This news release was edited on May 3, 2020, to clarify that patients who died from COVID-19 after living in long-term care facilities may have died in another location (e.g., a hospital).