NEW ROCKFORD, N.D. — Don Heinitz entered the grim annals of North Dakota’s coronavirus pandemic as a deceased “Man in his 80s from Eddy County with underlying health conditions.”
That mention of a nameless, faceless data point — one of five North Dakotans reported dead from COVID-19 on a Wednesday — appeared on a news release issued on Sept. 16.
To Kim Stafford, the statistical tidbit failed even to hint at a portrait of her father. For her, Heinitz was a beloved father, grandfather and great-grandfather who lived nearly all of his 84 years in Carrington, a tight-knit farming town in central North Dakota. He was a proud graduate of the University of North Dakota, an honorably discharged National Guardsman and a longtime small business owner.
His infatuation with golf lasted well into old age, with Stafford serving as his caddy when she was a girl. Heinitz helped build Carrington’s CrossRoads Golf Club and mowed the greens daily during warm seasons up until about a year ago.
“He loved that course like nothing else,” his daughter said. “That was his baby.”
Heinitz is one of at least 479 residents of North Dakota nursing homes who succumbed to the virus. Residents of long-term care facilities, in fact, make up almost 60% of North Dakota’s COVID-19-related deaths — reflecting the fact that the elderly are among the most vulnerable to the virus.
Almost one in 10 nursing home residents in North Dakota who was infected with the coronavirus died, according to the COVID Tracking Project.
Heinitz’s daughter believes he caught the virus from a staff member; he died within two weeks.
Stafford has an underlying health condition, and going to see her quickly fading father could have ended with her in the clutches of COVID-19 as well. She concluded that the risk was too great.
“That was probably the hardest decision I’ve ever had to make,” Stafford said through tears. “He died by himself.”
“I think for a lot of people, (the pandemic) doesn’t mean much to them because they haven’t lost a loved one and they think it’s all just a joke,” she said. “If your loved one is in a hospital or a nursing home, there’s no guarantee that you’re going to get in there to see them alive again.”
Along with her father, two other residents of the Lutheran Home of the Good Shepherd in New Rockford also died, Stafford said.
The administrator of the nursing home, Kim Jensrud, wouldn’t confirm that number, but hopes that a local mask mandate passed Nov. 4, 10 days before the statewide requirement took effect, will help curb community spread and keep residents safe.
“We're trying as hard as we can to keep it under control and minimize the spread in our facility,” she said, adding a plea for people to wear masks. “If everybody does their part it’ll help everybody in the end.”
As of late this week, more than 400 nursing home residents and more than 250 staff members were known to be infected by the virus. The highly contagious virus spreads quickly through congregate living settings despite stepped-up infection control measures — a consequence, health providers and public health officials say, of rampant community spread.
In fact, almost no nursing homes in the state are allowing visitors, a restriction forced by the infection rate in their communities or the fact that a resident or staff member is infected.
Despite the precautions, coronavirus outbreaks can sweep through nursing homes with lethal efficiency.
One tragic example can be found at the Good Samaritan Society home in Bottineau, located 128 miles north of New Rockford near the border with Canada. In a matter of weeks, the virus claimed the lives of 17 of the home’s 42 residents as well as one staff member.
Kelly Beaver, the former activities director at the nursing home, knew every resident who died. She attended several of their online funerals, a somber signature of the pandemic and its imperative for keeping safe distances and avoiding crowds.
“It’s a loss for our community,” said Beaver, now the director of the Chamber of Commerce in this farming town of 2,200 near the Turtle Mountains.
“It’s a void,” she said. “All those families and all those funerals.”
Yet another tragic outbreak in North Dakota recently swept through the Somerset Court assisted living center in Minot, where 21 residents died.
Mike Deuth, regional vice president for the Good Samaritan Society, based in Sioux Falls, S.D., echoed Jensrud’s plea for people to take precautions to curb community spread, which infects workers who bring the virus with them to work.
“There’s really a direct correlation between the rise in our facilities and community spread,” he said. “I think everybody’s aware of what they have to do.”
The advice from health providers and public health officials is by now familiar: wear a mask, keep a safe distance from others, avoid crowds and wash your hands often.
The repeated messages to take precautions likely are increasingly falling on the ears of a public that has grown weary with “COVID-19 fatigue,” he said. But Deuth and many others continue to stress the importance of adhering to the precautionary measures.
“I keep coming back to community responsibility,” Deuth said. “As a community, we need to be sure we’re doing what we can.”
The large number of COVID-19 deaths will be felt for a long time in Bottineau, Beaver said. Many staff members at the nursing home have worked there for years, and know the residents they care for almost as members of an extended family, she said.
“I feel bad for the staff and residents,” Beaver added. “How are they going to get past that?”
'An alarming trend'
The trend lines displaying how North Dakota’s nursing homes are coping in the face of the pandemic show disturbing deterioration, according to figures tracked by AARP.
Over a four-week period ending Oct. 18, the most recent comparisons drawn from federal data available, North Dakota’s skilled nursing facilities lagged behind the national average in several categories:
The death rate in North Dakota nursing homes — almost two per 100 residents — was nearly four times the national average.
Skilled nursing homes in North Dakota had 6.4 new confirmed cases per 100 residents, more than twice the national average.
Almost a quarter of skilled nursing homes in North Dakota, 23.7%, reported not having a one-week supply of full personal protective equipment, higher than the national average of about 20%.
More than half of North Dakota’s skilled nursing homes, 55.3%, had a shortage of direct care workers, such as nurses and aides, compared to less than 30% typical nationally.
“I think it is an alarming trend,” said Josh Askvig, director of AARP North Dakota, which represents those who are 50 and over.
Particularly troubling, he said, are the widespread staffing shortages. “Staffing shortages impact quality of care. We know that.”
Also, the higher-than-average death and infection rates in North Dakota nursing homes underscore the need to get the pandemic under better control and to improve infection control inside facilities, Askvig said. “I do think that is one of the items that needs to be reinforced here,” he said. “You can see that in the data.”
As the pandemic drags on month after month, nursing homes are increasingly finding it difficult to maintain staff levels, partly because employees become infected by the virus.
The challenge of battling the virus with fewer staff in nursing homes and other long-term care facilities has become more and more difficult as the pandemic wears on, said Shelly Peterson, executive director of the North Dakota Long-Term Care Association.
“We’re at extreme measures right now with extremely high rates” of infection around the state, she said. She welcomed an announcement by Gov. Doug Burgum on Nov. 9 that hospitals and nursing homes can allow staff who are infected with the virus to work — provided they are without symptoms and are restricted to COVID-19 units.
In North Dakota, 15,000 workers, full-time and part-time, staff the state’s nursing homes and assisted living facilities. Of those, an estimated 1,500, or 10%, are not available to work, including many who are infected or under quarantine because they were exposed to an infected person, Peterson said.
To manage, long-term care facilities can call upon a dozen contract agencies as well as the state’s “crisis strike team,” composed of registered nurses, licensed practical nurses and certified nursing assistants who are dispatched to centers based on need.
Also, dedicated staff have repeatedly worked overtime to care for residents, Peterson said. “The staff have been absolutely terrific,” she said.
The toll of isolation
Harvey Weyrauch was known for playing the accordion on horseback and riding a 3,000-pound steer in parades around Ray, N.D., near where he ran a farm and ranch for more than 60 years with his wife Aurita.
The Weyrauchs celebrated their 69th wedding anniversary in the long-term care unit at Tioga Medical Center on Oct. 6 — the day Harvey was diagnosed with COVID-19.
Aurita, who was in an independent living apartment at the center, was allowed to visit her husband to mark the occasion, after some persuasion from her daughter.
“I had to fight to get Mom in there to see him on that day,” said Marie Challes, the eldest of the Weyrauchs’ five children.
The contagion risks associated with the coronavirus mean that virtually no long-term care units in North Dakota are able to allow visitors under federal guidelines.
The lack of visitation is a source of frustration for many families who have loved ones in long-term care. Many believe the isolation, especially when the person is unable to understand why visitors aren’t allowed, leads to a decline in the resident’s condition.
In the warmer months, the Weyrauchs managed awkward visits, with Aurita standing outside a window or screen, sometimes with an umbrella to block the sun. But Harvey, who had advanced Alzheimer’s, couldn’t understand the need for separation.
Their daughter Marie bought wireless headsets with microphones for $400 — but they arrived too late to use. By the time they showed up, Harvey was in palliative care.
He died at age 93 on Nov. 6 of Alzheimer’s, with COVID-19 listed as a contributing cause of death. Aurita, who was hospitalized two days earlier with exhaustion, was unable to be with him. The same day she entered the hospital, test results came back indicating she was infected with the coronavirus. She is now recovering.
Ultimately, all of the center’s 30 skilled nursing residents contracted COVID-19, and eight or nine died from the disease, said Randall Pedersen, president of the medical center. As of Friday, Nov. 20, no residents or staff were positive.
Pedersen acknowledged that the lack of visitation, which still isn’t allowed because Williams County is considered high-risk, is detrimental to residents and their families.
“We’re looking forward to a day when we can start having a normal life in our nursing homes,” he said. “These residents need their family members to be with them.”
More than anything, the Weyrauch family wishes there were a better way for relatives to visit loved ones in long-term care. Ideally, a special room could be created, Marie said.
In August, Aurita was able to stand outside and sing to Harvey, who was wearing headphones. She sang, “Have I Told You Lately That I Love You?” — one of many favorite songs the couple shared.
“It was a disaster to try to get them to communicate,” Marie said. “It was heart-wrenching.”
This is the third story in a series examining North Dakota's worst-in-the-nation COVID-19 outbreak. Read the rest of the series here:
- Part 1: How did North Dakota's COVID-19 outbreak become the worst in the country?
- Part: 2 Do traits that normally help North Dakota endure hardship fuel its coronavirus crisis?
- Part 4: Until vaccine arrives, North Dakotans hold keys to curbing state's COVID-19 crisis, experts say