Tighter restrictions imposed: Compliance needed to protect most vulnerable, state health officials say

The Delaware Department of Health and Social Services put together a Kent County coronavirus response team, aimed at protecting the vulnerable homeless population in the Dover area, and tested many for COVID-19 symptoms at the Hopes and Dreams Peer Resource Center off West Division Street on Tuesday, March 24. They also put nearly 60 homeless people into Dover motels for shelter. Submitted photos

SMYRNA — To further protect Delaware’s high-risk population and because leaders said residents aren’t following emergency orders, Gov. John Carney Wednesday banned public gatherings of more than 10 and vowed to enforce the restrictions in place.

Delaware had 49 new coronavirus cases, including one death, on Wednesday, bringing laboratory-confirmed cases to 368 and deaths to 11.
Of those people, 51 Delawareans are hospitalized, with 13 critically ill, according to the Division of Public Health. Forty-nine people have recovered, meaning they have gone without symptoms for at least a week.

With emphasis on protecting senior citizens and other vulnerable, high-risk individuals from the COVID-19 spread, Delaware’s Division of Public Health began Wednesday urging everyone to act as if they are carriers of the coronavirus.

“I keep hearing stories about individuals who are in their 70s and 80s, getting together for parties. The reality is then we are seeing people succumbing to illness after those events together,” said Dr. Karyl Rattay, director of Delaware’s Division of Public Health.

“It is so important that we all have the belief that we are all carrying this virus, and that coming close to anybody is putting others at risk for illness and for death. We can’t have parties with one another. We must abide by social distancing. We must stay home as much as possible.”

Dr. Rattay spoke during a Wednesday panel discussion with Dava Newnam, director of the Division of Services for Aging and Adults with Physical Disabilities, and Ken Bock, CEO of Sussex County-based CHEER Inc. at the State Health Operations Center in Smyrna.

By Wednesday evening, Gov. Carney announced the new restrictions that public gatherings of more than 10 people are prohibited and businesses must put more safeguards in place to ensure social distancing.

Delaware has been in a state of emergency since March 12. Last week, Gov. John Carney closed non-essential businesses and instructed residents to stay home except for necessary activities like visiting a doctor, exercising or buying groceries. Some people have ignored the restrictions despite repeated warnings, however, prompting the newest decision to bar all but small groups.
Gatherings that can have no more than 10 people include weddings and funerals.

Businesses are limited to 20 percent of stated fire capacity at any time, must designate staff to enforce that rule and are required to mark six-foot spacing in check-out lines and “other high-traffic areas, including outside.”

“We will take action to enforce these restrictions if Delawareans, visitors, and businesses don’t comply voluntarily,” Gov. Carney said. “Our goal is to save lives. This is a serious situation and we need everyone to cooperate. Don’t go out in public unnecessarily. If you need to go out, stay away from others. Wash your hands and follow basic hygiene guidance. We’ll get through this, but it’s going to take all of us.”

The order takes effect at 8 p.m.

Of the most recent deaths in Delaware due to the coronavirus, all had significant underlying health conditions, DPH stated.

The most recent death is an 84-year-old man from Sussex County who was hospitalized and had serious underlying health conditions.

Of the 368 total positive cases, 226 involve New Castle County residents, 101 involve people from Sussex and 41 involve Kent Countians. The affected individuals range in age from 1 to 97.

The state announced its first coronavirus case March 11. The count was 119 a week ago.

In 104 of the cases, the person is at least 65, an age group considered to be at high risk from the virus. There have been two cases involving a child no older than 4.

As of Wednesday, there had been 4,015 negative test results, DPH said, although it cautions the figure is preliminary and should not be used as a substitute for the number of people who have been tested.

DPH said it cannot release or confirm further information about the patients due to privacy laws.

Educating the public on the consequences to seniors and those in high-risk populations was the goal of Dr. Rattay’s livestream Wednesday.

“We are especially concerned about individuals who are at higher risk — individuals over the age of 60, with chronic underlying conditions. The reality is that the older you are, and the sicker you are, the more likely you are to succumb to this illness,” she said.

Part of the livestream centered on services, including alternative shopping options for seniors and those at high-risk and continued emphasis on social distancing practices.

In Sussex County, CHEER is a staple for thousands of seniors, including nutrition through its Meals On Wheels program.

With CHEER’s senior centers closed during Gov. John Carney’s State of Emergency, CHEER has altered its meal nutrition program.

“People who depend on coming there daily for meals are no longer going to be able to get together in those congregate settings. So we have changed our program and we are now providing a ‘Grab and Go’ kind of service, where seniors that have the ability to drive to the center location can wait in their car and have curbside delivery by volunteers brining the meals out to them,” said Mr. Bock.
During the pandemic, the number of meals being served has increased.

“In the Meals On Wheels homebound delivered meal program, we’re seeing a huge growth. We have been working over the last two weeks trying not only to serve those additional people coming into the program and those people who can’t come into the senior center but those who still rely on us for meals to make sure they are getting their meals in their homes,” said Mr. Bock.

Additionally, CHEER has ramped up its production capabilities to produce frozen meals.

“We have gotten in additional and assembled shelf-stable meals so that we are able to provide up to 15 additional meals in the homes of each of these seniors,” Mr. Bock said.

Precautionary measures are taken for both clients and volunteers in the homebound meal delivery.

“Instead of the direct face-to-face contact … now meals are delivered in plastic bags that are hung on doorknobs. Volunteers knock on the door, ring the bell and step back to that social distancing six feet to allow the person to answer the door and take that meal in,” said Mr. Bock.

Dr. Rattay made note of the tragedy in Washington State where several dozen deaths have been linked to COVID-19 at a long-term care center near Seattle. Laboratory testing in the nursing home revealed that about 50 percent of those positive cases were individuals that had no symptoms, which “was quite a surprise,” she said.

“That again reinforces for us the incredibly important message that we all have to act as though we have the virus,” said Dr. Rattay. “That seems to be especially the case for seniors as well as children, that even though they may not have symptoms they certainly could have the virus and could spread it. We all need to keep that distance from others.”

Maintaining compliance

Dr. Rattay said Gov. Carney and the Division of Public Health are “extremely concerned” that many businesses are not being compliant with social distancing.

“We want to say that we intend to crack down on this. If we find businesses that are not being compliant, we want to know about it. If you are aware of a business where social distancing is not occurring, please send an email to: dphcall@delaware.gov. We want to know. We also want to know if there are positive cases who are not staying home and not being compliant with their isolation requirements.

“Some of the things that we keep seeing over and over in our cases, is that people are not being compliant with a lot of the guidance that is given.

“People are going out. People are going to work when they are ill. And yes, we appreciate the many people who are working for our essential services including healthcare providers, going out and doing the work right now. But anyone, no matter who you are, no matter what your work site is, if you have any symptoms of illness please, please, please do not go to work. Please don’t go to the supermarket, to the pharmacy. Please get somebody else to do that for you.”

Ms. Newnam urged seniors to take advantage of special shopping times designed to limit crowds in stores and decrease potential exposure to the virus.

She added, “We would ask you to contact your friends, your neighbors, family members and ask them to go for you. And to leave those items outside your door so that you don’t come into direct contact.”

Anyone unable to get to the store or have help from family or community is urged to contact the Aging and Disability Resource Center at 1-800-223-9074 or delawareadrc.com for help.

For individuals in good health opting to shop, Dr. Rattay emphasizes proper hygiene. That includes washing hands well before going out and taking hand sanitizer along.

“Use it several times through the trip. Make sure you stay six feet away from any other individuals in the store. The second you leave that store, clean your hands again with hand sanitizer and wash hands well when you get home. And be very careful not to touch your face during that time, until you have done a great hand washing once you’ve gotten home,” said Dr. Rattay. “Follow those things, and it should help quite a lot.”

Above all, if there is any sign of illness, the message is to stay home. In addition to COVID-19 symptoms of fever, cough and shortness of breath, Dr. Rattay said the health world is now seeing cases that include body aches, sore throat, runny nose, stomach pain and diarrhea.

“We are learning every day more about COVID-19. There was a study that was just released a couple days ago that really shows that those especially with diabetes, any type of lung disease like COPD, and those with cardiovascular disease are especially at higher risk,” said Dr. Rattay, adding it also includes those undergoing cancer treatment.

Coping with isolation

To help seniors deal with possible isolation and depression that may come from state of emergency restrictions, officials urged family and friends to reach out through phone calls and technology.

“I would encourage you to call your family members, call your grandparents, call your friends, call your neighbors,” said Ms. Newnam. “All of you kids that are stuck at home, when you’re caught up on Schoology, call your grandparents, or draw pictures. If you don’t have grandparents who you can call or draw pictures for, send them to the nursing homes. These are tough times for these individuals that aren’t having any contact with the outside world. Please, do what you can to touch base with them by phone, video chat or even letters.”’

For information, call Division of Public Health at 1-866-408-1899 or email DPHcall@delaware.gov.

Reach CHEER Inc. at 302-515-3040 or visit cheerde.com and the Delaware Aging and Disability Resource Center at 1-800-223-9074, email DelawareADRC@delaware.gov or visit www.delawareadrc.com.

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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