Robin Wolzenburg, the director of housing and clinical services for the senior living advocacy group LeadingAge Wisconsin, recently received an email that broke her heart.

The email, from a Wisconsin senior living provider, read: “Hi Robin, I want to let you know we have a COVID outbreak in our facility. I have 13 residents, two have already tested positive earlier this week, with eight more today. Two of them have already died. I have three staff members who are positive and I have no one to staff my building.”

Over the last month, Wolzenburg, who helps senior living facilities stay up-to-date with rapidly changing public health guidelines, says emails like that are “becoming the norm” as senior living facilities struggle to contain COVID-19, despite the array of safeguards in place meant to prevent its spread.

Community spread of coronavirus in Wisconsin has gotten so bad that employees are contracting the virus outside of work because much of the public still refuses to take the virus seriously, Wolzenburg explained.

“I’m hearing desperation and a lot of really defeated feelings in a lot of ways, going into the fall surge,” she said. “It didn’t feel as close to home until the last 10 weeks, when we just started seeing this awful increase with the community spread.”

That’s because senior living facilities throughout Wisconsin are either bracing for a potential outbreak, recovering from a previous outbreak or currently experiencing one, according to Wisconsin Assisted Living Association CEO Michael Pochowski.

“Even simply going to the gas station or to the grocery store there is a potential chance that you could be exposed to COVID,” he said. “So there’s really no one to blame when an outbreak happens.”

Locally, the Wisconsin Department of Health Services reported public health investigations at six nursing homes in Winnebago County.

The DHS list included investigations at Bethel Home, Eden Meadows, Edenbrook of Oshkosh, Evergreen Retirement Community, Park View Health Center and Peabody Manor.

However, any nursing home with a case among residents remains on the DHS website for 28 days as an active investigation.

To prevent coronavirus outbreaks in nursing homes, Wolzenburg says Centers for Medicare & Medicaid Services is requiring all staff members to be tested in nursing homes twice a week because the COVID-19 positivity rate is so high in Wisconsin. Residents are tested if they become symptomatic or if there is an outbreak.

Additionally, she said DHS is requiring nursing homes to test staff for COVID-19 every other week, regardless of positivity rate.

If a staff member tests positive, Wolzenburg explained that they are immediately sent home. The facility then begins contact tracing to locate people who were in close proximity to the positive case and then immediately test those close contacts.

Testing presents another problem as most of the tests being used take three days for results because most nursing homes do not have access to rapid testing, she noted.

Wolzenburg added that nursing homes have “some access” to COVID-19 tests that produce results within hours, but those are not as accurate on asymptomatic carriers.

At assisted living facilities, Pochowski said if a resident or a staff member tests positive for COVID-19 it is considered an outbreak.

Once an outbreak occurs, the facility contacts its local public health department to confirm the outbreak and order testing supplies, he added. Assisted living facilities then test residents and staff members for COVID-19 based on recommendations from public health officials.

While the pandemic has created new pressures for nursing homes and assisted living facilities, it has also magnified a problem that existed before the pandemic, according to Wolzenburg and Pochowski.

Even before the pandemic, there was a shortage of workers in senior-living facilities, which combined with staff contracting the virus has created the perfect storm of staffing shortages.

“Prior to COVID, we had a very significant staffing caregiver crisis going on,” Pochowski said. “Then when COVID hit, it really intensified, so we just are in dire need of having caregivers come to work for our facilities.”

Beyond increasing the quality of care for residents, Wolzenburg said increased staffing in nursing homes specifically could help take pressure off the healthcare system.

“Even hospitals are trying to think about how they can help nursing homes with staffing because nursing homes could take more of their residents and free up some of those hospital beds for COVID,” she said.

However, nursing homes are not allowed to accept new residents until 14 days after their last positive case, Wolzenburg explained.

“The problem is most facilities in Wisconsin right now are in some kind of constant outbreak,” she said. “They’re having at least one staff member test positive every time they test, especially in nursing homes, because they’re doing the regular testing.”

Aside from staffing concerns, Wolzenburg and Pochowski say the acquisition of personal protective equipment (PPE) remains an issue for many senior-living facilities as it’s become more accessible, but also more expensive.

“We were in dire need of any PPE when the COVID-19 pandemic first broke around February/March; and the supply chains have gotten better, but the prices are just unbelievable,” Pochowski said. “There’s some stuff that ebbs and flows in terms of availability.”

Wolzenburg added that the pandemic has taken an emotional toll on the staff in senior-living facilities, who are “working tirelessly” to care for our most vulnerable population.

“They have to meet their own needs to homeschool their children, too,” she said. “They’re also meeting the emotional, spiritual and psychosocial needs of all these residents in absence of having contact with their families.”

Going forward, Wolzenburg hopes people can start acting more selflessly in taking the pandemic seriously.

“We all have grandparents — we all have great aunts and uncles — think about them getting sick,” she said. “We need to really think about our actions, especially going into the holidays.”