The COVID-19 outbreak in an admission unit at the Oregon State Hospital authorities disclosed this week has expanded to more patients and now includes hospital staff, according to court documents filed Friday.
The additional cases make this the largest outbreak at the Salem psychiatric hospital since the pandemic began. It means the facility, which stopped admitting new patients this week, won’t open it’s doors again until at least mid-December, almost certainly delaying mental health treatment to an unknown number of the state’s most vulnerable.
This week, six patients tested positive, up from the two cases the state hospital first disclosed in court documents Tuesday. In addition, the court documents reveal three staff also tested positive for COVID-19.
“Contract tracing indicates that all nine cases are linked to the original two patients on the Admission Monitoring Unit,” Derek Wehr, deputy superintendent of the state hospital, said in a declaration filed in federal court. He said the hospital was monitoring another 16 patients “who are either exhibiting symptoms of the virus or are at high risk of exposure linked with the recent outbreak.”
The Oregon State Hospital in Salem, Ore., is pictured on Thursday, June 27, 2019.
Bryan M. Vance / OPB
The Oregon State Hospital is a state-run psychiatric hospital that houses hundreds of people in the criminal justice system who need treatment for mental illness, as well as other Oregonians who are committed involuntarily. Since 2002, the hospital has been under a federal court order to admit patients within seven days, if a judge finds them so mentally ill they’re not able to assist in their own criminal defense. The defendants wait in local jails for admission to the state hospital where they get mental health care, with the goal of restoring the person so they can be released back to local counties and their criminal case can continue.
In the last two years, the hospital has fallen out of compliance with the court order several times, leaving criminal defendants with acute mental illness in local jails — sometimes for weeks — where their illness only worsens, disability advocates and public defenders have argued.
In May, a federal judge relaxed the seven-day requirement, over the objections of disability advocates who have appealed the ruling. With a growing outbreak at the hospital now requiring a pause in new admissions, disability advocates are once again concerned about what that delay could mean for those with acute mental illnesses stuck in jails awaiting care.
“Protecting the health of the patients and staff at the state hospital is important,” said Emily Cooper, legal director for Disability Rights Oregon, which has sued the state in the past over admission delays to the hospital. “Halting admissions at the state hospital means more people with mental illness will be stuck in county jails indefinitely, violating their constitutional rights.”
Related: Oregon State Hospital closes admissions after two patients test positive for COVID-19
Rather than jails and state hospitals, Cooper wants the state to significantly expand community-based mental health treatment for mentally ill defendants.
The hospital had three positive cases of COVID-19 in late September and early October and also halted admissions after the pandemic struck for the safety of those inside. This latest outbreak began after two patients, who were asymptomatic, were admitted to the hospital from local jails during the week of Nov. 16, court documents state. The hospital’s chief medical officer said this week that the source of the cases was under investigation, but was likely either the jails where the patients came from or hospital staff. Officials declined to say which jails the inmates came from, citing health privacy laws.
The hospital received the positive test results on Thanksgiving Day. The two positive patients were moved to a separate COVID unit and testing was expanded to other patients and staff. The outbreak is in an admission unit, which is separate from the rest of the hospital’s patient population. It’s designed to quarantine a group of incoming patients where they’re tested and monitored for COVID-19 for several weeks before joining the larger hospital population.
Wehr warned that resuming admissions in mid-December might not be possible if the number of cases continues to climb in the coming days. Even if that’s avoided, there may not be enough staff, he said. During the last two months, 111 nurses on average have been out every day because of the pandemic, Wehr said. The number of nurses on COVID-related leave is expected to increase this month, he said.
“Every unit requires staffing, and if there are not enough staff to cover every unit in [the Oregon State Hospital], that will limit the number of beds that can be filled,” Wehr said.