DULUTH, Minn. — Long-term care facilities in North Dakota and Minnesota have imposed a wave of measures in recent weeks to protect elderly and vulnerable residents from the coronavirus outbreak.

And while both states have avoided deaths that have hit facilities elsewhere, an industry official on Monday, March 23, warned against becoming complacent as the pandemic dictates a new reality for millions of Americans.

The disease caused by the virus, COVID-19, is especially dangerous for older people. In Washington state, an outbreak at a nursing home resulted in 35 deaths.

Government and industry officials issued guidance earlier this month aimed at preventing the virus’s spread in long-term care settings. Facilities in the region have restricted visitors, started screening workers for symptoms, initiated social distancing measures and implemented more sanitizing procedures, among other actions.

“I don’t know that there’s anything more we can do, other than totally locking the doors. But we do need people here to take care of our residents,” said Grant Richardson, senior executive for development and community relations for Bethany Retirement Living in Fargo. “While there are more things we possibly could do, some of those things may not be realistic either.”

The measures taken at long-term care facilities are part of a broad response to the pandemic that has upended American life. Leaders in North Dakota and Minnesota have urged people to largely avoid each other to slow the virus’s spread while shuttering schools and many business operations, such as dine-in service at restaurants.

But some of the earliest steps were taken to stop the virus from slipping into long-term care facilities.

Edgewood Healthcare, a Grand Forks, N.D.-based company with more than 4,000 assisted living residents in seven states, announced several “precautionary measures” in early March, more than a week before President Donald Trump issued a national emergency. Jill Leonardi-Wilson, executive vice president of Edgewood Health Network, said they’ve been following federal guidelines in responding to the pandemic.

“We’re really doing everything we can to prevent this from coming into our buildings, knowing that we take care of a very vulnerable population,” she said.

On Monday afternoon, Minnesota Health Commissioner Jan Malcolm said officials had identified four cases of the virus in long-term care facilities. She said they’re “working aggressively with those facilities on infection control practices” and testing all of the residents.

Minnesota reported 262 total confirmed cases of COVID-19 Tuesday.

“We have said from the beginning that we know that congregate living settings, especially among our elderly … are going to be very important to react to very quickly,” Malcolm said.

People who are at least 80 years old are at the greatest risk of death or illness from the coronavirus, according to the Centers for Disease Control and Prevention. People with underlying health conditions are also vulnerable.

Patti Cullen, president and CEO of Care Providers of Minnesota, said facilities have stepped up to protect their residents. But she worried about losing a sense of urgency surrounding the virus the longer the pandemic continues.

“If this lasts a long period of time and people start getting stir-crazy and maybe a little lax with the guidance, we may have to revisit this,” she said.

North Dakota reported 34 total cases Tuesday morning. Gov. Doug Burgum declined to say Monday whether any of the confirmed cases were in nursing homes, citing the state’s policy against releasing any identifying information about infected people, but an industry official was unaware of any confirmed cases in those facilities.

Bruce Pritschet, director of the health facilities division at the North Dakota Department of Health, said a team of staffers met with employees at more than 200 facilities to answer questions and provide guidance on how to prevent the virus from reaching residents.

Though she said the state has been well-positioned to respond to the pandemic, North Dakota Long Term Care Association President Shelly Peterson raised concerns about access to testing for health care staff and the long-term supply of personal protective equipment for workers on the front lines. She’s also hoping government officials will ease regulations to ensure facilities can be adequately staffed when sick workers are sidelined.

Peterson said it’s been “stressful” for families who aren’t able to visit their loved ones, but she praised staff for finding alternate means of communication.

Lillian Crook of Bismarck, N.D., said her parents are staying in separate nursing homes in nearby Mandan. She’s able to talk to her 87-year-old mother on the phone while standing outside of her window, and facility staff are working to set up an online video chat with her 95-year-old father, who Crook said has “some dementia.”

“It’s so hard to … look through the window and see him sitting there by himself without any of us,” Crook said. “That’s just really heartbreaking.”

Forum News Service reporter Jeremy Turley contributed to this report. As a public service, we’ve opened this article to everyone regardless of subscription status.