For residents of nursing homes and their loved ones, new and disturbing information has come out on long-term care facilities’ persistent failure to safeguard the vulnerable from the coronavirus that has killed tens of thousands of the institutionalized and infected hundreds of thousands of them and their caregivers.
Six months after the pandemic exploded across the country, more than a quarter of nursing homes nationwide are “reporting shortages of personal protective equipment (PPE) and staff, and almost half have staff infected with Covid-19,” according to the AARP, the country’s largest advocacy group for older Americans.
The organization based its finding on its scrutiny of federal data, reporting:
“The new analysis draws on self-reported data from nursing homes collected by the federal government over four weeks from late August to late September. While some states fared much worse than others, all 50 states and the District of Columbia had one or more nursing homes that reported inadequate PPE supply, staff shortages, staff infections and resident cases. Forty-seven states reported at least one Covid-19 death among residents. The analysis found that more than 28,000 residents tested positive for Covid-19 during the four-week reporting period, and more than 5,200 residents died, showing that the virus is still raging in nursing homes. More than 84,000 long-term care residents and staff have died since January, and more than 500,000 residents and staff have contracted the disease, according to the Kaiser Family Foundation’s tally, accounting for roughly 40% of the national death toll. Long-term care providers include assisted living, adult day care centers and more, while AARP’s new analysis features just nursing home data.”
Bill Sweeney, AARP’s senior vice president of government affairs, commented on the “profoundly disappointing” findings, developed by his organization and the Scripps Gerontology Center at Miami University in Ohio, adding:
“While the pandemic has been unexpected to all of us, basic infection control should have been going on in nursing homes for a long time. These are places where people are vulnerable to infection, whether it’s Covid or something else, so for these facilities to still not have basic PPE, even now, with a deadly virus in the air, is outrageous and unacceptable.”
The Centers for Medicare and Medicaid Services (CMS) — the chief federal regulator of nursing homes and long-term care — has veered from slashing institutional inspections and locking down facilities, to recently insisting that owners and operators open homes up and test staff. The agency and the Trump Administration have been self-congratulatory about providing problematic tests and testing equipment, while also insisting, in a hotly disputed assertion, that PPE supplies are adequate and without issue.
While others, including the state of Nevada, have raised major concerns with claims about PPE and testing, AARP said its findings should force owners, operators, and regulators of nursing homes to reckon with big problems in facility staffing. Both care givers and residents are getting coronavirus infections at similar and troubling rates.
It’s the staffing …
AARP’s information is worth quoting at length:
“The national total of Covid-19 cases among staff over the four weeks of data almost matched that of residents: 26,945 for staff versus 28,405 for residents. But only a quarter of all U.S. nursing homes reported resident cases within their facilities, meaning staff infections are far more widespread, present in double the amount of facilities. Studies show that infected staff are one of the greatest drivers of infections among residents. Sweeney calls the staff Covid-19 infections a ‘truly a shocking issue.’
“’These are folks who are not getting paid well at all, who don’t have access to sick leave and who may be working between multiple homes to make ends meet, unknowingly transmitting the virus from nursing home to nursing home,’ he says. Many nursing assistants make less than $15 an hour, and there’s high staff turnover. About 700,000 certified nursing assistants (CNAs) work at nursing homes, according to the National Association of Health Care Assistants, making up the overwhelming majority of care workers at nursing homes.
“I’m not blaming the staff — they’re doing their very best — but I do blame the nursing home industry and companies that were too slow to provide the testing, the support and the compensation that’s needed to attract and retain high-quality staff,” Sweeney says.
Yes, sir. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by neglect and abuse at nursing homes and long-term care facilities.
The shambolic federal response to the coronavirus has left the nation open to yet another worrying surge in infections and an unacceptable and ever-mounting death toll. The alarms have sounded and continue to do so about the savaging by Covid-19 of the old, sick, and injured in nursing homes and long-term care facilities. So why aren’t federal and state officials doing more?
A risky idea rises
The Trump Administration clearly has decided that its coronavirus strategy will be to deny, deflect, downplay, deride, and defy the challenges and nightmares of the pandemic. The latest dangerous distraction that the White House increasingly has embraced involves the destructive notion of “herd immunity,” or as it is termed in euphemistic and chilling terms “focused protection.”
This fringe theory would encourage younger, healthier Americans to resume their pre-pandemic lives, arguing that even if infected, their coronavirus illnesses might be milder. Further, as larger swaths of the public got sick and recovered, and as the prospect of a still unproven vaccine increases, so, too, would the population with resistance to the disease. If the numbers reached an undetermined point, the country would enjoy “herd immunity,” the protection achieved when an illness cannot spread so readily because so many in a group aren’t felled by it.
Proponents of “focused protection” have not answered critics who ask if they are willing to accept evidence that there would be millions of deaths to achieve it. They wave at growing evidence that the disease can have serious and sustained harms, even to those with mild cases. They do not explain how the country would lock down and protect those more vulnerable to coronavirus. This includes giant numbers of Americans with underlying conditions that put them at higher risk, including those who are overweight, have kidney problems, chronic illness, immune system issues, and heart and respiratory conditions.
By the way, this approach — assailed by the preponderance of medical scientists and experts on viruses and epidemics — would demand safeguards for the vulnerable old and in institutions as the rest of the country toils to achieve herd immunity. Really? Isn’t that an idea already overtaken by reality? The federal government estimates that 1.3 million Americans reside in nursing homes, and, if AARP and others are correct in their data, 6% of that total already are dead due to Covid-19 and more than 38% are infected with it. They weren’t safeguarded before, what would this new magic do now?
We’ve got a lot of work to do, not only to battle the pandemic’s menace in nursing homes and long-term care facilities but also to figure how to get these institutions and the people in them and their loved ones who rely on them in a far better place than they are in now
