- The coronavirus has hit more than 2,100 nursing homes, killing more than 2,300 people, the Wall Street Journal and NBC News both have reported, based on the news organizations’ separate outreach to public health and industry groups. Those figures are very likely to be low.
- The New York Times reported that the death count in nursing homes in the tri-state region alone (New York, New Jersey, and Connecticut) has hit 2,000, with thousands more sickened. The newspaper added this ominous note: “The actual infection rate in nursing homes is almost certainly higher than the data indicate because few homes have the capacity to test residents. The assumption among many in the industry is that every nursing home in the region has people with Covid-19.”
- In Riverside, Calif., county public health officials were forced to step in and relocate more than 80 residents of a senior care facility after staffers stopped showing up for their shifts. Authorities tried to step with care in accusing the workers of abandoning patients after nurses and others said that the facility’s owners had failed to provide them with protective gear and guidance on caring for residents who tested positive for Covid-19.
- At a nursing home in Texas City, in the Galveston, Tex., area, a staff doctor administered a controversial anti-malarial drug to dozens of elderly residents diagnosed with Covid-19. He did so with disturbing questions about whether the residents could provide a medical fundamental right — their informed consent. He did not seek permission from the sick and frail patients’ loved ones but has said he is seeking to do so now. He has asserted that he is conducting an observational test of the treatment, promoted in highly disputed fashion by President Trump. Critics have questioned the ethics of his human experimentation.
Federal officials in recent weeks have sought to better protect institutionalized seniors, for example, by banning visitation and non-essential personnel from going in and out of facilities. At the same time, in jaw-dropping fashion, regulators have told most facilities they are on a voluntary, honor system to ensure they meet appropriate safeguards, with inspectors reserving their work for facilities with records of infection-control problems.
NBC News and the Wall Street Journal both reported that states vary in the information they will make public about outbreaks in facilities caring for the aged and the federal Centers for Disease Control and Prevention offered the only federal data weeks ago, indicating 400 institutions had recorded infections.
Patient safety advocates have assailed the facilities owners and federal and state officials for their Covid-19 responses. They noted that facilities caring for the aged have struggled, in the crush for tragically lacking coronavirus tests, to determine which residents may be infected. Owners have failed to provide facilities’ staff members — many of whom are poorly paid and may work multiple jobs — with necessary protective gear or information on how to deal with infections or their control.
Nursing homes, of course, were under fire long before the pandemic broke out for failing to protect residents’ health and well-being, including with serious problems with infection control and staffing shortages. The facilities now confront nightmares about the ways they operate with hospitals, with the institutions shuttling the ill among themselves. Hospitals say their beds are too needed and valuable to be occupied with ailing but improving patients, shipping them to long-term and nursing home care. But patients often do not rally as expected in these new settings, forcing their staff to try to get them readmitted to hospital care. In better times, this created a cauldron of infections and medical issues.
James Wright, the medical director at a Virginia nursing home with one of the nation’s worst tolls, offered some trenchant thoughts on what happened in the facility where 148 residents have been infected and 40 have died, saying at a news conference:
“If I were to do something different, I would have a nursing home that had enough staff around-the-clock, around all the time. I would have a nursing home where everyone had private rooms. I would have a nursing home where there was greater access to the outdoors. In other words, I would have a nursing home funded by a society that puts more emphasis on treating our elders the way they should be treated. It’s also important to see what we, as society, could do differently, because this will not be the last untreatable virus to decimate our elders. When we, as a society, see that it’s appropriate to warehouse our elders, and to put them in small spaces, to underpay their staff so that there are chronic staffing shortages — I think if we see that as an adequate treatment of our elders, then we’re going to have a bad time. We are going to see this over and over again. We all opted for this type of environment for our elders. And as a result, this virus spread through a publicly funded nursing home … like wildfire.”
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 abuse and neglect at nursing homes. The coronavirus-related deterioration of the health conditions at nursing homes is nothing short of a national shame, especially because federal and state officials got a ringing alarm about potential problems with the outbreak in February at a nursing home in Kirkland, Wash., where 35 residents died and many others — including first responders and medical personnel — were infected with Covid-19.
Even if it was tough already to research and find solid senior care in difficult circumstances, families and friends now face wrenching decisions about scared, lonely, and shut-off elderly and incapacitated loved ones in institutions and whether to bring them into their residences. Federal and state officials must step up — they cannot allow these important caregiving places, as seemingly occurred with luxury cruise ships, to become infectious petri dishes or warehouses of sickness and death. Enough of the presidential blabbering about his ratings or his non-starter activities, purportedly to assist the nation.
When the pandemic eases, Congress and its staff need to dig hard and deep into the care of the aged during this time of raging sickness. This may not focus just on right, wrong, and blame for the terrible treatment of 1.5 million Americans living in 15,000 U.S. nursing homes. Our nation is growing grayer by the instant, with 10,000 baby boomers turning age 65 each day and every day for the next decade or so. Where will these seniors go and how well will they be cared for in their declining years? Covid-19 is holding up a harsh mirror and giving us one terrible view of the future for too many. We have much work to ensure the nation sees better days, including for the aged.