“#Gov. Cuomo is still failing New York’s nursing homes”
June 9, 2020 | 7:22pm | Updated June 9, 2020 | 7:28pm
The Parker Jewish Institute for Healthcare and Rehabilitation in Queens reported over 70 coronavirus-related deaths.
But we aren’t celebrating. The state Department of Health soon arrived to conduct testing of all of our residents; now, almost a week later, we are still waiting for the test results — another stunning example of the state’s ongoing neglect of nursing homes.
Gov. Cuomo is happy to show off the state’s declining infection, death and hospitalization rates. But he has never presented comparable data on nursing-home infection rates, even though the DOH has collected these statistics since the beginning of the pandemic.
If nursing-home infection rates are declining like the others, why is there such a rush to test everybody this late in the game? And if it is indeed important to do so, then why the delay in reporting results?
The Empire State was tragically unprepared for the disaster. Contrary to federal guidelines, the state didn’t involve nursing homes in strategic pandemic planning. And despite the knowledge that the nation’s first COVID-19 outbreak occurred in such a facility, Cuomo missed the opportunity to engage the industry when cases started breaking out.
To this day, the governor communicates with nursing homes by means of one-way, reactive and often threatening mandates, while consistently relegating our needs to last place. Early on, personal protective equipment was prioritized to the hospitals, leaving many homes without the ability to fully protect their staff and residents; at the peak of the pandemic, many lacked adequate testing materials.
Facilities were stunned by the infamous, now-retracted March 25 mandate that they must admit actively ill COVID-19 patients. Forced to change overnight into mini ICUs, nursing homes performed remarkably well, considering their limited resources.
The DOH didn’t collect statistics on nursing-home COVID-19 mortalities until mid-April, after the governor was pressured for the information. He then required the facilities to conduct a frenzied review of all deaths from the beginning of March over the course of a single weekend afternoon.
To date, the nursing-home COVID mortality count is nearly 6,000; however, the real number is likely much higher. Many residents who weren’t tested for COVID-19 died suddenly during those early weeks, without the typical respiratory symptoms that would result in their deaths being labeled “COVID presumed.”
We have since learned that COVID-19 can cause fatal heart attacks, strokes and blood clots, events that could account for the discrepancies between the number of deaths that actually occurred and those officially attributed to the illness; yet the governor has threatened homes with seemingly excessive or errant mortality rates with criminal investigation.
On May 10, the state mandated twice-weekly testing of all staff members, a frequency that hasn’t been recommended by any other public-health authority. With less than a week to prepare, beleaguered nursing homes were forced to abruptly divert energy and focus away from patient care to create mass staff-testing programs, all at their own expense; labs are so overwhelmed by the volume that results from one test are often not received by the time the next swab is due.
Nearly 500 nursing-home employees have lost their lives to COVID-19. If their deaths are not to have been in vain, we must learn and heed the lessons of this catastrophe for the future.
The state must collaboratively engage representatives of the nursing-home industry in planning for tomorrow’s outbreaks. Data on COVID infections and deaths in these facilities must be shared and analyzed, followed by the development, resourcing and implementation of both surveillance and response-driven testing of residents and staff.
And we must be ready to address test results in a timely manner with solid, evidence-based action plans. To wantonly engage in testing without these considerations in place is a reckless waste of time and of a piece with the wider failures the governor is now trying to blame on everyone but his own administration.
Elaine Healy, MD, is a practicing geriatrician, nursing-home medical director and member of the Infection Control Subcommittee of the Society for Post-Acute and Long-Term Care Medicine.
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