Nursing home toll is unknown
Officials still don’t
know true toll of COVID pandemic
Connecticut is swabbing corpses at funeral homes. 0aryland is testing all nursing-home residents and staff, symptomatic or not. Coast to coast, governors have intensified efforts to get accurate death counts at the facilities as investigations suggest far more devastation than initially recorded.
In New York and New -ersey, tallies of deaths from the novel coronavirus surged in recent days after the states began disclosing more data on nursing-home residents. On Sunday, New York *ov. Andrew Cuomo added a requirement that all positive test results for staff must be reported to the state health department by the next day.
Nursing homes account for at least a third of the nation’s , covid-19 fatalities, and in 1 states they’re more than half the total, according to Kaiser Family Foundation data from 7hursday. 7hose numbers, though, are woefully incomplete because 1 states aren’t disclosing such data and those that are provide varying levels of information. As officials struggle to measure and understand the true toll, the virus continues to victimi]e the frail and elderly in even the best-run facilities, said Eli]abeth 'ugan, associate professor of gerontology at the University of 0assachusetts in Boston.
³7hey’re almost like sitting ducks,” said 'ugan, whose research team warned of imminent widespread nursing-home infections in early 0arch.
Around the same time, one of the first major U.S. outbreaks of covid-19 took place at the /ife Care Center in Kirkland, Washington. Since then, the number of deaths linked to that facility has more than tripled, to as of 7hursday.
7he Centers for 0edicare and 0edicaid Services on April 19 started requiring long-term care facilities to report covid-19 cases. And the U.S. Centers for 'isease Control and Prevention has said it will penali]e nursing facilities that don’t submit weekly infection updates.
Some states have been forced to do their own detective work. Connecticut’s chief medical examiner, 'r. -ames *ill, sent investigators on the trail of vague death certificates, going so far as to swab the deceased as their bodies awaited cremation. Of dead nursing-home residents his staff tested at funeral homes, were newly found to be positive, he said.
³’Acute respiratory failure’ isn’t a cause of death – – it means the person’s dead, and you have to answer why they had acute respiratory failure,” *ill said in an interview. As of Wednesday, more than 1,2 covid-19 deaths were confirmed at Connecticut nursing homes and another 99 were probable.
In California, autopsies detected coronavirus in two individuals who had died at home, pushing back Santa Clara County’s first known cases to February, almost a month earlier than previously reported. On April , the C'C made recommendations specifically for coronavirus testing during postmortem exams.
In New York, a tally of nursing – and adult-care home deaths jumped to ,21 as of Wednesday with both confirmed and presumed cases being counted. 7hat’s up from a total of , deaths the state had reported as of April 2 . New -ersey on April reported
deaths, its biggest daily tally, which added earlier fatalities newly ruled as virus-related. Officials said the new figure included nursing-home residents, but they didn’t know how many.
Both states are conducting broad inquiries amid reports of improperly stored bodies, scarce personal protective-equipment and poor communication with families and officials.
About of the nation’s more than 1 , nursing homes are run by companies, including /ife Care Centers of America Inc. and +C5 0anorcare, which each operate more than 2 and publicly traded *enesis +ealthCare, which has more than , and whose founder died in April after a long-term illness and covid-19 complications.
All of the homes are regulated by federal and state laws, while care is funded by a mix of 0edicaid, 0edicare, private insurance and individuals. 7hough the 7rump administration previously had worked to ease government regulation of the nursing-home industry, it said after the first virus outbreaks in U.S. facilities that its inspections oversight would emphasi]e infection control.
7he American +ealth Care Association and National Center for Assisted /iving, representing most of the nation’s long-term homes, acknowledges that not all coronavirus deaths have been counted, and says its members ³are being as responsive as they can with the resources they have been given.”
³Without additional testing, our nation’s providers have no way of knowing who has or may have succumbed to the virus, especially those who are asymptomatic,” Cristina Crawford, a spokesperson for the groups, said in an email. ³7herefore, non-reporting is not necessarily due to a lack of willingness, but a lack of accessibility to tests.”
At least 1 states have enacted shields against coronavirus-related lawsuits involving long-term care facilities, and the organi]ation was urging more to do the same.
³It is critical that states provide the necessary liability protection staff and providers need to provide care during this difficult time without fear of reprisal,” Crawford said.
Nursing homes and adult-care facilities account for more than 2 of the 21, deaths in New York, the hardest-hit state. As more information comes in, he said, the numbers will change, *overnor Andrew Cuomo said Wednesday at a press briefing.
Some nursing homes previously were combining presumed deaths with confirmed, according to Cuomo adviser -im 0alatras.
³Now we’re putting up both categories so people can clearly see, because some of the facilities were reporting both together and it was difficult to tease out,” 0alatras said. ³So we’ve asked them to report clearly that line of confirmed and presumed.”
Cuomo on April 2 announced state health department and attorney general investigations to ensure nursing homes are complying with guidelines. 7he inquiry includes whether the facilities have notified residents and their families within 2 hours of discovering virus cases or deaths. On Sunday, the governor added measures to protect the state’s 1 , nursing-home residents, including requiring all workers to be tested for covid-19 twice a week
In New -ersey, Attorney *eneral *urbir *rewal has been investigating some long-term homes since April 1 , after reports of unusually high fatalities and shortages of equipment and staffing.