Nursing home failures
State had aggressive plan that wasn’t used
Even before the first COVID19 case was confirmed in Pennsylvania, state health officials knew the most-vulnerable targets of this aggressive virus would be the elderly and those with compromised health systems. In short, nursing homes would likely become the areas of greatest concern.
Although an aggressive, quick-response plan for dealing with outbreaks at such facilities was developed by the state, it was not implemented. And two months into the outbreak, it’s clear we have failed those living in nursing homes.
As of May 8, there were infections reported at 522 facilities statewide and 2,458 deaths — about 68% of all COVID-19 fatalities in Pennsylvania. Testing of residents and staff is lacking, as is contact tracing.
It didn’t have to be this way. A report by Spotlight
PA, an independent newsroom of which the Pittsburgh Post-Gazette is a partner, reported that Pennsylvania officials had developed a three-page blueprint in mid-March that included quickstrike teams of medical professionals that would be dispatched to nursing homes with the first reports of positive COVID-19 cases.
The plan called for teams of doctors, nurses and epidemiologists to show up at a facility within six hours of a call for help and complete a needs assessment within two hours. Among the priorities of the team would be to establish protocols and training, set up plans for contact tracing and identify quarantine areas.
Despite being circulated within the state Health Department and shared with providers, it was never fully implemented and it wasn’t until mid-April that a far more limited plan was put into place, long after major outbreaks had occurred.
Even the state plan to have assistance provided by National Guard medics and nurses at facilities where staff illnesses threatened care has been sorely limited. The outbreak at a Beaver County facility — the Brighton Rehabilitation and Wellness Center — has been well documented for weeks, but it is only now that the National Guard is offering “staff support.”
That facility accounts for a reported 71 of the county’s 78 COVID-19 deaths and is the main reason the county is the only one in Western Pennsylvania that will continue to have “red” status. The state only recently appointed a temporary manager at the besieged facility, and elected officials are calling for a federal investigation of the operations at the home.
A quicker response at nursing homes at the first sign of the outbreak may have slowed or mitigated the spread at facilities, but even that is difficult to determine because the state refused to release a facility-by-facility list showing confirmed cases and fatalities. In contrast, neighboring states New York, New Jersey, Maryland and Ohio have all provided such information. State health officials are only now requiring nursing homes to provide such information, which will be made public starting next week.
Most troubling is that despite the overwhelming number of deaths in nursing homes, the state did not ramp up testing for patients and staff as other states did weeks ago. The state Health Department finally changed course on Tuesday when it announced a plan for widespread testing.
It’s disheartening that the plan for quick-response teams was not implemented two months ago when it might have been more effective. Identifying the facilities with significant outbreaks and immediately committing to testing, tracing and isolation would have been the prudent course of action.
Unfortunately, we’ll never know if that plan might have saved more lives of those most at risk.