Ducey care site choice: Go bold or go home

Gov. Doug Ducey has been cautious, if inconsistent, on COVID-19 actions to protect public health.

On those related to nursing homes, Ducey finally took off the restraints on Tuesday and acted decisively. On mandated testing, on personal protective equipment, on a more cohesive approach to help keep the virus spread in check.

The White House on Monday lent urgency to the cause, recommending residents and staff in those facilities get tested in the next two weeks.

Ducey pledged the next day to "surge" resources to those living and working in long-term care facilities, not wait longer for pressure to mount from advocates of older adults or for responses from the long-term care industry to coalesce.

The novel coronavirus confounds in many ways. We've learned the disease could level even the healthiest among us, its adverse effects can last long after initial recovery and, most recently, children once thought practically immune to the virus can be stricken with serious inflammatory conditions.

What has been long known and indisputable is older adults with serious medical conditions face the greatest mortal danger. Nationally, those 65 and older account for 80% of COVID-19 deaths.

A bulk of the sickest in that age group lives in long-term facilities. In Maricopa County, those homes account for 2 out of every 3 virus-associated deaths.

Yet, outside of the first executive order to limit access to long-term care facilities in March, the governor and his team had largely been quiet on action.

Efforts to "flatten the curve" have given way to protecting doctors, nurses and other hospital workers. Attention now seems dominated by what parts of the economy to open up and how.

How to protect the most vulnerable Arizonans had been glaringly absent until last week, when Ducey talked of a goal to test all patients at nursing homes, starting with a pilot program.

This despite the state's increased capacity and speed for diagnostic testing. And advancement on antibody testing that would affirm exposure to COVID-19.

The moribund response by the Ducey administration raised questions:

❚ Why the push for blitz testing of the general population the past couple of weeks instead of a captive one that has unquestionable need? A negative test in the latter group that's largely sequestered is instructive and meaningful.

❚ Shouldn't those lining up for diagnostic and antibody tests behind firstresponders and the symptomatic be the population most susceptible to dying from the coronavirus? To know who is sickened and who may have some immunity?

❚ Shouldn't the testing of certified nursing assistants and other staffers at these facilities be mandatory now, not the subject of a pilot program?

❚ Shouldn't the Ducey administration be mandating and helping to secure PPE for every one of these facilities?

❚ Shouldn't it work with county health departments to lay out a clear priority on contact tracing when a positive case following initial testing surfaces in a nursing home? Especially given that some caregivers work in multiple homes? And pledge help to overwhelmed departments to ensure that happens?

Ducey's administration was already taking lumps, rightfully, for its refusal to release COVID-19 data on individual homes. Some also questioned the governor's good Samaritan executive order that, if only temporarily, makes it more difficult for people to sue nursing homes and long-term care facilities.

On Tuesday, the administration snapped to attention.

It committed to testing at an estimated 150 long-term care facilities, including diagnostic tests of more than 11,000 residents and diagnostic and antibody tests for thousands of workers. It also pledged to help with personal protective equipment and staffing assistance should workers need to take time off.

Whether a prescriptive testing and contact tracing system materially alters the trajectory of COVID-19 cases in those facilities is beside the point.

It is sound practice, it instills public confidence and it is long overdue.

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