Cuomo takes heat over N.Y. nursing home study
NEW YORK — New York Gov. Andrew Cuomo is facing blistering criticism over an internal report that found a controversial state directive that sent thousands of recovering coronavirus patients into nursing homes was “not a significant factor” in some of the nation’s deadliest nursing home outbreaks.
Scientists, health care professionals and elected officials assailed the report released last week for flawed methodology and selective stats that sidestepped the actual impact of the March 25 order, which by the state’s own count ushered more than 6,300 recovering virus patients into nursing homes at the height of the pandemic.
And some accused the state of using the veneer of a scientific study to absolve the Democratic governor by reaching the same conclusion he had been floating for weeks — that unknowingly infected nursing home employees were the major drivers of the outbreaks.
“I think they got a lot of political pushback and so their response was, ‘This isn’t a problem. Don’t worry about it,’” said Rupak Shivakoti, an epidemiologist at Columbia University’s Mailman School of Public Health.
“It seems like the Department of Health is trying to justify what was an untenable policy,” added Charlene Harrington, a professor emerita of nursing and sociology at the University of California at San Francisco.
Cuomo, who has been praised for leadership that helped flatten the curve of infections in New York, has also been criticized over his handling of nursing homes, specifically the order that told homes they could not refuse to accept recovering COVID-19 patients from hospitals as long as the patients were “medically stable.” The order barred homes from even testing such patients to see if they still had the virus.
The directive was intended to free up hospital beds for the sickest patients as cases surged. But relatives, patient advocates and nursing home administrators have called it a misguided decision, blaming it for helping to spread the virus among the state’s most vulnerable residents.
Cuomo reversed the order under pressure May 10, long after New York’s death toll in care homes had climbed to among the highest in the nation. To date, nearly 6,500 deaths have been linked to the coronavirus in the state’s nursing home and longterm care-facilities.
But the 33-page state report flatly says “that nursing home admissions from hospitals were not a driver of nursing home infections or fatalities.”
Instead, it says the virus’ rampant run through New York nursing homes was propelled by the 37,500 nursing home workers who became infected between mid-March and early June and unknowingly passed the virus on.
The report noted that the number of residents dying at nursing homes peaked on April 8, around the same time as COVID-19 deaths statewide, but nearly a week before the peak of coronavirus patients being transferred from hospitals.
It also said 80% of the 310 nursing homes that admitted coronavirus patients already had a confirmed or suspected case among its residents or staff before the directive was issued. And it contends the median number of coronavirus patients sent to nursing homes had been hospitalized for nine days, the same period that the study said it likely takes for the virus to no longer be contagious.
“If you were to place blame, I would blame coronavirus,” Dr. Howard Zucker, the state health commissioner, told reporters last week.
Cuomo said in a later news conference that“ugly politics” were behind “this political conspiracy that the deaths in nursing homes were preventable. And now the report has the facts, and the facts tell the opposite story.”
But several experts who reviewed the report at the request of The Associated Press said it has fatal flaws, including never actually addressing the effect of the order.
Denis Nash, an epidemiologist at the City University of New York School of Public Health, also noted that New York’s nursing home death toll doesn’t include nursing home residents who died at a hospital, a “potentially huge problem” that undercounts the virus’ toll and could “introduce bias into the analysis.”
Among the holes in the study highlighted by University of Texas, Houston, epidemiologist Catherine Troisi was a lack of data on what happened at dozens of nursing homes that had no COVID-19 infections before those sick with the virus were sent to them.