‘Track outbreak in homes’

Pressure mounting on health officials to make Covid-19 statistics in nursing homes public

FEDERAL health officials are coming under increasing pressure to start publicly tracking Covid-19 infections and deaths in nursing homes amid criticism they have not been transparent about the scope of outbreaks across the country that have already claimed thousands of lives.

Experts say the lack of tracking and transparency had been a major blind spot, and that publicising outbreaks as they happen could not only alert nearby communities and anguished relatives but also help officials see where to focus testing and other safety measures.

“This is basic public health – you track this, you study it, and you learn from it,” said David Grabowski, who specialises in health-care policy at Harvard Medical School.

He said it’s difficult to have confidence in officials’ ability to contain the virus if they aren’t tracking where it has struck and why.

Such an action by the agencies that oversee the nation’s 15 000 nursing homes is seen as long overdue, coming more than a month after a nursing home in Washington became the first Covid-19 hot spot in the US – forcing the homes to be evacuated.

Because the federal government has not been releasing a count, the Associated Press has been keeping its own running tally based on media reports and state health departments. The AP’s latest count was at 4 485 deaths, is up from 450 two weeks ago.

“We recognise there should be more reporting,” said Seema Verma, head of the Centers for Medicare & Medicaid Services on Wednesday.

Verma said her agency was working with the Centers for Disease and Control and Prevention to increase reporting on outbreaks. She said they were considering requiring homes to disclose information to residents and their family members.

Many individual states have added to the lack of transparency by releasing only totals of infections and deaths and not details about specific areas. Foremost among them is the nation’s leader, New York, which accounts for more than 2 200 nursing home deaths – 20% of the state’s entire death total – but has so far refused to give details, citing privacy concerns.

New York Health Commissioner Howard Zucker said this week that even releasing total numbers by nursing homes could violate the privacy of individuals, which is protected under federal health privacy law.

“The issue is here as I’ve mentioned previously, this is their home. The nursing homes are their home.

“It’s just scandalous not to tell the public which facilities have the virus,” said Charlene Harrington, a professor emeritus at the University of California San Francisco.

“Even some staff members don’t know. They’re hiding it because it’s bad for business and it’s just horrible,” he said.

Mark Parkinson, the head of the American Health Care Association, which represents nursing homes and assisted-living facilities, said a national reporting system for homes could at least help prioritise the potential hot spots most in need of testing and personal protective equipment such as masks and gowns.

That lack of personal protective equipment and mandatory testing for residents and staff are among the gaps experts say have allowed deaths to continue mounting at nursing homes, despite federal officials ordering them in mid-March to ban visitors, stop group activities and screen workers.

Chris Laxton, executive director of the The Society for Post-Acute and Long-Term Care Medicine, said a national database would help to create a picture “of how completely dire the situation is in nursing homes.

“Not only is it under-reported, but we’re nowhere near the peak and it’s continuing to surge.”