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Nursing Home Deaths and COVID-19: A National Disgrace

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At the Hubert Humphrey Building dedication, Nov. 1, 1977, in Washington, D.C., former vice president Humphrey spoke about the treatment of the weakest members of society as a reflection of a government: “The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life, the sick, the needy and the handicapped.”

These words ring true in the way the elderly have been treated during the COVID-19 pandemic. According to most counts, approximately 50 percent of the deaths from the coronavirus can be attributed to residents in nursing homes. There are, no doubt, many staff and health providers who have died at these homes as well. The true number may be closer to 60 percent. Nursing homes and rehabilitation centers for the aged are fertile breeding grounds for the virus. Nursing homes pix

How did this happen? Who is to blame? What can we do about it? These are questions to address to better understand how we have failed the most vulnerable among us – the aged – many of whom have underlying medical conditions in addition to their age.

Ground zero for the disgrace is New York State. The coronavirus  pandemic has claimed the lives of nearly 5% of nursing home residents in New York. This is the reported number. It is not a far stretch to assume the real number is closer to 10 percent. Imagine if 10 percent of the entire U.S. population died from the virus. That would mean around 33 million deaths, a staggering number.

Many people blame NY Governor Andrew Cuomo for the high rate of deaths. The reason is more than 4,300 recovering coronavirus patients, virtually all of whom were younger than 65, were sent to New York’s nursing homes under a controversial state directive issued on March 25 that was ultimately scrapped because of the unintended consequence of spreading the virus even more.

Cuomo reversed the decision once it was determined that the directive had inadvertently caused a rapid rise in deaths. He rationalized the original directive by saying it conformed to Trump's policy at the time. However, just as he deserves credit for handling the crisis overall in NY, he deserves blame for how nursing home patients were exposed to the virus and subsequent deaths. Mixing the recovering with the most vulnerable was a bad idea to say the least. We could not know whether the antibodies were present to strengthen the immune system.

The antibody does not check for the virus itself. Instead, it looks to see whether the affected person’s immune system-- our body’s defense against illness -- has responded to the infection. Given that there is no guarantee that an infected person will not get the virus again, it is reckless, at best, to expose both recovering people and those in nursing homes to the risk of additional outbreaks.

The directive came when the governor feared the hospital system would be overwhelmed and was looking to free up as much hospital space as possible. In doing so, Cuomo shoved aside the aged and made room for the younger who had attracted the virus. Is this this a humane policy? Is it an ethical policy?

The answer to both is ‘no.’ Instead, the nursing homes should have been reconfigured at the outset to separate the infected from the uninfected. Also, protective equipment should have been available for all staff and medical personnel in the homes. Even today, some facilities lack the personal protective equipment (PPE) needed to safely deal with those who have the virus.

Just imagine you are a patient in one of these homes. You may have been exposed to someone who is asymptomatic; someone who already has the virus; and many who have not been tested.

All nursing homes should immediately test all residents, staff, and medical personnel. Their temperature should be taken each day. They should not treat those with coronavirus unless they have the proper PPE.

So, here we have thousands of our most vulnerable citizens exposed to a virus that may hasten their death. Their interaction with other residents has been limited. They are living in a facility where they cannot have face-to-face meetings with family members. They cannot hold their grandkids.

It is not just New York State to blame. Nursing homes in many states tell a similar tale. As for the elderly, the last days of their lives are not joyous occasions.

Posted by Steven Mintz, aka Ethics Sage, on May 26, 2020. You can sign up for our newsletter and learn more about Dr. Mintz’s activities at: Follow him on Facebook at: