Ground Zero: A fifth to half of all coronavirus deaths have been in nursing homes

Staggering numbers shine light on lack of preparedness and drastic actions required to slow pandemic's toll at long-term care facilities.

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ItalyNursingHome
A nursing home room is decontaminated for coronavirus in hard-hit Lombardy region of Italy.
TASS via Getty Images
Updated: April 27, 2020 - 11:24pm

A few days ago the World Health Organization’s European regional director garnered global headlines by providing a grim statistic that pinpoints the ground zero in this coronavirus pandemic.

More than half of the COVID-19 deaths in Europe have occurred in long-term care or nursing home facilities. It is “an unimaginable human tragedy,” Dr. Hans Kluge declared.

Europe is not alone. At least one in five deaths recorded in the United States so far has occurred in nursing homes or long-term care facilities and experts believe that percentage may grow substantially.

The Kaiser Family Foundation, one of the leading health nonprofits in America, reported late last week that 27 percent of the COVID-19 deaths in the 23 states that report fatalities publicly by location have occurred in nursing homes and long-term facilities.

In six of those states — Delaware, Massachusetts, Oregon, Pennsylvania, Colorado and Utah — the percentage of coronavirus deaths in nursing homes was over 50 percent of total deaths, the foundation reported.

“The individuals that reside in long-term care facilities are among the most vulnerable in the US to this virus, given occupation density of these facilities and residents’ underlying poor health,” Kaiser warned.

The disproportionate death toll in long-term care facilities is shining a painful light both on how poorly prepared these facilities were for a lethal outbreak and how the drastic measures since taken to stem the tide — including a ban on family visits — are creating isolation in the final days of victims’ lives.

“They are no longer getting their emotional and physical support that such visits provide,” Kluge said. “Sometimes residents face the threat of abuse and neglect.” 

Dr. Max Arella, a Quebec-based virologist and molecular biologist studying coronavirus for decades, told Just the News that in Canada some nursing homes have had 40% or more of their residents infected. 

“From the start everyone was responding as if this were a normal influenza virus and with the aging population and underlying conditions whether it is diabetes, rheumatoid arthritis or cancer patients it is hard to practice social distancing,” he said. 

“Everyone failed from the start. The Chinese and the World Health Organization failed and even at the international, regional and national levels leaders failed,” he said. ”There are sometimes two or more people in one room so if a healthcare provider goes from bed to bed or the patients play cards the virus spreads. Not recognizing what this was and responding early was a major issue.” 

The first U.S. nursing home coronavirus case identified was in late February in King’s County in the state of Washington. As subsequent cases were reported, the Centers for Disease Control (CDC) issued an indication of their findings that large quantities of viral RNA in asymptomatic, pre-symptomatic, and symptomatic residents, and recommended that “all residents should be placed on isolation precautions if possible.” 

In New York. where the coronavirus numbers continue to climb, coronavirus patients in hospitals were returning to nursing homes because a New York state mandate required nursing homes to accept patients recovering from COVID-19 even if they were still contagious.

The March 25 New York Department of Health’s advisory to nursing home administrators and hospital discharge planners bears Gov. Andrew Cuomo’s name and states: ”No resident shall be denied re-admission or admission to the nursing home solely based on a confirmed or suspected diagnosis of COVID-19.”  

Over 100 residents and employees at Hayward, California's Gateway Care and Rehabilitation Center have been infected. Gateway is one of 250 nursing homes in California that have been hit with the virus. 

As the number of patients have become infected and perished with Gateway’s history of past state violations, the district attorney’s office has opened a criminal investigation.  The facility’s owners have repeatedly declined comment.

Last week The Washington Post reported that at least 255 nursing homes in the District of Columbia, Maryland and Virginia had cases of the virus, nearly double the number from two weeks earlier. More than 2,000 residents and workers have now been infected. 

Although Lombardy, Italy’s reputation for healthcare was widely recognized as one of the best in Europe, it turned out to be the hardest hit-region in one of the hardest-hit countries. Of Italy’s 100,000 plus COVID-19 fatalities Lombardy’s official toll represents 70% of that total. 

Almost one-sixth of Italy’s 60 million residents live in Lombardy which includes Milan and the industrial heartland.  Lombardy has more people over 65 than any other Italian region and houses 20% of the country’s nursing homes. 

Italy closed its borders with China on Jan. 31 and its first case was reported on Feb. 21. Shortly thereafter the numbers started to explode, and the Rome-based national government locked down Lombardy on March 7, although the factories remained open. It was not until March 26 that all but essential production was stopped. 

By April 7 the Lombardy doctor’s association issued a letter to regional authorities listing seven “errors” in their response to the virus which resonated with what is found in nursing homes in America, including lack of protective equipment and gear and lack of data about the contagion. 

What this has meant for family members on the outside who cannot visit their loved ones on the inside is a sense of worry and anxiety as the separation continues.

“I believe people are designed by God to live in community while one of our purposes is to share in others’ joys, concerns, and losses,” said Pastor Paul Teske, a retired Navy Chaplain and former minister of a church in Westport, Conn. “Part of the current social dilemmas of isolating those in nursing care facilities is creating deeper emotional issues of guilt and closure for their loved ones while facing death."

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