Rehab and senior living centers face challenges dealing with coronavirus outbreak
Genesis Health Care chief medical officer Dr. Richard Feifer on danger COVID-19 poses to nursing homes and rehab centers.
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Across the nation, Americans have responded to the COVID-19 crisis with ingenuity, can-do spirit and fortitude. In the worst public health crisis our nation has ever faced, we have seen everyday Americans mobilize quickly to save lives.
Much of the recognition has rightfully focused on the nurses, doctors and facility employees serving on the front lines at our country’s hospitals. They have been working day and night in extremely difficult situations.
Yet, another group of health care workers deserves our praise, acknowledgment and help: those working in our nation’s nursing homes.
These people are protecting 1.4 million of our parents and grandparents. These frail nursing home residents, nearly half of whom lived through the Great Depression and World War II, are the least able to withstand even common infections, not to mention a virus like the one we are fighting now. In fact, the COVID-19 case fatality rate is approaching 20 percent in nursing homes.
At our centers, we have been stringent and aggressive with infection prevention measures, and this has helped keep the volume of cases much lower than they otherwise might have been. Our precautions range from the no visitation rules and residents remaining in their rooms, to no outside medical appointments except for life-saving treatments, to staff always wearing personal protective equipment (PPE).
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We have seen the pictures of family members outside of quarantined nursing homes, holding up signs, singing happy birthday, and celebrating wedding anniversaries. This is heartbreaking, but the restrictions are necessary. To support those residents and families, we have equipped centers with iPads to enable resident-family video conference calls.
We remain vigilant, but we are greatly concerned because the situation is likely to get much worse without additional support from Washington, D.C., on three important fronts.
First, the nurses, doctors, aides, therapists, PAs, NPs and others coming to work each day in America’s nursing homes and throughout the health care system are the heroes, putting themselves at risk to care for those who are in these facilities. They need to be protected so they remain healthy and effective and – importantly – to reduce the possibility of spreading the virus to residents.
Yet, even as more PPE is arriving into the health care system now, nursing homes still are still facing significant shortages, especially of facemasks and gowns.
It is our hope that President Trump continues to put pressure on businesses to ensure more production of N95 respirators, surgical masks, gowns, face shields, gloves and ventilators. The president has in his arsenal the ability to compel businesses to meet the needs of the American people in this time of turmoil. He would save seniors who continue to die and have the support of millions of health care workers around the country for fully embracing the Defense Production Act: not just redirecting essential supplies, but actually creating more PPE in support of an increasingly beleaguered health care system.
Those in nursing homes and long-term care facilities need the president’s leadership now more than ever.
Second, we need faster, broader testing for residents and employees in nursing homes. Dr. Deborah Birx, the White House coronavirus response coordinator, agrees, stating in an April 9 press briefing, “We need to really ensure that nursing homes have sentinel surveillance. And what do I mean by that? That we’re actively testing in nursing homes, both the residents and the workers, at all times.”
This is welcome news from the president and his administration, and we look forward to nursing homes being elevated to Priority Level 1 alongside hospitals and other acute settings. A few states have already taken steps in this direction, such as Maryland, Massachusetts and Rhode Island. This can be replicated nationally.
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Finally, we recognize space in hospitals is limited, but public health officials must be very careful about setting rules that direct nursing facilities to admit contagious patients with COVID-19. State health departments must work together with the hospitals and the nursing facilities to identify safe locations for patients with suspected or confirmed coronavirus, without unnecessarily exposing the most vulnerable. The president can ask state leaders to come up with solutions to avoid making potential tragic policy decisions that put healthy seniors in harm’s way.
Our seniors deserve the best care possible. We must come together as a nation and put politics aside to protect the nurses and doctors serving them through this crisis. Those in nursing homes and long-term care facilities need the president’s leadership now more than ever.
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