In The Era Of COVID-19, Mass. Needs To Get Long-Term Care Right

Share on Facebook
Share on Twitter
Share on
LinkedIn
+

This op-ed originally appeared in WGBH News.

In much of the country, a substantial number of Covid-19 deaths have occurred in nursing homes. Too many states were caught unaware that crowding, poor infection control, insufficient isolation facilities, and lack of proper training and equipment for nursing home workers would create petri dishes for Covid’s destruction. As of now, this lack of preparation accounts for 24,000, or over one-third, of Covid-related deaths nationally.

We saw what was happening in Italy, where frontline doctors were forced to make age-based life and death decisions because so many elderly people were sick and ventilators were in short supply. We saw the first signs of the virus on our own shores in Washington state nursing homes.

So what happened in Massachusetts?

As of this writing, about 60 percent of Massachusetts’ 5,000-plus Covid-related deaths are nursing home residents. Some of those residents were receiving temporary rehabilitative services, others were in long-term care.

Apart from overall number of deaths, we know little about the faces behind the numbers. The Commonwealth has provided minimal information; for example, although the Department of Public Health (DPH) discloses overall nursing home deaths, it does not disclose numbers of deaths by facility on its public website. The federal government has now required such information be disclosed to residents’ families. DPH says it will take weeks to comply.

What we know about specific nursing homes, we have learned from local media investigations.

There is still limited transparency about state plans to protect nursing home residents. We need answers to the following questions:

1. During the early stages of the pandemic and currently, who in state government was/is in charge of the health and safety of long-term care facility residents and what lessons have been learned thus far?

2. What plans guided the efforts of the DPH, the state Office of Elder Affairs and the Executive Office of Health and Human Services as they sought to limit contagion in Massachusetts nursing homes?

3. Going forward, is the state prepared for a potential second wave of Covid in nursing homes?

These questions are crucial because nursing home deaths should not be inevitable. Mistakenly, some believe that nursing home residents are primary targets of Covid simply because they are old or gravely ill. That is not at all the case.

Seniors don’t contract Covid because of their age. They are infected through exposures to individuals who have the virus. The effect of infection for those with serious pre-existing health issues is more significant, and can lead to death, but that’s also true of 30- or 40-year-olds with similar pre-existing conditions.

Clearly, the elderly are more likely to have compromised immune systems and many seniors have underlying conditions that make the virus more destructive or even deadly. When Covid is introduced into an environment with little social distancing, ineffective infection control, lack of proper isolation units, and inadequately trained healthcare workers who lack essential protective equipment, spread is inevitable.

As we approach the fall, with its sobering predictions from experts, we are presented with an opportunity to learn from our prior faults and protect those who are the most vulnerable. The virus is as deadly today as it was in March or April. Preparing for what comes next starts with the Commonwealth answering these three critical questions.

Barbara Anthony is senior fellow in healthcare and Mary Z. Connaughton is director of government transparency at Pioneer Institute, a Boston-based think tank.

Get Our COVID-19 News, Tips & Resources!

COVID-19 unemployment surge is on pace to wipe out the MA Unemployment Reserve Fund within three months

/
The unprecedented surge of COVID-19- related unemployment claims that began two weeks ago is on pace to wipe out the MA unemployment Reserve Fund within three months, which will force state leaders to turn to the federal government for a bailout loan.

Report: MA Likely to See Sharp Spike in Unemployment Rate

The COVID-19 recession could cause Massachusetts’ unemployment rate to skyrocket to 25.4 percent by this June, according to a new policy brief published by Pioneer Institute. The authors recommend that the state join others in lobbying Congress for large block grants to avoid a severe fiscal crisis.

COVID-19 Roundup from Pioneer: Antibodies & serology tests to the rescue; Why such wide-ranging forecasts?; the Droplets v. Aerosol debate; Crowdsourcing symptoms & more!

/
Pioneer staff share their top picks for COVID-19 stories highlighting useful resources, best practices, and questions we should be asking our public and private sector leaders.

Stanford Pulitzer Winner David Kennedy on Lessons for COVID-19 from the 1918 Flu Epidemic & Great Depression

/
This week on “The Learning Curve” Cara and Gerard continue coverage of COVID-19’s impact on K-12 education, joined by Pulitzer-winning historian David Kennedy, the Donald J. McLachlan Professor of History Emeritus at Stanford University.

COVID-19 Roundup from Pioneer: Will we see a spike in crime?; Ranking states on social distancing; Ramping up remote learning; Secrecy about case numbers & more!

/
Pioneer staff share their top picks for COVID-19 stories highlighting useful resources, best practices, and questions we should be asking our public and private sector leaders.

New Report: Quality Adjusted Life Years (QALY) Methodology Discriminates Against Older Americans, Threatens to Deny Seniors Access to Life-Saving Care

New report asserts that with older americans more vulnerable during the COVID-19 pandemic, all health plans should avoid using the QALY methodology when assessing the value of care for older patients

Learning in the Time of COVID-19

/
Parents are deeply frustrated with the loss of learning their children will be provided as a result of COVID-19. Here are some resources to help address this gap.

Pioneer Launches Report Series Highlighting Massachusetts Job Growth and Business Trends Since 1998

In “Some Big, Broad Economic Trends in Massachusetts,” Pioneer analysis of two decades of data shows fluctuating employment changes across the state, as well as firm size information and the largest employers. The report is part one of aa series that aims to provide deeper insight into COVID-19's economic impact.