We’ve touched on this several times before. Back in late April the NY Times reported that New York state had issued a new rule mandating that nursing homes take COVID-19 patients back after hospitals had diagnosed and cared for them. That decision, which was prompted by a desire to prevent hospitals from being overwhelmed, turned out to be one of the biggest mistakes the state made.
This week, ProPublica published a story looking at the results of the decision. Not only did New York require nursing homes take patients back from hospitals it also specified that the homes were not allowed to test those returning to see if they still had the virus.
If a hospital determined a patient who needed nursing home care was medically stable, the home had to accept them, even if they had been treated for COVID-19. Moreover, the nursing home could not test any such prospective residents — those treated for COVID-19 or those hospitalized for other reasons — to see if they were newly infected or perhaps still contagious despite their treatment. It was all laid out in a formal order, effective March 25. New York was the only state in the nation that barred testing of those being placed or returning to nursing homes.
In the weeks that followed the March 25 order, COVID-19 tore through New York state’s nursing facilities, killing more than 6,000 people — about 6% of its more than 100,000 nursing home residents. In all, as many as 4,500 COVID-19 infected patients were sent to nursing homes across the state, according to a count conducted by The Associated Press…
States that issued orders similar to Cuomo’s recorded comparably grim outcomes. Michigan lost 5% of roughly 38,000 nursing home residents to COVID-19 since the outbreak began. New Jersey lost 12% of its more than 43,000 residents.
In Florida, where such transfers were barred, just 1.6% of 73,000 nursing home residents died of the virus. California, after initially moving toward a policy like New York’s, quickly revised it. So far, it has lost 2% of its 103,000 nursing home residents.
Much of the story focuses on one nursing home called Diamond Hill where 18 people would eventually die from the virus, most after accepting COVID patients from hospitals. According to one nurse who complained about the situation, workers had little or no protective gear and were asked to come in and work even when they were supposed to be under quarantine. After several complaints about how things were being run, she was fired and told she was “anti-management.”
County executive Steve McLaughlin was in charge of a county-run nursing home in the same area as Diamond Hill. He refused to obey the state’s order and didn’t admit any COVID patients to his facility. That county-run facility didn’t have a single death from the virus. McLaughlin said the deaths at Diamond Hill were, “uncalled for, unnecessary, should never have occurred, and wouldn’t have but for a tragically misguided order from the state.”
Cuomo was asked last month who was responsible for the high death toll in nursing homes. Here was his answer (see the video below):
We lost 139 people yesterday in hospitals. Who is accountable for those 139 deaths? Well, how do we get justice for those families who had 139 deaths? What is justice? Who can we prosecute for those deaths? Nobody. Nobody. Mother nature. God. Where did this virus come from? People are going to die by this virus. That is the truth. Best hospital system on the globe, I believe we have. Best doctors, best nurses who have responded like heroes, every medication, ventilators, the health system wants for nothing. We worked it out so we always had available beds. Nobody was deprived of a bed or medical coverage in any way.
And still people died. Still, people died. Older people, vulnerable people are going to die from this virus. That is going to happen despite whatever you do. Because with all our progress as a society, we can’t keep everyone alive. Despite what everything you do and older people are more vulnerable. And that is a fact. And that is not going to change…There’s a randomness to this virus that is inexplicable. Why do people die?…Who’s accountable? You can have a situating where everyone did the right thing and everyone tried their best and people still died.
But Columbia University epidemiologist Charles Branas had a different take. He told ProPublica, “If you introduce 4,500 people sick with a potentially lethal disease into a vulnerable and notoriously imperfectly monitored population, people are apt to die.”