Albany

State: Infected staff to blame for high nursing home COVID death toll

New report by state Department of Health finds agency's policies were not to blame
Gov. Andrew Cuomo recently
PHOTOGRAPHER:
Gov. Andrew Cuomo recently

Categories: News, Saratoga County, Schenectady County

ALBANY — A state report Monday said staff members and possibly visitors infected with the coronavirus — not residents returning from hospitals — caused the surge of COVID-19 infections in New York nursing homes this spring.

More than 6,000 nursing homes residents have died of the virus during the pandemic.

Gov. Andrew Cuomo has been criticized, sometimes bitterly, for the state Department of Health’s order in late March that nursing homes not deny readmission to residents who were sufficiently recovered to be discharged from the hospital solely because they were COVID-positive.

Cuomo has never conceded any error in that strategy, maintaining the state was only following federal guidance. But he reversed it in mid-May by executive order.

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The Department of Health announced the report’s findings Monday in a news release that made no mention of Cuomo.

Key points in the report include:

  • There have been 6,432 COVID-19 resident deaths in New York state nursing homes through late June.
  • Extrapolating test results, 37,500 to 45,820 nursing home employees could be presumed infected with COVID, or about 25% to 29% of the total workforce statewide.
  • Given the incorrect early understanding of how the disease infects people and spreads, thousands of employees are likely to have unknowingly spread the disease at their workplace in mid-March.
  • It is likely that infected family and friends visiting nursing home residents introduced the virus to nursing homes before the state closed such facilities to visits on March 13, but there are no data available to prove or quantify this.
  • Nursing home staff member infections correlate with peak nursing home resident mortality and peak geographic intensity.
  • Peak nursing home mortality occurred a week before peak numbers of re-admissions of previously infected residents, suggesting other factors are at least partly responsible for the high death toll.
  • In one instance, 43 residents died of COVID at a Brooklyn nursing home before the first infected resident was discharged from a hospital and returned to the facility.
  • COVID-positive nursing home residents readmitted to their facilities after hospital treatment were, in most cases, no longer contagious when readmitted.
  • Nursing home quality was not a factor in fatalities.

The issue has turned into a political football, with state and federal Republican lawmakers calling for an investigation of Democrat Cuomo. The Health Committee in the Democrat-controlled state Senate has previously said it would hold hearings on the matter. The Democrat-controlled Assembly has not committed to one, and rejected a Republican legislator’s attempt to engineer an investigation.

State Sen. James Tedisco, R-Glenville, who is seeking a non-partisan review by medical professionals with bipartisan oversight, said Monday the Department of Health’s report is not enough.

“The families of the over 6,200 people who lost their lives in nursing homes across New York state during the COVID-19 crisis deserve answers and a fair and unbiased investigation to find out what really happened that led to these tragic deaths,” he said via email.

“I appreciate the work of the state health commissioner, who is appointed by the governor, but this report should not be the final word on this subject. Given the magnitude of deaths during this terrible crisis, the families need the truth about what happened and some degree of closure over the loss of their loved ones and that can only be achieved through complete and total transparency.”

The state has been handicapped at times by relying on data self-reported by 613 nursing homes, which have been incomplete or inaccurate in some cases.

In turn, the state’s public reporting of fatalities has obscured the true scale of the pandemic’s impact on nursing homes — the official state nursing home death toll does not include residents who have contracted the virus at a nursing home but died elsewhere.

As of Monday, the state still does not offer even a partial total of the number of nursing home residents who have died on the website dedicated to the situation.

The 6,432 deaths cited in the new state report comes from an analysis published June 27 by the New York Times.

As they have many times before, reporters questioned Cuomo about nursing home deaths during his COVID-19 news conference Monday. As he has many times before, Cuomo sidestepped the question of errors by state policymakers and blamed the feds.

What went wrong and what could have been done differently?

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The federal government could have raised the alarm in December when the COVID-19 pandemic broke out in China, Cuomo said. It should have continued the alarm in January. By the time the first COVID-19 case was confirmed in New York state on March 1, the disease was already established in the state and beginning to infect nursing homes.

What could the state have done differently?

Monitoring international pandemics and strategizing global health are a federal job, not a state role, Cuomo said. If the state had known the disease was present, which it didn’t, and if the state had the testing capacity, which it didn’t, the state would have begun COVID testing in nursing homes in January.

The New York State Health Facilities Association, a trade group for many nursing homes and assisted living facilities, said Monday that these elder-care sites were not a state priority in the early, critical days of the pandemic — even though they house the population known to be the most vulnerable to COVID-19.

“it is essential that nursing homes and assisted living providers receive the full support and assistance from elected officials and policymakers to ensure they have the necessary resources to defeat this virus and safeguard their residents and staff, Stephen Hanse, CEO of the association, said in a prepared statement.

“For too long, nursing homes and assisted living providers have been subjected to significant Medicaid cuts. These cuts must stop. Policymakers must renew their commitment to fully support and fund nursing home and assisted living care for the most vulnerable in our communities. 

“As [state Health Commissioner Dr. Howard] Zucker stated today, outbreaks of COVID-19 in nursing homes were not the result of inadequate quality in nursing homes. As such, we are all in this together — providers, policymakers and the public. Together, each of our individual actions must be directed at safeguarding our most vulnerable and lead us to collectively overcome our present circumstances and create a stronger and safer future.”

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