N.Y. to finalize nursing home COVID death toll as preliminary count jumps 46%

GOVERNOR'S OFFICENew York state Health Commissioner Dr. Howard Zucker speaks at the opening of a state-run COVID vaccination site on Jan. 13.
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GOVERNOR'S OFFICE

New York state Health Commissioner Dr. Howard Zucker speaks at the opening of a state-run COVID vaccination site on Jan. 13.

ALBANY — A day after a sweeping report was released on COVID nursing home deaths and the state’s incomplete accounting of them, the state health commissioner said he would expedite review and release of the full, accurate death toll.

The report by New York state Attorney General Letitia James, released Thursday, estimated the actual death toll might be 50% higher than publicly stated by the state Department of Health.

Just hours later, the DOH revised the nursing home death toll from 8,737 to 12,743. That’s only 46% higher, but the DOH audit is still underway, and the new official death toll runs only through Jan. 19.

So the 50% prediction could yet come to pass.

Dr. Howard Zucker’s remarks Friday came during the question-and-answer portion of one of Gov. Andrews Cuomo’s frequent press conferences on the COVID-19 crisis.

The governor in very lengthy remarks discussed virtually everything except nursing homes and the report, which found extensive fault with nursing homes’ response to the pandemic. 

When Cuomo finally opened the air to questions, reporters asked him about virtually nothing else.

“The report affirmed everything the commissioner said for the past year,” Cuomo said, deflecting what many people have said is a damning expose of a massive failure by his administration during the worst public health crisis in a century.

The DOH and Zucker have said all along that the actual death toll was higher than what they were reporting because they were intentionally excluding nursing home resident deaths that occurred outside nursing homes.

Nonetheless, the Cuomo administration had stalled disclosure of the actual full number for more than six months, saying it needed to audit the data.

Zucker said Friday that once his agency saw the report by the Attorney General’s Office on Thursday, it decided to expedite the process.

The report by James, a Democrat like the governor, was very measured in its treatment of the Cuomo administration, pointing out problems without the explicit criticism it leveled at the for-profit nursing home industry.

Cuomo and Zucker, in turn, did not attack James or her report.

Zucker did take exception to the report’s use of the word “undercount,” saying that every known COVID death in a nursing home has been counted.

Which is a neat bit of semantics: Every known nursing home resident death may well have been counted, but not all were labeled as nursing home deaths. So the official, publicly reported nursing home death toll was worthless for its intended purpose: identifying where the problems were and determining a cause.

However, the state has acknowledged this all along. And Zucker repeated it Friday.

“We’ve always been transparent on the number of nursing home deaths that have been reported in facilities,” he said.

When the accurate, final tally is released, the total number of COVID deaths in New York state won’t change, he predicted. Rather, the tally of deaths outside nursing homes will decrease and the tally inside nursing homes will increase.

Roughly 35,000 New Yorkers are known to have died of COVID since mid-March. The great majority of them have had significant pre-existing health problems, been elderly or both.

Nursing homes are populated by elderly people with health problems; this, combined with their close living quarters, has been a deadly combination during the COVID pandemic.

Cuomo held forth Friday about vaccinations, New York City restaurants, Republican money-grabs, federal malfeasance, crisis budgeting, Buffalo Bills games, human nature and political extremism, among other topics — everything but the nursing home report that landed with a big splash a day earlier.

“Find your best self in this moment and let’s all of us applaud each other when we find our best and let’s strive for that,” he said, before finally taking questions from reporters at the 42-minute mark.

He, Zucker and secretary to the governor Melissa DeRosa were ready with answers:

  • The state relies on self-reported numbers from hospitals and nursing homes, which the report indicated are very inaccurate in some cases, so the state is checking them before releasing them.
  • The death toll is very painful and needs to be stated accurately, all the more reason for a careful review.
  • The long-running barrage of criticism on the matter began as a partisan attack by the Trump Administration and its Republican allies.
  • Everyone — the state DOH, the federal CDC under President Trump, doctors, nurses, aides — tried their best with the information they had during the initial onslaught of COVID. The early guidance that asymptomatic COVID-positive people couldn’t infect others proved wrong with devastating consequences.
  • Even today, with nursing homes on lockdown, staff tested twice a week and better treatment available, 40% of COVID deaths occur in these facilities.
  • The only surefire way to keep COVID out of a nursing home was used in France: Hermetically seal the facility and sequester the staff inside.

One of the reporters’ questions aimed directly at the nature of the issue: COVID nursing home deaths in New York are at once highly politicized and extremely painful. Cuomo (or more often his aides) aggressively counterattack any criticism as political and the other side ridicules anything Cuomo says as obfuscation.

However, WHEC reporter Jennifer Lewke said, some of those who disagree with you are people whose loved ones have died in nursing homes. “As a father, as a son, what would your message be to those families today?”

“What I would say is, everyone did the best they could,” Cuomo replied. “When I say ‘The state Department of Health, as the report said, followed federal guidance, if you think there was a mistake, go talk to the federal government,’ it’s not about pointing fingers or blame, it’s that this became a political football. Look, whether a person died in a hospital or died in a nursing home, its — people died.”

It was his longest answer to the string of nursing home questions posed to him Friday, and he searched for words at times as he moved from God’s will to epidemiology to his emotions at the death of his own father.

“It’s a tragedy and I understand maybe the instinct to blame or to find some relief for the pain that you’re feeling,” he added. “So I understand the pain. I understand the search for answers. I feel the anguish and I feel the pain and I get the anger.”

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3 Comments

You must be an expert then. What would you do?
You read the report, right? Then you know most of the problems were due to private nursing homes regulated by the federal government, whose staffing and support were deficient and below grade. And they also failed to accurately report their own statistics.
But surely you know that, so what would you have done when we were also facing a catastrophic hit to our general emergency services and bed space? When bodies were piling up in refrigerator trucks and being buried in mass graves?
Well?

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