One More Time: The COVID Crisis Is Largely a Nursing Home Crisis

Source: Virginia Department of Health COVID-19 dashboard

by James A. Bacon

The daily numbers reported about COVID-19 in Virginia are volatile, and it would be imprudent to read too much into a single day’s statistics. But two numbers published on public dashboards this morning are symbolic of the true nature of the epidemic.

The first data point is the number of new COVID-19 deaths reported: 20.

The second is the number of of new deaths reported for long-term-care facilities: 19.

In other words, 95% of the deaths reported were of people living in long-term-care facilities. That’s just one day, to be sure, and there have been days when nursing homes accounted for only one-third of total deaths. Over the course of the epidemic, the percentage is 57%.

Surely, Governor Ralph Northam is aware of these numbers, even as he mandates the wearing of facial coverings and signs an executive order extending the state of emergency indefinitely. What’s so frustrating is how little he has had to say about the nursing home outbreaks and what he plans to do about them. At the risk of sounding like a broken record, let me repeat: The COVID-19 epidemic is mostly a nursing home epidemic.

We do know that the Virginia Department of Health is building a force of some 1,500 or more investigators, data analysts, and contact tracers. This force will include “surge” teams around the state whose job is to respond to outbreaks of the virus. Given the fact that nursing homes account for 62% of all outbreak cases and 96% of all outbreak deaths, we can presume that the surge teams will focus largely on nursing homes.

But that’s just a presumption. It would be nice if Northam would explain the plan.

In the meantime, it would be helpful if the Virginia Department of Health would rescind its ban on reporting which nursing homes are experiencing outbreaks. Apparently, the right of nursing home operators to “privacy” or “confidentiality,” or something, outweighs the right of the public to know where COVID-19 is the most virulent.

Likewise, it would be helpful to know if there were any match-up between the nursing homes experiencing outbreaks and the nursing homes reporting shortages of personal protective equipment. Although hospitals have solved their supply chain issues, not all long-term care facilities have. Of the 255 facilities reporting their data, 13 are experiencing “difficulty” in obtaining N95 face masks, six in obtaining surgical masks, six in obtaining gloves, seven in obtaining face shields, and 14 in obtaining isolation gowns.

Is the Northam administration doing anything to help address these shortages?

Meanwhile, the news headlines today are devoted to Northam’s mask mandates, which go into effect today. There is a weird feedback loop at work here: The media covers what the Governor says and does, and the Governor responds to what the media is is covering. Both need to shift attention from the reducing the number of COVID-19 infections, only a small percentage of which lead to lasting harm, to the number of deaths. Such a change in perspective will put the focus on nursing homes, where it rightly belongs.