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.

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8 responses to “One More Time: The COVID Crisis Is Largely a Nursing Home Crisis

  1. The COV2 death crisis is largely a nursing home crisis. Death crisis. OTOH… who knows what else it does?

    https://www.healthline.com/health-news/painful-debilitating-long-term-effects-of-lyme-disease
    Chronic Lyme disease … can cause muscle aches, mental fog, and fatigue for years or even decades.

  2. Sounds like the usual generalized complaints!

    If Northam was doing things very different from other states – he could rightly be criticized, but what exactly is he off the ranch on?

    Isn’t Virginia proceeding pretty much like other states with some variations?

  3. Yes, it is largely a nursing home crisis. And our state government has failed at addressing that crisis. In what should surprise nobody who has been watching the buffoonish Northam Administration bungle the state’s Coronavirus testing effort Virginia’s percentage of COVID19 deaths in nursing homes is among the highest in the nation.

    https://www.nytimes.com/interactive/2020/05/09/us/coronavirus-cases-nursing-homes-us.html

    Equally unsurprising, Virginia is one of a minority of states that refuses to disclose nursing home statistics by facility. Our governor, a Prince of the Byrd Machine, happily tramples on the US and state constitutions but won’t even consider publishing facility specific facts about nursing homes. After all, nursing home operators have paid up at the unlimited campaign contribution trough. Their “rights” need to be protected.

    Is it just me or does Northam look more and more like the scarecrow from the Wizard of Oz with each passing day?

    • geeze DJ, did you look at that map? It’s pretty much everywhere there are urban areas with concentrations of Medicaid patients!

      It’s not just a Virginia problem.

      and agree.. not happy with how Virginia does not release data…

      • Click on the “share of state deaths” column and it will sort from lowest percentage to highest. Of the 50 states and DC Virginia is #45. Higher than Michigan, New York, New jersey, etc.

        Facts are stubborn things.

        • yep they are:

          Minnesota 472 80%
          West Virginia 43 80%
          Rhode Island 314 73%
          Pennsylvania 2,529 66%
          Delaware 137 61%
          Massachusetts 2,922 59%
          Virginia 489 58%
          Colorado 557 57%
          North Carolina 322 57%
          Kentucky 177 57%

          Virginia is clearly not in the better group but they got LOTS of company including NC and WVA.

          This is just a continuing drumbeat about Virginia… everything that can be dredged up to impugn them.

          I’ll stipulate that they are not among the better states – no question but they’re not that different from a lot of other states either.

          this type of criticism is bascially the same thing going on in other states under partisan banners..

          You pointed out San Francisco as doing better than other states….. yep.. the most LIBERAL jurisdiction in the entire country!

          Are liberals doing nursing homes better? is that the point?

          😉

  4. A good article on how some states and nursing home operators got it right. In what should surprise nobody Virginia is cited as an example of failure.

    https://www.wired.com/story/some-nursing-homes-escaped-covid-19-heres-what-they-did-right/

    • agree, good article and yes Virginia is not exactly a great performer on COVID19 in the nursing homes – but they do have a lot of company.

      Here’s apparently a right way of doing it from the article:

      “So what helped the SFCJL fare better than many of its counterparts? It’s likely a combination of early action and luck. The facility was one of the first in California to start screening visitors before they entered the premises. They stocked up on protective equipment and were ready to hand out masks to every single resident and staff member. Laguna Honda Hospital and Rehabilitation Center, another long-term care facility in San Francisco that quarantined early, has over 700 beds and has had similar success—reporting only 29 cases among residents and staff. “San Francisco acted really early, so I don’t think it’s by chance,” says Troy Williams, the chief quality officer at Zuckerberg SF General Hospital and Trauma Center, who has been in charge of Laguna Honda’s response to the pandemic.”

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