Controlling the coronavirus in nursing homes won't be easy
The structural issues that have plagued U.S. nursing homes for years will make it difficult for them to prevent coronavirus infections and deaths, even though we now understand the high-risk nature of the facilities.
Driving the news: Within the 80% of nursing homes that have reported coronavirus data to the federal government, nearly 26,000 residents died, the Centers for Medicare and Medicaid Services announced yesterday.
The big picture: Older people are particularly vulnerable to the virus, and nursing homes became devastating outbreak sites right away.
- And the nursing home industry has long been under scrutiny for its problems with infection control.
Between the lines: Experts say that nursing homes need to be extra vigilant about testing staff and residents, and then isolating patients who do get the virus.
- That means keeping coronavirus patients out of nursing homes to begin with, which some states failed to do early on when patients were sent from hospitals to recover in nursing homes.
- But it also means having strict protocols for residents who become infected.
Yes, but: That's when nursing homes' long-standing problems present themselves once again.
- The physical structure of the nursing home becomes very important, including details about things like shared bathrooms, where the nurses' station is, and how air circulates through the building, David Grabowski, a Harvard professor who studies post-acute care, told me.
- "Some facilities have tried to set up [coronavirus] units or wings or floors," he said. "Sometimes that’s doable based on the numbers and the layout, and sometimes it’s not.”
It's also important to dedicate specific staff to each population — coronavirus patients and non-infected patients. But nursing homes were suffering from staff shortages long before the pandemic hit.
- “I don’t know how many nursing homes are doing that well to have dedicated staff for covid versus non-covid patients," Grabowski said. He added that most nursing homes also don't have enough personal protective equipment for their workers.
The bottom line: We've certainly learned from our mistakes in terms of how to protect nursing home residents from the coronavirus. The question is whether we'll be able to effectively apply those lessons to prevent future outbreaks.