Impact of the COVID-19 pandemic on long-term care facilities
As of mid-April 2020, nearly half of the COVID-19 deaths in Canada were at long-term care facilities. Residences are provincially-regulated, meaning that standards are inconsistent as to worker to resident ratios, as does the minimum training.
In British Columbia, the number of cases in long-term care facilities jumped from 9 to 235, including 143 residents and 92 staff.
In Ontario on 18 March, an outbreak began in the Pinecrest Nursing Home in Bobcaygeon, and as of 6 April, 29 of its 65 residents have died as a result of COVID-19. On 6 April, the City of Toronto discovered that a large shipment of Chinese-made masks delivered to its long-term care facilities were defective. On April 16, the province decided to halt transfers to long-term care homes.
In Quebec, a team of health care professionals inspecting Résidence Herron after a resident's death from COVID-19 found the facility largely abandoned by staff. Living conditions inside were similar to "a concentration camp", according to the officials.
About a third of reported coronavirus deaths have occurred among residents—more than 3,000—causing the homes to run low on body bags. More than 2,300 homes have had at least one case reported. Nursing home residents are being isolated in their rooms to slow the spread of the disease, while hospitals are reluctant to admit patients who have little chance of recovering. Most elderly requiring care in France live in EHPADs.
On 2 April, Robert Koch of the Institute in Germany, affirmed that as of 1000 German deceased, 87% were older than 70 years. Of these, more than 50 were residents in nursing homes in Bavaria, Cologne and Wolfsburg. By 9 April, 29 residents of the nursing home in the city of Wolfsubrg died.
As of 9 April, 3,859 people have died in care homes operated by RSA since 1 February of whom 133 tested positive and 1,310 had symptoms consistent with coronavirus. Prosecutors are investigating a home in Milan where 27 residents died of suspected coronavirus infection during the first week of April.
The death rate in care homes accelerated in April. Beginning 29 April, health secretary Matt Hancock said the government would begin daily reports of separate statistics for these facilities. This announcement was made after 4,343 deaths were reported in care homes between April 10-24; half of those deaths occurred during the last five days of the period.
Sky News correspondent Alex Crawford wrote an editorial about care homes in general, and in relation to COVID, suggesting the situation was a "scandal" that future generations would question. She also noted care assistants' working conditions, including zero hour contracts, and homes urging sick employees to come in anyway.
To prevent bringing COVID-19 into the facility, assistants at Liverpool's Beechside Home have moved in, as of April 2020. Nearby Oak Spring has had 14 deaths in two weeks, as of mid-April; only two of the deceased were tested, and both were positive for COVID-19. As of early April, that facility was operating with a quarter of its normal staffing, after the staff or their families were exhibiting symptoms, and were self isolating. Two-thirds of remaining residents were exhibiting symptoms. The Member of Parliament for Liverpool, Paula Barker, has criticised the lack of PPE at social care facilities, compared to NHS workers.
On 17 April, the New York Times reported that there had been more than 7,000 deaths in American nursing homes—about a fifth of the national death toll—and more than 36,500 residents and employees had tested positive. This actual figure is considerably higher since many facilities are not reporting cases or deaths. Federal government has designated long-term care facilities as lower priority than hospitals for coronavirus testing, leading to longer wait times for results. In addition to steps taken by individual facilities, the federal government has barred visitors, ended group activities, and instituted a mandatory testing regime for workers. However, this is not necessarily effective at preventing infections. While some affected facilities are understaffed and have a history of safety violations, others are luxury facilities with excellent records.
In California, Governor Gavin Newsom announced on 10 April that some healthy residents at nursing homes would be transferred to USNS Mercy, a US Navy hospital ship. The vessel previously was only expected to take patients from southern California hospitals, to free up space there for COVID-19 patients. Six hundred nurses with infectious disease control training were to be dispatched to nursing homes and adult care facilities to contain the disease. Some facilities have reorganized residents into discreet buildings for those with and without the virus.
As of mid-April 2020, Florida Governor Ron DeSantis was considering a request to grant nursing homes "sovereign immunity" from negligence lawsuits during the pandemic. The request was made by a trade group that represents nearly 700 nursing homes in the state.
One of the most severe outbreaks was at the state-run Holyoke Soldiers' Home for aging veterans. In late March, there were 210 residents; by late May, 74 of them had died with a COVID-19 diagnosis. Dozens of employees also tested positive.
Sagepoint Senior Living was fined $10,000/day by state regulators. The facility was notified on May 6, 2020 that the fine would be retroactive to March 30 and would continue until Sagepoint complied with state health regulations. At the time of the notification, 34 residents and 1 employee had died from COVID-19 in the 165-bed facility.
The state of Minnesota held a legislative hearing on 7 April into the senior care industry, weeks into a lockdown. The executive director of one facility noted that her residents are showing signs of depression and anxiety from the confinement.
As of 17 April, two thirds of the state's long-term facilities—a total of 394—had reported cases of the virus, with 1,500 deaths linked to nursing facilities, about 40% of the state's death count. One facility, Andover Subacute and Rehabilitation Center II, with 543 beds, had a record of safety problems and inadequate staffing. After an anonymous tip, police found seventeen bodies in bags on 13 April. Seventy residents had died of the disease by 19 April. Federal and state investigators have launched an investigation into the facility.
As of early April, in New York state's 613 licensed facilities, there were nearly 5,000 COVID diagnoses. By mid-April, 72 facilities had five or more confirmed deaths; Cobble Hill Health Center in Brooklyn reported 55 deaths. By early May, it was estimated that 5,000 people had died in nursing homes in New York state.
A Life Care Center facility in Kirkland, Washington was the source of a major outbreak of COVID-19 first reported on 19 February 2020, which became the first outbreak in a United States nursing home. On February 19 there were 120 residents and 180 Center employees at the facility. By 18 March, 101 of the residents had been diagnosed with COVID-19, and thirty-four residents had died, for a case fatality rate of 33.7%. On 2 April 2020 Life Care Center was fined $611,000 for deficiencies in its response to the outbreak, and has until 16 September 2020 to correct the deficiencies, or else face termination of its participation in the Medicare/Medicaid program.
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- Media related to COVID-19 pandemic in long-term care facilities at Wikimedia Commons