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Sister Jeanne Arsenault returns to her room after breakfast at St. Chretienne Retirement Residence, a home for Catholic nuns in Marlborough, Massachusetts on August 26, 2020. (Photo: Craig F. Walker/The Boston Globe via Getty Images)

'Our Worst Fears Have Come True': With No Sign of Federal Relief, Nursing Home Industry Study Shows Surge in Covid-19

"Trying to protect nursing home residents without controlling community spread is a losing battle."

Julia Conley

Calling on federal lawmakers to take responsibility for the wellbeing of Americans living in nursing homes amid the current surge in coronavirus cases, the nation's top organization of long-term care providers demanded urgent action as they released a report Tuesday showing that the recent spike across the country has corresponded with rising cases in nursing homes. 

"Our worst fears have come true as Covid runs rampant among the general population, and long-term care facilities are powerless to fully prevent it from entering due to its asymptomatic and pre-symptomatic spread," stated Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), the industry groups that produced the new findings.

"Our health are heroes are doing everything they can to prevent it from spreading further," Parkinson added, "but this level of Covid nationwide puts serious strain on our workforce, supplies, and testing capacity."

The new AHCA/NCAL study (pdf) shows that weekly Covid-19 cases in nursing homes have reached record numbers this month and traces the spike to community spread outside the facilities. 

According to Johns Hopkins University, weekly new cases of Covid-19 rose 140% in the first week of November, with more than 572,000 Americans infected. That same week, more than 10,000 people living in long-term care facilities tested positive, and nearly half of those cases were in Midwestern states with huge spikes in community transmission, including North Dakota and Minnesota. 

"The public must realize that their actions not only endanger our nation's most vulnerable, but also trigger government lockdowns of facilities, keeping these residents from their loved ones. This is detrimental to their health, wellbeing, and happiness."
—Mark Parkinson, AHCA/NCAL

Since mid-September, northern states in the Midwest have seen a 200% weekly increase in nursing home cases. 

While White House officials including Dr. Scott Atlas, a top coronavirus adviser to President Donald Trump, have pushed a "herd immunity" strategy in which relatively young and healthy people would be urged to go about their daily routines without wearing face masks or social distancing, while nursing home residents and other medically vulnerable people would be quarantined, the AHCA/NCAL study demonstrates the impossibility of such an approach—as medical experts have warned for months. 

"Trying to protect nursing home residents without controlling community spread is a losing battle," Tamara Konetzka, an expert on long-term care at the University of Chicago, told the Associated Press earlier this month. "Someone has to care for vulnerable nursing home residents, and those caregivers move in and out of the nursing home daily, providing an easy pathway for the virus to enter."

Dr. David Grabowski, professor of healthcare policy at Harvard Medical School also recently stated, "The strongest predictor of whether or not we'll see cases in [a particular setting] is community spread."

The prevalence of community spread as a cause of outbreaks in nursing homes has caused care providers to underscore calls by immunologist Dr. Anthony Fauci for a drastically scaled back holiday season. 

"We are especially concerned that this situation will only get worse with Thanksgiving just around the corner," Parkinson said in a statement. "We urge everyone to do their part to slow the spread immediately and exercise caution when celebrating Thanksgiving."

While he said that nursing homes are doing everything possible to protect those under their care, Parkinson added: "If everybody would wear a mask and social distance to reduce the level of Covid-19 in the community, we know we would dramatically reduce these rates in long term care facilities."

Parkinson's comments came shortly after Atlas insisted on Fox News that Americans should consider celebrating the holidays as they normally would, including traveling and spending time indoors with family members, to combat the isolation faced by many elderly Americans. Atlas also recently decried lockdown measures put in place by Michigan Gov. Gretchen Whitmer. 

Atlas's approach, Parkinson suggested, is precisely what puts elderly Americans in danger of both Covid-19 infection and prolonged isoltion. 

"The public must realize that their actions not only endanger our nation's most vulnerable, but also trigger government lockdowns of facilities, keeping these residents from their loved ones," said Parkinson. "This is detrimental to their health, wellbeing, and happiness."

While Covid-19 cases in nursing homes only account for 8% of total cases in the U.S., the virus has proven especially deadly for populations in long-term care facilities, where many patients have multiple co-morbidities. Forty percent of Americans who have died of Covid-19 lived in nursing homes. 

To reduce the mortality rate in nursing homes, Parkinson said, the federal government must replenish the $175 billion Provider Relief Fund which was included in the CARES Act in March. Most of the funds have been spent, leaving care providers scrambling to secure enough personal protective equipment to mitigate Covid-19 transmission, testing supplies, and staff to care for patients. 

"Congress must fulfill its duty," said Parkinson. "Without adequate funding and resources, the U.S. is repeating the same mistakes made during the initial outbreak last spring and the major spike over the summer. We need Congress to prioritize our vulnerable seniors and their caregivers in long-term care facilities, by passing another Covid relief package during the lame duck session in Congress."

Senate Majority Leader Mitch McConnell (R-Ky.) has shown no signs of budging on his plan to provide the public with just $500 billion in Covid-19 relief, while Democrats have pushed for a $2.2 trillion package including $400 billion for state and local governments and small business loans to potentially enable businesses to shut down temporarily, limiting coronavirus spread. 

On Tuesday, a day after more than 166,000 people in the U.S. tested positive for Covid-19, McConnell directed the Senate to vote on a lifetime appointment for one of Trump's federal judicial nominees. 

"McConnell is still prioritizing Trump's judges over Covid relief," tweeted Vanita Gupta, president and CEO of the Leadership Conference on Civil and Human Rights.

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