Today marks two months since the Trump Administration declared the novel coronavirus pandemic a national emergency. In at least two ways, it feels like we are back where we started from. One aspect is the tenor of the Administration’s discussion of the pandemic. The other way in which it feels like we have come full circle is the centrality of nursing home neglect as a factor in the death toll of the coronavirus, which causes the lethal and little-understood disease known as COVID-19.
A Messaging Merry-Go-Round
Throughout January, February, and into March of this year, the Administration downplayed the severity of the coronavirus and provided a rosy outlook into the nation’s preparedness to face it. [1] But in mid-March, the Administration declared the pandemic a national emergency and began holding daily press conferences to discuss new developments and achievements in ramping up testing for the virus, acquisition and production of personal protective equipment (i.e., “PPE,” as it has come to be known in the shorthand), and potentially treating the virus. [2]
The daily briefings faded away around the end of April, not long after Donald Trump drew criticism for riffing on the potential benefits of injecting disinfectants as a treatment method. [3] Some speculated that this gaffe sounded the death knell for the briefings, which Trump seemed to enjoy because they were covered so widely. But around this time protests began springing up challenging the economic restrictions put in place to slow the spread of the virus, [4] and Trump began to openly embrace the rhetoric of “liberating” people from anti-virus measures. [5]
At this point, the Administration seems ready to move on from the pandemic, just as it had initially wanted to avoid engaging it as a serious issue. The new mantra is “Transition to Greatness,” [6] essentially a retooled version of the “Make America Great Again” slogan that brought Trump to power. Trump and his political allies are largely united in casting the pandemic as a concern that their political rivals (i.e., Democrats and “the Left”) are all-too-eager to over-hype to gain a political advantage. There are echoes in this rhetoric of Trump’s comment, back in February, that criticism of his coronavirus response was the Democrats’ “new hoax.” [7]
Vulnerability Déjà Vu
In one of our earliest blog posts discussing the novel coronavirus, we emphasized the double-whammy the virus poses for the vulnerable populations of Nevada nursing homes. It is with heavy hearts that we observe that not only were our predictions right, but we apparently understated the havoc this disease can wreak on some of our most vulnerable loved ones.
We initially observed that the coronavirus was a double threat for Nevada nursing homes because the disease seemed to be incredibly lethal for elderly people and because there is already a national crisis of nursing home neglect. In past posts we have discussed issues like the shortcomings of regulators tasked with monitoring for Nevada nursing home abuse, instances of sexual abuse in nursing homes, and the challenges for family members in trying to detect neglect in assisted living facilities. We theorized that nursing home neglect would only increase from this baseline level, due in part to the need to keep family members at a distance to prevent the spread of the virus.
We were partly right in one sense and all-too-correct in another. The last two months have revealed that, although it is especially deadly for people over age 60, the coronavirus can be devastating for younger people, too. Healthy people in their 30s are dying at alarming rates, and many others are experiencing mild cases of COVID-19 followed by the onset of severe stroke-like symptoms. [8] There is even emergent evidence that the illness may cause dangerous inflammatory responses in some children, potentially debunking the early idea that children were immune carriers of the disease. [9] Although it remains clear that this disease is deadly for nursing home residents, its threat is not limited to them.
Sadly, we under-sold the other aspect of our analysis. We theorized that the baseline amount of nursing home abuse would increase due to the absence of watchful family members. But the coronavirus pandemic has wreaked havoc on nursing homes precisely because of the systemic issues facilitating nursing home neglect. Nursing home abuse happens because the staff at assisted living facilities are on the whole less well-trained, more poorly vetted, and less generously compensated than we would like them to be. As one journalist recently observed, assisted living facilities are places we rarely give thought to until the time comes to place a loved one there; by the time we want to advocate for better conditions in Nevada nursing homes, it is generally the moment when we need to utilize their services. [10]
In nearly every state, coronavirus deaths in nursing homes constitute a significant portion of overall COVID-19 fatalities. Here is a list of the top ten states ranked by portion of COVID-19 deaths in long-term care facilities:
- Rhode Island – 73%
- New Hampshire – 72%
- Pennsylvania – 70%
- Nebraska – 62%
- Massachusetts – 60%
- North Carolina – 59%
- Oregon – 59%
- Virginia – 59%
- Washington – 58%
- Kentucky – 57% [11]
It appears that years of under-investment in these facilities – and in the regulatory apparatus necessary to safeguard our elderly loved ones from nursing home abuse – has began to pay a terrible divided during this pandemic.
[3] https://www.bbc.com/news/world-us-canada-52407177
[4] https://en.wikipedia.org/wiki/Protests_over_responses_to_the_COVID-19_pandemic#United_States
[8] https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients
[11] https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus