The discovery of 17 bodies packed inside a makeshift nursing home morgue in Andover, N.J., was enough to finally persuade state officials to release coronavirus infection and death statistics from individual facilities statewide. The gruesome April 13 revelation of how one nursing home was overwhelmed by the dead also ought to be enough to convince Pennsylvania and Philadelphia to be more transparent about COVID-19′s toll in elder care facilities.
More than 11,000 nursing home residents nationwide have died of the disease, according to the Associated Press. In New Jersey, the 1,800 deaths among residents of elder care facilities represent about 40% of total deaths to date. In Pennsylvania, elder care facilities account for a staggering 60% of all coronavirus deaths.
Pennsylvania does provide the number of nursing home cases and deaths on the state Department of Health website, but only on a county by county basis, not by facility. A 1955 law limits public disclosure of information about infections but allows for exceptions when public interest outweighs privacy concerns, the Pittsburgh Post-Gazette reported.
Last week, AARP state director Bill Johnston-Walsh wrote Gov. Tom Wolf a letter, asking for names of nursing homes with confirmed COVID-19 cases to be made public. We agree: greater transparency and more information are better for public health and public trust, especially during this emergency. Health-care advocates in New Jersey and Pennsylvania report that frantic family members of nursing home residents — whom they can no longer visit — have been blowing up the phones trying to get information. Some of their loved ones have dementia and are no longer able to speak for themselves.
Medical ethicists note that simply listing the number of cases and deaths per facility does not inherently violate the privacy of patients. But more information may help their families make better decisions. The federal Centers for Medicare & Medicaid Services last week issued new guidance that calls for nursing home residents, and their families, to be notified of cases in their facility. The guidance also requires nursing homes to report cases to the Centers for Disease Control and Prevention but does not call for making this information more widely available.
Recent Inquirer stories about coronavirus infections and deaths in Pennsylvania, as well as in South Jersey, nursing homes should not come as a surprise. The CDC includes older adults among the groups most vulnerable to serious or fatal coronavirus complications; regardless of age, people in nursing homes often have pulmonary, cardiac, and other conditions that make them more vulnerable to the pathogen. Philadelphia officials say close to half of the more than 1,400 COVID-19 deaths in the city are among residents in nursing homes.
As the pandemic exposes supply gaps and other shortcomings across the American health-care system, nursing homes are no exception. Many employees who provide direct care to patients are poorly paid; facilities tend to be short-staffed, especially now. Workers are at risk of exposure, or may unknowingly carry the virus. And shortages of masks and other pieces of personal protective equipment have been all-too-common.