Desperate times may call for desperate measures, but that doesn’t mean those measures are always smart or even effective. As part of a struggle to clear out ICU beds in California to make room for swelling numbers of COVID-19 patients, the California Department of Public Health has ordered all skilled nursing homes to take in patients regardless of their COVID-19 status. Considering the brutal death toll at other nursing homes where the virus has taken hold, this has a lot of the staff at nursing homes around the state understandably upset. (Los Angeles Times)
As fears escalate about the toll the coronavirus will take on the sick and elderly in nursing homes — who are among the most vulnerable to the deadly virus — California regulators have told skilled nursing facility operators that they must accept patients even if they have the disease.
The order comes amid a fierce debate between healthcare providers. Hospitals are desperate to clear space for an expected wave of COVID-19 patients, so they are discharging as many patients as possible, including nursing home residents.
Many nursing home administrators are equally desperate to keep those residents out until they are proven virus-free, fearing a catastrophic result if the deadly pathogen gains a foothold in their institutions.
One point worth noting is that the order only applies to “skilled nursing homes” with full-time, professional doctors and nurses on staff. Other long-term elder care homes, that fall under the state’s Department of Social Services and don’t provide the same hospital-level medical care are not affected.
Overcrowding of hospital beds is a serious issue to be sure, but I’m having a hard time picturing a worse idea than this as a way to address it. People living in nursing homes are there for a reason. First, they are pretty much all elderly. They also tend to have significant underlying medical issues which is why they wind up in a skilled nursing home to begin with. In other words, these are the people who are statistically at the greatest risk of dying if they become infected with the novel coronavirus.
The executive director for California Advocates for Nursing Home Reform was quoted as describing the directive as “unconscionable” and “nothing less than a death sentence for countless residents.” It’s apparently a sentiment shared by countless medical professionals at these nursing homes.
There are other solutions for overcrowding at the hospitals without doing this. California should look to New York City, where they converted a variety of other types of buildings into overflow hospital space. There are even large tents set up with hospital beds outside of those facilities. Hotel rooms have been converted also. Los Angeles has just as many of these types of facilities as New York City. The same can be said for the other large cities up and down the west coast.
Also, not to deride the dedicated medical professionals who work at these nursing homes, but they tend to specialize in geriatric care. They aren’t experts in enforcing quarantines or dealing with epidemics of respiratory illness. All it’s going to take is for one infected patient to come in contact with a nurse and the entire nursing home could turn into a death trap in the following two weeks, just as we saw in Seattle last month. And at that point, we’ll need to wheel Chuck Todd out and have him ask Gavin Newsom who has “blood on their hands” then.