Duke professor: Nursing homes 'wells of infection'

Don Taylor, a professor at Duke University's Sanford School of Public Policy, said a national strategy of repeated testing of nursing home residents and staff is needed for the U.S. to get a handle on the coronavirus pandemic.
Posted 5/23/2020, 12:47:45 AM

CENTER, THERE ARE 22 RESIDENTS

AND TWO STAFFERS INFECTED.

>>> HALF OF THE NURSING HOMES

IN AMERICA HAD PROBLEMS

CONTAINING INFECTIONS BEFORE

COVID-19.

THE GOVERNMENT ACCOUNTABILITY

OFFICE RELEASED A REPORT THIS

WEEK WHICH RUN 40% WERE

DEFICIENT IN INFECTION

PREVENTION AND CONTROL IN ONE

OR MORE YEARS IN 2013 TO 2017.

THE REPORT CALLS THIS AN

INDICATOR OF PERSISTENT

PROBLEMS.

THEY FOUND THAT STAFF DID NOT

REGULARLY WASH THEIR HANDS,

ISOLATE RESIDENTS, OR USE MASKS

OR PPE BEFORE THE PANDEMIC.

IN NORTH CAROLINA, 64 THE 407

NURSING HOMES SURVEYED FELL

UNDER THIS CATEGORY, WHICH IS

JUST UNDER 16%.

>>> THE DATA TRACKER SHOW THAT

THE CASES OF LONG-TERM

FACILITIES MAKE UP 18% OF ALL

LABORATORY CONFIRMED CASES AT

MORE THAN HALF OF THE TOTAL

DEATHS IN THE STATE.

DON TAYLOR IS AN WITH DUKE

UNIVERSITY AND HE JOINS US LOOK

TONIGHT TO DISCUSS THE FINDINGS

AND OTHER ISSUES.

THANK YOU FOR YOUR TIME.

IN HER MOST RECENT PUBLICATION,

HE SAID WE WILL NOT GET A

HANDLE ON THE PANDEMIC IN THE

STATE OR THE NATION UNTIL WE

CAN CONTROL IT IN THE NURSING

HOMES.

YOU CALL THEM WELLS OF

INFECTION.

CAN YOU SPEAK MORE ABOUT THIS

AND WHAT YOU THINK NEEDS TO BE

DONE TO MAKE THEM SAFER.

>> YES.

THE PANDEMIC CONTINUES APACE IN

NURSING HOMES.

LESS THAN 1% OF THE POPULATION

LIVES THERE, AS YOU SAID, 20%

OF THE CASES ARE OCCURRING IN

NURSING HOMES AND MORE IF HALF

THE DEATHS.

THE WAY TO THINK ABOUT THE RISK

OF NURSING HOMES ARE THAT YOU

HAVE WORKERS WHO ARE THERE AT

RISK OF OCCUPATIONAL EXPOSURE

TO BRING INFECTION WITH COVID-

19 INTO THE NURSING HOME AS

WELL TO TAKE IT OUT OF THE

NURSING HOME AS WELL AS

PATIENTS ARE TRANSFERRED FROM

HOSPITALS FOR SHORT-TERM NURSING

OR REHAB STAYS WHO ARE STILL

THE FACILITY WITH LONG STAY

PATIENTS.

I THINK THAT THE UNITED STATES

IS NOT DOING ENOUGH.

WE DO NOT HAVE A FEDERAL

TESTING POLICY.

THEY HAVE EXCESS CAPACITY BUT

IN SOME PLACES THE LABS ARE

WORRIED ABOUT GETTING PAID.

FIRST WE NEED THE FEDERAL

GOVERNMENT TO GUARANTEE MONEY

FOR TESTING.

THAT NEEDS TO THEN BE PASSED

DOWN TO STATES LIKE NORTH

CAROLINA TWO OVERNIGHT GUYS --

OVERNIGHT TESTING GUIDELINES.

THEN THE NEED TO BE

PARTNERSHIPS WITH UNIVERSITIES

TO WORK WITH NURSING HOMES TO

IMPLEMENT TESTING PROGRAMS BUT

ALSO TO COLLECT EVIDENCE TO

FIGURE OUT HOW TO DO IT.

WHAT TYPES OF TESTS, HOW OFTEN

THE TEST SHOULD BE DONE, ALL OF

THESE THINGS ARE QUESTIONS THAT

WE NEED TO KNOW THE ANSWERS TO,

SO I THINK THAT WE NEED A

COMPREHENSIVE NATIONAL STRATEGY

AND FEDERAL MONEY WITH STATE

ABILITY TO DECIDE EXACTLY HOW

TO IMPLEMENT IT.

>> THIS IS PERSONAL FOR YOU.

HOW DOES YOUR EXPERIENCE CHANGE

YOUR VIEW ON WHAT IS HAPPENING

WITH THE NURSING HOMES?

>> I'VE HAD A LOT OF

EXPERIENCE.

MY MOM LIVES IN A CARE FACILITY

IN CARY AND THE UNSUNG HEROES

OF THE PANDEMIC ARE PEOPLE THAT

, YOU KNOW, WORK WITH OLDER

CITIZENS.

THESE ARE WOMEN, ALMOST ALWAYS.

OFTEN IMMIGRANTS, MOST OF THEM.

MOST OF THEM ARE BLACK OR

BROWN.

MANY OF THEM ARE CONSIDERED

ESSENTIAL, WHICH THEY ARE, BUT

THEY ARE UNDERPAID.

WHEN I HAVE COME TO REALIZE IS

THOSE WOMEN WHO SHOW UP EVERY

SINGLE DAY, THEY ARE REALLY

IMPORTANT IN DETERMINING HOW

WELL MY MOTHER IS ABLE TO LIVE,

SO THIS IS AN AN IMPORTANT

ISSUE AND I THINK IT IS VERY

IMPORTANT TO REALIZE THAT THE

WORKERS ARE AT RISK THEMSELVES

IN ADDITION TO BEING A RISK FOR

INFECTION.

WE DO NOT NEED TO BLAME THEM,

WE NEED TO SUPPORT THEM WITH

TESTING AND PPE AND PAID TIME

OFF.

>>> ONE MORE QUESTION, WHEN THE

PANDEMIC BECAME A REALITY, DID

YOU AND YOUR FAMILY EVER

CONSIDER REMOVING YOUR MOTHER

FROM THE FACILITY?

>> MY SISTER AND MY MOM HAD A

DISCUSSION ABOUT THAT. WHERE

THEY GOING TO TAKE MY MOM TO

LIVE WITH MY SISTER?

WE DECIDED NOT TO BECAUSE THE

PLACE SHE IS HAS CARED WELL FOR

HER AND I WAS IMPRESSED WITH

THEIR EARLY ADOPTION OF SOME

RULES TO TRY TO DEAL WITH THE

PANDEMIC AND IN THE END, WE

FELT LIKE THAT WAS STILL THE

BEST PLACE FOR HER.

BUT, THE PROBLEM WITH ANYPLACE

THAT YOU HAVE CONGREGATED MANY

ELDERLY PEOPLE, WITH UNDERLYING

CONDITIONS, JUST LIKE DRY

KINDLING WAITING FOR A SPARK.

THE EPIDEMIC DID NOT CREATE THE

PROBLEMS IN THAT SYSTEM, JUST

HAS EXPOSED THEM AND LEAVE THEM

THERE.

>> WE WISH HER MOTHER AND

FAMILY THE BEST.