PA Department of Health Secretary Rachel Levine (right)
When calculating COVID-19 data, should nursing home cases be counted with the rest of the population?
For Department of Health Secretary Rachel Levine, the answer is an emphatic yes. She insists that all cases should be counted together. On Monday, while answering a reporter’s question, she said the following:
“We are not going to separate nursing home cases from other cases in the counties. What we have certainly learned in this global pandemic of COVID-19 is that we are all interconnected. One section of our community, such as a nursing home or personal care home, impacts the general community, and the community impacts that facility. The staff goes back and forth. So, it really is an example of how we are all connected, and it’s very important to include those type of facilities among other congregant settings in the total counts for a county.”
I respectfully disagree with her argument, which, frankly, I find illogical.
In fact, nursing homes have indeed been cut off from the general community—they’re no longer interconnected. Not even family members can visit their loved ones anymore.
Even in normal times, nursing homes are very unique places. They’re comprised almost entirely of elderly, frail people, many with serious underlying health conditions. In addition, the residents live in very close quarters. Unfortunately, these conditions became the perfect breeding ground for the coronavirus.
The data reflect this.
As of Monday, 67 percent of total COVID-19-related deaths statewide have been residents of nursing homes or personal care facilities. Meanwhile, there are nearly 10,000 positive cases of COVID-19 in nursing homes–about 19 percent of total cases. These residents there aren’t going anywhere and can’t have visitors, so they pose little danger of virus spread to the broader community.
As Levine states, the staff does venture outside the facility, and they represent another 2.4 percent of total cases. At this point in the pandemic, we should reasonably expect–we should insist–that nursing home staff be routinely tested and avoid venturing out.
Now, this issue wouldn’t matter so much if the stakes weren’t so high—but they are. They’re sky-high.
For almost two months, people have been stuck inside their houses. Many have lost their livelihoods. Businesses are beginning to go under. People are suffering financially, personally and psychologically. Their lives have been profoundly impacted. They’ve canceled weddings, missed graduations, skipped funerals and can’t go to school. People can’t see loved ones, and those who live alone basically can’t see anyone.
Given the enormous stakes, state officials need to exercise the greatest wisdom when making decisions on our behalf. For one, they need to recognize the obvious fact that there is a tremendous difference between cloistered nursing home populations and the broader population outside those facilities. This difference must be taken into account.
Let’s say, for instance, you live in Montgomery County.
You’ve already been in lockdown for almost two months, and let’s face it, with nearly 5,000 positive cases, there’s little chance you’re getting out anytime soon, based upon the state’s own “color” categories and metrics.
Meanwhile, 80 nursing homes in the county make up nearly one-third of all those positive cases. Should you have to suffer under lockdown for an additional month or two or three because the state has decided to lump together nursing facility cases with non-nursing facility cases?
It simply doesn’t make sense.
To date, most Pennsylvanians have understood that sacrifice has been necessary, but we also shouldn’t have to sacrifice unnecessarily. Combining this data has the very real effect of prolonging the shutdown substantially, adding to our suffering with no real benefit to public health.
I urge Secretary Levine to reconsider and reverse her position on this issue.
Lawrance Binda is co-publisher and editor-in-chief of TheBurg.
