Why nursing homes are the epicenter of covid 19?
It’s not surprising that nursing homes have become havens of infections and death, according to testimony from Tamara Konetzka, a professor in the Departments of Public Health Sciences and Medicine at the University of Chicago.
Homes need to be able to provide regular and rapid testing of all residents and staff, whether they have symptoms or not, and to separate the infected from the non-infected, which means they’ll need more staff, so workers don’t need to care for both, Konetzka testified.
Large numbers of older people with multiple health issues live there in close quarters, needing hours of hands-on care every day, making social distance impossible, she testified. There are frequently shortages of workers, who thus often need to care for both infected and non-infected residents, she said.
“Given asymptomatic spread and inadequate testing, staff often do not know which residents are infected,” she said.
It’s challenging, given that most hands-on care in homes is provided by nurses’ aides, who generally earn minimum wage and often have no paid sick leave or health insurance, with oversight and skilled care provided by registered nurses, who “would often rather work in hospitals, which often offer higher wages and better working conditions,” Konetzka said.
In homes that have fared the worst, most such staffers are non-white, low-income and dependent on public transportation, and they live in neighborhoods with other essential workers — all of which makes it difficult to practice social isolation, according to Konetzka.
They are “more likely to be sick, to have caregiving responsibilities for children or other family members, and to be facing financial hardship,” they’re more likely to fear getting sick themselves if they come to work and — paradoxically — more likely not to stay home, even if they are feeling sick, according to Konetzka.
It would help if they would be given “paid sick leave, guaranteed coverage of health care costs, hazard pay” and possibly the use of hotel rooms to prevent infecting family members, she testified.
Long-term reform is needed, she said.
“The structure and level of nursing home funding, or long-term care funding more generally, has to change,” she testified. “At least, Medicaid rates need to be substantially higher.”