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.”

Comments (13)
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There is another reason that I think is bigger, nursing homes are chronically understaffed, there simply is not time for handwashing measures. When I signed up for nursing school back in the eighties I had to get a CNA and work in nursing homes, they worked us like slaves because we were cheap, night shift routinely had two people to care for 120 patients and were expected to do three rounds each shift. There were patients that were basically continent all night most of the time, and others that were wet or worse all three rounds. Use of incontinence gear was generally prohibited because it encouraged bedsores. I had an argument against that but simple fact does not sway a bureaucrat that will ALWAYS know more than you do.

When I worked for a temp company in nursing I got called out to a nursing home once to relieve an evening shift that was already an hour late getting off work. For about 45 minutes I was the only non resident in the building, and mind you I had never been there before so was unfamiliar with where things were, till another temp showed up. Then we both were winging it. There was no linen. We had about enough clean linen to make one full round, and clearly no rounds had been made in housr, most patients were wet or soiled. There was a literal mountain of wet/soiled linen in the closets as well as in a therapy room. There just was no place else to put it.

I knew when I got there I should have called adult services so they could come shut the place down. It was a hazard especially when it was just me, what if there had been a fire and only me to evacuate 120 bedridden elderly from the building?

We did the best we could but even working at an exhausting pace we could not get all beds changed more than one round.

The worst part is that is not at all so unusual.


You might also ask why we need nursing homes in the first place ! Because the medical industry keeps people alive far too long for the medical industry and its shareholders' benefit maybe ? I have my dementia suffering mother living with me, it is MY fckn burden and that s the way it should be ! Two years ago she spend 3 days in hospital, going through all kinds of unnecessary and overly expensive, paid by the belgian state, check ups, they really wanted to keep her there for a while( and 20K euros more) and then send her to a fckn nursing home, I found her tied on chair one afternoon because of her run away behaviour and took her home again... She is doing fine actually.... and didn t catch covid !


The same demographic works meat packing and nursing home--low pay and unattractive duties.

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