The initial devastating wave of Covid-19 resulted in the tragic loss of 60,000 lives in nursing homes and long-term care facilities within a span of five months. Despite medical guidelines recommending the prompt administration of newly approved antiviral treatments to high-risk infected patients, less than 20% of nursing home residents with Covid actually received these treatments between May 2021 and December 2022. This revelation is just one example of how nursing homes in the country failed to ensure the safety of their patients during the pandemic.
Experts have given the overall performance of nursing homes during the pandemic a D grade. According to Brian McGarry, a health economist at the University of Rochester, and David Grabowski, a health care policy researcher at Harvard Medical School, nursing homes were not prioritized at any point during the pandemic. The consequences of this lack of prioritization are severe, with more than 167,000 residents and at least 3,100 staff members losing their lives to the virus.
In December 2021, the Food and Drug Administration granted emergency authorization for Paxlovid, a pill that significantly improves the prognosis for eligible high-risk patients. However, despite virtually all nursing home residents falling under this high-risk category, only a quarter of infected residents received antiviral treatment, even after Paxlovid became widely available and free. Approximately 40% of nursing homes reported no antiviral use at all, a concerning finding that healthcare professionals find both surprising and disturbing.
One area where nursing homes showed some success was in the rollout of the Covid vaccine. By early 2022, 87% of residents and 83% of employees had been vaccinated, thanks to a federally coordinated effort. However, the administration of boosters, which is crucial for maintaining the effectiveness of the vaccine, has been lacking. Only about 62% of residents and 26% of staff are up-to-date on Covid vaccinations, including boosters.
Other factors contributing to the poor performance of nursing homes during the pandemic include a shortage of critical protective equipment, delays in receiving test results, and extended lockdowns that had detrimental effects on residents’ mental and physical health. Nursing homes also faced challenges with staffing, an issue that remains unresolved as many employees left during the pandemic and have not been replaced.
To better prepare for future pandemics, nursing homes could invest in improvements such as ventilation systems, private rooms instead of semi-private ones, and smaller units with consistently assigned staff. However, these changes would require increased investment, primarily from Medicaid, and would likely come with increased federal oversight, something the industry may resist.
Overall, the experience of nursing homes during the pandemic highlights the need for significant improvements in healthcare systems and increased investment to ensure the highest quality of care for vulnerable populations.
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