By Yoav Gonen, Josefa Velasquez and Ann Choi
Nursing homes have emerged as a second major front in New York’s battle to stem the coronavirus crisis — with their residents accounting for 15% of COVID-19 deaths in the state, the state Department of Health revealed Sunday.
Like staffers at many city hospitals, nursing home industry officials say they’re suffering from shortages of protective equipment and testing kits — even as they’re caring for a population with the highest risk of succumbing to the virus.
“I’m not getting the equipment I need to properly protect my staff and to properly protect my patients — and that is my absolute biggest concern,” said Scott LaRue, CEO of ArchCare, a network of five nursing homes with 1,700 beds in the city and upstate that’s affiliated with the Archdiocese of New York.
LaRue, who confirmed residents in his network have tested positive for COVID-19, said he spent Sunday delivering thousands of items of protective equipment to his facilities — but that it was barely enough for one day.
He said his workers don’t have enough surgical gowns and face shields to keep them safe when caring for symptomatic patients.
“We’ve been buying rain ponchos and beautician gowns off of Amazon,” said LaRue.
Manhattan Hard Hit
State officials revealed there have been 888 positive coronavirus cases in nursing homes statewide as of Saturday, including 601 in New York City. Just two days prior, there had been 438 confirmed cases among nursing home residents in the city.
As of Saturday, nearly 39% of nursing home cases were in Manhattan, according to the state Department of Health. Manhattan has 14% of all occupied nursing home beds in New York City, according to the state data. Roughly 28% of cases were in Queens, proportional to that borough’s share of occupied nursing home beds.
The state Department of Health declined to say which nursing homes in New York City had recorded the most confirmed COVID-19 cases.
Nursing home residents have so far accounted for 147 of the 965 deaths statewide from the virus. The Kaiser Family Foundation tallied 101,518 nursing home residents in New York in 2017 — 0.5 percent of the state’s total population.
Nationally, nursing homes have been at the center of a number of COVID-19 outbreaks — including one leading to at least 35 deaths at the Life Care Center in Kirkland, Wash.
Gov. Andrew Cuomo on Sunday remarked that New York has been “lucky” that the spread among nursing home residents hasn’t been worse.
“This virus preys on the vulnerable, preys on seniors, preys on people with compromised immune systems and underlying illnesses,” he told reporters in Albany. “Coronavirus in a nursing home is like fire in dry grass.”
No Testing
The concern about coronavirus spread among the elderly is heightened by the inability of nursing homes to test residents who don’t appear sick — or even those with symptoms, industry officials say.
The latest advisory from the state Department of Health says residents and health care workers in nursing homes who display symptoms of coronavirus should be presumed to have it — so that testing “is no longer necessary.”
The advisory calls for residents or healthcare workers with presumed COVID-19 to be isolated from other residents. But the lack of widespread testing means it’s impossible to know whether asymptomatic residents are at risk of transmitting the virus to their peers, and whether symptomatic patients should be moved near others presumed to have it.
“There are patients in the nursing home world that are what we call PUI — patients under investigation— but if we can’t get the swabs there’s no way to know whether they’re positive for the virus or not,” said Dr. Martin Grossman, a palliative care physician for a number of nursing homes in the city. “I think the focus should be on testing all the patients in the nursing homes — identify the ones that are positive, cohort them together.”
The state Department of Health also drew concerns from nursing home officials last week because of a separate advisory that bars nursing homes from rejecting people sent from hospitals based on their COVID-19 status.
Dr. Jeffrey Nichols, a spokesman for the American Medical Directors Association, says nursing homes operators understand they play an important role in creating space at hospitals for the sickest people.
But, he noted, not every nursing home is equipped to care for recovering COVID-19 patients, and that a more collaborative approach would have been better.
“You’re expected to have all the infection control equipment in space, [but] nursing homes cannot at the drop of a hat acquire this stuff,” said Nichols. “Most places do not have a large stash of protective equipment other than gloves and standard surgical masks.”
Pleas for Protection
Last week, the New Jewish Home on Manhattan’s Upper West Side was pleading for protective equipment from elected officials and via Twitter.
The 514-bed residence has logged several dozen COVID-19 cases to date, according to multiple sources. New Jewish Home officials didn’t respond to an email seeking comment.
Ann Marie Spitzer said her husband, Morris, who turns 60 on Monday, has been in and out of the nursing home for months because of a foot injury.
She expressed concern about how the facility is handling the outbreak — including putting a roommate in her husband’s room a day before her husband was told his COVID-19 test results were negative.
“It’s really bad there,” said Spitzer.