COVID-19 has confounded the scientific community since it first arrived on our shores. Between the uncertainty about the need for face masks to the safety of the drug hydroxychloroquine, it’s taken a while to get up to speed on this supremely dangerous and highly complicated enemy.
Now, several months after the first outbreak in a nursing home near Seattle, we have finally gotten our arms around some indisputable facts regarding this virus, particularly as it affects nursing home residents. Here are some of them:
• Testing is imperative to defeat COVID-19. The Centers for Disease Control and Prevention recently found that repeated point prevalence surveys (serial testing) and robust infection prevention support can lower case counts. When investigators conducted more testing and infection prevention and control support on hard-hit skilled nursing facilities in Detroit, new cases subsequently fell from 35% to 18%. A serial testing strategy along with robust infection prevention support should be standard tools for COVID-19 control, they concluded.
The takeaway: Going forward, nursing homes will need access, financial and otherwise, to testing to keep the virus out of their buildings.
• The virus has a strong asymptomatic component. The situation in New York is politically charged, with a tug-of-war between the Trump administration and the Cuomo administration over who or what is to blame for the high death toll at nursing homes. A new report from the New York State Department of Health helps to shed important light on a cause of the facility outbreaks in that state. Based on the data regarding infection transmission rates, it seems clear that thousands of employees, who were infected in mid-March, unknowingly passed the virus to residents.
The takeaway: Given how easily the virus spreads, personal protective equipment and testing are a must (see fact No. 1) to protect residents. And now that we have learned how to properly screen staff for the virus, we can take measures to keep employees home, when necessary.
• Hydroxychloroquine is not an effective treatment for COVID-19. The antimalarial drug, which originally was touted as a preventive medication for the coronavirus, has long been discredited for this purpose. Unfortunately, a Pennsylvania veterans nursing home used it indiscriminately on its residents, including some who had not even been tested for COVID-19. It’s not clear to what extent it is to blame for the 42 resident deaths linked to COVID-19, but the reckless disregard for the scientific facts is disturbing.
The takeaway: Nursing homes need to listen to the experts. The Food and Drug Administration issued an emergency-use authorization for the drug in March but stressed that it should be used prudently and after discussions with patients and families about the risks. That said, when our president continued to tout the potential of hydroxychloroquine as a miracle drug for COVID-19, despite the experts’ warnings, he was putting residents in harm’s way.
Why do we need to reiterate these facts, even though they are widely known at this point? Because they offer a baseline to conquer this virus. If we ignore science and play politics instead, we just give the virus license to continue its deadly march. And that’s a fact.
Liza Berger is Senior Editor at McKnight’s Long-Term Care News.