A federal testing and surveillance program is key to containing the devastating spread of COVID-19 across nursing facilities, according to testimony from a leading long-term care policy expert.

Some are quick to point fingers at facility quality and state failures to explain COVID-19’s outsized impact on the industry, David Grabowski, Ph.D., of Harvard Medical School told a congressional subcommittee on Thursday. But research shows that infections are simply concentrated wherever COVID-19 is present in the larger community, he said. 

“This suggests that COVID-19 is not a ‘bad apples’ problem, but a system-wide problem that can impact any nursing home in any state,” he said.

The pandemic’s toll on residents and staff has been enormous. The latest data puts the COVID-19 fatality rate in nursing homes at 40,000, with 0.4% of the population representing half of the U.S. COVID deaths to date, Grabowski reported.

David Grabowski, Ph.D., testifying remotely before the Select Subcommittee on the Coronavirus Crisis.

Meanwhile, nursing homes are in lockdown, with residents isolated for nearly three months. Nearly 700 staff nationally have died from COVID-19 infections, with many unable or unwilling to work due to illness or fear. And while visitors have been barred from facilities since March, staff unknowingly continue to bring the virus from the community to work.

Yet much of COVID-19’s negative impact on nursing homes could have been avoided, Grabowski told the Select Subcommittee on the Coronavirus Crisis. Historic underfunding, inconsistent access to COVID-19 screening tests and medical equipment, and severe staffing shortages have helped to create a crisis made worse by an uncoordinated federal response.  

The federal government should “own this issue” by paying for and arranging testing in eldercare facilities nationwide, Grabowski concluded.

“We allowed a problem that could have been contained to grow into a national crisis,” he said. “Now that we are here, it is time for the federal government to make the necessary investment to mitigate the spread of COVID across all U.S. nursing homes.”