May 8, 2020
I read with interest yesterday (May 6, 2020 Health and Science, by Dunn and Brenuninger, CNBC) that our governor, Andrew Cuomo was “ shocked” to learn from a study of 100 NY hospitals that 2/3 (66%) of the new admissions to the hospital for covid 19 were from New Yorkers who were sheltering at home. The next largest group was elderly patients from nursing homes (18%) and the reminder from homeless, inmates, and other facilities.
Our governor was “shocked” to learn this sad fact. I was not.
Governor Cuomo is apparently unable to “connect the dots”—dots which he created himself.
It was on March 25, a few weeks back, that Mr. Cuomo made the startling decision to mandate that our state nursing homes accept elderly patients and those that were recovering or diagnosed with Covid19.
Mr Cuomo, too eager to use the covid pandemic to build up his favorability ratings, may have spent too much time bantering with his brother on that sibling’s TV program and not enough thinking about his gubernatorial actions. As a result, he failed to realize the disaster he was creating by forcing nursing homes to accept covid 19 patients. Cuomo’s act placed the most vulnerable to covid 19, in danger. In doing so he also exposed thousands of health care workers and their families who were responsible for the care of this vulnerable population to disease. I suggest here that his mandate can in good part explain the “ shocking fact” of 18% nursing home elderly being admitted to hospital, as well as the 66% new hospitalizations from those sheltering at home.
Let’s take a look at the numbers. There are estimated more than 600 nursing homes in New York State according to the 2006, Elliot Spitzer report (Staffing Levels in New York Nursing Homes). According to that report more than a quarter million elderly patient were being cared for in those facilities. State staffing requirements for licensed “care givers” in those facilities require a minimum of 3.2 hours/ day/patient. Assuming an eight hour day for these workers who care for a quarter million patients we can estimate (250,000 x 3.2 = 800,000 hours/ 8 hours = 100,000) the State would require a minimum of 100,000 licensed staff members to serve these patients. This estimate does not include the large group of support staff such facilities require for maintenance, cleaning, cooking etc. etc. Thus the 100,000 number is probably very conservative estimate for 2020.
So what was the result of Governor Cuomo’s thoughtless mandate? He introduced covid 19 patients into nursing homes which were woefully unprepared for such patients. These facilities had no trained staff to deal with this disease, no proper PPE for staff, no isolation wards, no negative air pressure rooms, and no help from the governor’s office. The result caused a massive increase in disease in these facilities. (Recent data “discovered” 1700 “new” cases of nursing home deaths. ) The NY hospital study claims that 18% of new hospitalizations came from nursing homes. How is it that the Governor could not relate those two facts? He sends covid 19 patients into nursing homes and then reports on a nearly 20% increase of new hospitalizations from these facilities! There seems to be an obvious correlation there.
But what about the 66% of those who were “sheltering at home” that Gov. Cuomo was so shocked about. . Could it be that the more than 100,000 workers in those nursing homes who were untrained and who were forced to care for covid 19 patients without proper PPE and in unsafe circumstance were more likely to infect themselves and to carry the covid 19 virus back to their homes and to their families and loved ones sheltering at home? One hundred thousand virus carriers is no insignificant number and could well account for a surge in disease in the “home sheltering population” and hospitalizations of same.
Another factor which points the finger at Cuomo and his mandate is that nearly half of the new hospitalization cases were Afro-Americans and Hispanics —the most likely ethnic groups to be employed in these nursing home facilities.
Connect the dots! Send covid 19 patients to nursing homes—- get a surge of elderly sick patients from said nursing homes—force untrained, unprotected workers to treat covid 19 patients —get a big surge of Hispanic and Afroamerican patients who were sheltering at home and may well have been in contact with or related to infected nursing home workers.
What was Gov. Cuomo thinking? Or as Gerry Seinfeld would say that it—“he wasn’t.”
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