All nursing homes, throughout NJ and PA, as well as around the country, by March 15, 2020, placed restrictions on family visitation except for compassionate reasons, such as pending death. However, what has become clearer by the day, such visitation restrictions have not prevented the spread of COVID-19 within nursing homes. Why?
The Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report for March 18, 2020 may provide part of the answer. The CDC investigated the spread of COVID-19 at the Life Care Center at Kirkland (Washington State) nursing home that resulted in COVID-19 positive cases among 81 residents, 34 staff members, and 14 visitors; 23 persons died. The CDC concluded staff members working in multiple facilities contributed to intra- and interfacility spread.
Why did nursing home staff members contribute to the spread? One reason could be that nursing home workers, such as CNAs, are low paid, with many earning minimum wage. Many employees do not get paid when they are out sick. It is also very common for them to work two jobs in order to make ends meet. As such, employees who had symptoms continued to work and worked in multiple settings.
The coronavirus pandemic brings dramatically into view the problem of allowing facilities to pay workers inadequate wages and to give them inadequate benefits. To be clear, inadequate wages is not the only reason nursing home residents are at serious risk. Ageism, rationing of care, lack of adequate federal and state action, inadequate infection control procedure, and lack of adequate protective equipment all have contributed to the current crisis. These issues will be explored in the coming weeks.
Hopefully, the pandemic will move this country toward a national solution to adequately compensate and provide important benefits to these very important front line workers.