On the first evening of the Democratic Nationwide Conference, Unique York Gov. Andrew Cuomo modified into as soon as amongst the first in a weeklong parade of audio system to peril scathing opinions of the Trump administration’s coronavirus response.
Cuomo’s criticisms drew a lickety-split answer in a tweet from Michael Caputo, an assistant secretary for public affairs on the Division of Health and Human Companies.
“Does the #DemConvention know @NYGovCuomo compelled nursing homes across NY to soak up COVID particular patients and planted the seeds of infection that killed hundreds of grandmothers and grandfathers?” he wrote.
It modified into as soon as a easy jab: Cuomo has been dogged by criticism for months over his March advisory directing nursing homes in the pronounce to accept patients who had or were suspected of having COVID-19. So long as they were medically stable, the attention said, it modified into as soon as appropriate to slip patients in. Additional, nursing homes were prohibited from requiring that medically stable prospective residents be tested for the virus sooner than they arrived.
Between March 25 and Might perhaps well merely 8, roughly 6,326 COVID-particular patients were admitted to nursing homes, based fully mostly on a pronounce neatly being division document.
Whereas consultants command this policy modified into as soon as unsuitable, is it aesthetic to reveal that the governor’s directive “compelled” nursing homes to decide patients who were ailing with COVID-19? And to what extent did that contrivance sow the seeds of illness and death? When we examined the proof, we found it modified into as soon as much less particular-decrease than the assertion makes it seem. The policy doubtless had an attain, nonetheless epidemiologists identified further elements that fed the peril. What’s extra, the policy did not “pressure” nursing homes to accept COVID-particular patients. Nursing homes interpreted it this form.
We checked with HHS to search out the premise for Caputo’s comment nonetheless got no response.
The Again Fable
As the virus tore via nursing homes, killing dozens at some of them, Cuomo came below withering censure. His administration’s policy, utilized with an discover in direction of releasing up neatly being facility beds for an onslaught of COVID patients, looked as if it would forget the dangers to frail and elderly nursing dwelling residents who were particularly at risk of the illness.
In line with the COVID Monitoring Venture, 6,624 folk bear died of COVID-19 in nursing homes and other long-time interval care providers in Unique York, accounting for 26% of the pronounce’s 25,275 COVID deaths. Some command the staunch series of deaths is a ways elevated because, not like many states, Unique York does not depend the deaths of frail nursing dwelling residents who are transferred to hospitals and die there as nursing dwelling deaths.
Cuomo’s motive in the relieve of the policy — that he modified into as soon as merely following steering from the federal Companies for Disease Abet watch over and Prevention — didn’t decrease it. A most current PolitiFact half analyzing his disclose rated it “Largely Fraudulent.”
In Might perhaps well merely, the governor amended the March pronounce, prohibiting hospitals from discharging patients to nursing homes until they tested detrimental for COVID-19.
A Misguided Strategy
Within the early days of the COVID-19 pandemic, when Unique York modified into as soon as the epicenter and further than a thousand folk were being hospitalized every day, there modified into as soon as a gradual dread that hospitals would not be ready to accommodate the influx of desperately ailing patients.
Absorbing folk out of the hospitals and into nursing homes modified into as soon as one contrivance to support hospitals meet these needs.
In line with the CDC steering cited in the sooner PolitiFact memoir, there were two elements to bear in solutions when deciding whether or now to not discharge a affected person with COVID-19 to a protracted-time interval care facility: whether or not the affected person modified into as soon as medically prepared, and whether or not the facility might perhaps well perhaps also put in pressure the instant infection-abet watch over procedures to soundly treasure a affected person convalescing from the virus.
A doc from the federal Companies for Medicare & Medicaid Companies said nursing homes must silent accept most productive patients they were ready to treasure.
Long-standing pronounce steering is per the identical situation.
Peaceable, nursing homes didn’t mediate turning away patients with COVID-19 modified into as soon as an chance.
“On its face, it looked appreciate a requirement,” said Christopher Laxton, executive director of the Society for Put up-Acute and Long-Term Care Medicine, which represents medical mavens in nursing homes and other long-time interval care providers. “The nursing homes we spoke to felt it modified into as soon as a mandate, and a series of them felt they’d no different nonetheless to decide COVID patients.”
Whereas the overarching steering now to not decide patients in until they would perhaps even be safely cared for might perhaps well perhaps also were particular, nursing homes’ ride modified into as soon as on the overall diversified, said.
Richard Mollot, executive director of the Long-Term Care Community Coalition, an advocacy community for elderly and disabled folk. “There modified into as soon as dinky motive in the relieve of nursing homes to think they must silent most productive soak up patients in the event that they’ve the facility to attain so safely because these guidelines are not on the overall enforced recurrently.”
Backside line: Reveal and federal guidelines didn’t pressure nursing homes to accept COVID-particular patients, nonetheless deal of them believed they’d no other different.
A Lethal Consequence?
How much of the blame for the deaths of hundreds of folks in nursing homes from COVID-19 shall be attributed to Cuomo’s March advisory?
That’s the 6,000-particular person demand.
In a July diagnosis of COVID-19 nursing dwelling deaths, the pronounce concluded that the lethal virus modified into as soon as introduced by nursing dwelling workers contributors in preference to ailing patients.
It noted that peak nursing dwelling resident mortality from COVID-19 on April 8 preceded the peak influx of COVID patients on April 14. As neatly as, it found that when it comes to 1 in 4 nursing dwelling workers — 37,500 folk — were infected with the virus between March and early June.
In line with these and other elements, the document concluded that the pronounce admissions policy might perhaps well perhaps also not were a driver of nursing dwelling infections or fatalities.
Epidemiologists and nursing dwelling advocates beg to vary.
“To affirm that introducing patients [to nursing homes] who had COVID did not motive considerations is ridiculous,” said Laxton.
Calling the survey’s methodology “slightly unsuitable,” Denis Nash, an epidemiologist at Metropolis College of Unique York College of Public Health, said he didn’t have confidence the document’s conclusion that the policy had nothing to attain with deaths.
Others had the identical survey. “I didn’t think they showed records to reveal [the policy] isn’t a ‘driver,’” said Rupak Shivakoti, an assistant professor of epidemiology on the Mailman College of Public Health at Columbia College.
Nonetheless Gary Holmes, assistant commissioner on the Unique York Reveal Division of Health, had a diversified decide. Critics of the document, he said, must be intentionally ignoring the rising death tolls in nursing homes in sizzling spots across the country.
“Public neatly being officials in these states are experiencing (and acknowledging) what NY’s document indicated weeks ago: these providers are microcosms of the community and transmission is going down unknowingly by asymptomatic unfold amongst workers contributors,” Holmes said, in an electronic mail.
Whereas public neatly being consultants quibbled with the document’s self-serving disclose that the governor’s policy wasn’t a element in COVID-19 nursing dwelling deaths, they on the different hand agreed with the document’s broader conclusion that nursing dwelling staffers besides company, sooner than they were banned, were doubtless the first drivers of COVID-19 infection and death in nursing homes.
“In line with the timeline of the policy and deaths in the metropolis, it is miles terribly unlikely that policy contributed to hundreds of deaths,” said Shivakoti.
Infection abet watch over is a protracted-standing peril at nursing homes, Nash said, and the COVID deaths were a standard failure of infection abet watch over. That said, “it’s unclear how many of the deaths the policy will bear triggered.”
Additionally unclear: how many of the slow were grandmothers and grandfathers.
Our Ruling
In a tweet, the HHS assistant secretary for public affairs said that Unique York Gov. Andrew Cuomo “compelled” nursing homes across the pronounce to admit COVID-particular patients and that this policy fueled the unfold of COVID-19 that resulted in hundreds of deaths in the nursing dwelling inhabitants.
Even supposing nursing homes felt rigidity to accept COVID-particular patients, they were now potentially not compelled to attain so. Reveal regulations require nursing homes to accept patients most productive in the event that they might be able to treasure them, and so that they might be able to also bear refused them on these grounds.
As neatly as, it’s unclear the extent to which the governor’s policy modified into as soon as in mark for nursing dwelling COVID-19 deaths. Infection abet watch over is a protracted-standing peril in nursing homes, predating the pandemic, and a document showed peak numbers of nursing dwelling deaths came prior to the peak influx of patients as a results of Cuomo’s advisory. Whereas the introduction of COVID-19 particular patients into nursing homes undoubtedly had an attain on infection unfold, Caputo’s assertion suggests it modified into as soon as completely in mark. That’s not what the proof displays.
We price this Largely Fraudulent.
Linked Topics
Ageing Public Health States
COVID-19 KHN & PolitiFact HealthCheck Unique York Nursing Homes
