The scandal of nursing home deaths in the pandemic

Michael Cook
April 18, 2020
Reproduced with Permission

Governments the world over have turned their countries upside down with social distancing, forced unemployment and massive welfare spending, -- all to save the most vulnerable and oldest people in the population pyramid.

Reports on deaths have come to the same conclusion : "deaths have been concentrated at older ages". In a sense, it is an impressive testimonial to 21st Century commitment to human dignity that government have moved so quickly and sacrificed so much to save the elderly. It is believed that the death rate is almost 10 times higher than the average for those over 80.

New York Governor Andrew Cuomo said it best in a recent press conference: "My mother is not expendable. And your mother is not expandable…We're not going to accept a premise that human life is disposable. We're not going to put a dollar figure on human life. We are going to fight every way we can to save every life that we can. Because that's what I think it means to be an American."

Which makes it all the more puzzling that people in nursing homes are being poorly looked after in the United Kingdom and the United States and elsewhere.

In the UK, this has become a major issue in the media. An open letter to the government sent by Care England and four other leading organisations is scathing . "We're seeing people in [care homes] being abandoned to the worst that coronavirus can do," it reads. "Instead of being allowed hospital care, to see their loved ones and to have the reassurance that testing allows; and for the staff who care for them to have the most basic of PPE, they are told they cannot go to hospital, routinely asked to sign 'do not resuscitate' orders, and cut off from families when they need them most."

It also appears that deaths in nursing homes are routinely ascribed to other ailments. "The current figures are airbrushing older people out like they don't matter," Caroline Abrahams, of Age UK, told the BBC .

The first major outbreak in the US occurred in a nursing home in Washington state. It has killed at least 35 people. Since then, it has spread like wildfire in other nursing homes. According to a blistering report in The Guardian , this is at least partly due to social conditions in the US:

With about 1 million elderly residents, long-term care homes have emerged as incubators for Covid-19 outbreaks across the US. It is not a coincidence that the industry is already notorious for creaming profits off while pleading poverty in order to pay low wages to a workforce overwhelmingly of women, usually African American, Hispanic or immigrant. Too often, they are forced to take more than one job to make a living, a factor that has helped spread the virus between care centers.

It's not limited to these two countries, either. Monique Pelletier, a former minister for women in the French government criticised the "incomprehensible and inhumane" way residents in some retirement homes were being treated.

One lesson from the Covid-19 pandemic is sure to be a reassessment of nursing home care. As two experts wrote in the JAMA Health Forum :

"Although many prefer not to think about nursing homes, they are a critical safety net for frail older adults and part of the fabric of our society. According to a 2014 report from the Center for Retirement Research, 44% of men and 58% of women 65 years and older will use nursing home care at some point in their lives. Therefore, the grave threat that COVID-19 poses for nursing homes involves all of us."