An article in Nowhere Magazine several years ago explored the ways ancient cultures dispatched the elderly, a practice known as senicide. Author Justin Nobel recounted several gruesome rites that made the Inuit habit of putting Granny on an Arctic ice floe seem humane.
At one point, Nobel mentioned that his own grandparents had moved “to a fancy nursing home in the suburbs of New York City.”
That made me shudder.
If they are honest, historians judging the American experience during the coronavirus pandemic will excoriate our barbaric failure to protect the elderly. We think of ourselves as civilized, but mindless policies and bureaucratic indifference turned many nursing homes and rehabilitation centers into killing fields.
At least 28,000 residents and workers in long-term care facilities already have died from the virus, according to a New York Times analysis done more than a week ago. That represented one out of every three COVID-19 deaths recorded in the United States at the time and was likely an undercount because of reporting lags and varying state methods.
This massacre of a helpless population shames America and Washington must find out why it happened and who is responsible. Elderly people in these institutions could not protect themselves, and because most states banned visitors early in the outbreak, the institutions, their regulators and elected officials were fully obligated to shield them against infection.
They failed miserably.
The Times found 14 states where more than half of total deaths occurred in facilities for the elderly. It was 55 percent in Connecticut, 57 percent in Colorado, North Carolina and Kentucky, 58 percent in Virginia, 59 percent in Massachusetts, 61 percent in Delaware, 66 percent in Pennsylvania, 73 percent in Rhode Island and 80 percent in West Virginia and Minnesota.
The states with the most nursing-home deaths, New York and New Jersey, didn’t make the list because of so many other deaths, yet more than 10,000 people died in their facilities. The 5,500 nursing-home deaths in New York are more than the total deaths in all other states except New Jersey.
Many if not most could have been avoided. The earlier outbreaks in Asia and Europe demonstrated that the elderly were easy prey for the virus, doubly so when they have underlying health conditions. Everybody knew that.
Florida got the message and implemented a model response. Despite its vast enclaves of long-term care homes, it reported under 750 deaths in them, or slightly more than one for each of its 615 facilities.
The striking contrast between Florida on one hand and New York and New Jersey on the other can be traced largely to policy decisions by their governors. Gov. Andrew Cuomo of New York and Gov. Phil Murphy of New Jersey issued almost identical orders in late March requiring nursing homes to accept COVID-19 patients being discharged from hospitals. The orders barred the homes from even asking if the patients had the virus, lest they be discriminated against.
Those politically correct orders quickly became death sentences as infections spread like wildfire.
Florida, thankfully, followed a different path. Gov. Ron DeSantis said his state moved early to protect the elderly because statistics from South Korea showed “that not all age groups were equally at risk” and that most deaths happened to “folks 65 and up.”
As a result, he allowed his nursing homes to reject hospital referrals who were still infected. More recently, Florida started sending infected residents in the opposite direction, from nursing homes to hospitals.
“Our goal is to keep the virus out of our facilities,” one Florida nursing-home CEO told the Sun-Sentinel. “Hospitals are more concerned about their beds.”
Because Cuomo and Murphy had the same information as DeSantis, their ruinous actions remain inexplicable. They can’t say they weren’t warned.
On March 8, Dr. Thomas Frieden, former head of the federal Centers for Disease Control and Prevention, wrote on CNN that “nursing homes and other long-term care facilities are ground zero.” On March 18, the CDC, in a study of the nation’s first large outbreak, in a nursing home in Kirkland, Wash., told health officials, “Substantial morbidity and mortality might be averted if all long-term care facilities take steps now to prevent exposure of their residents to COVID-19.”
Yet seven days later, Cuomo issued his infamous March 25 order that said, “No resident shall be denied readmission or admission to NH solely based on a confirmed or suspected diagnosis of COVID-19.”
Six days after that, on March 31, Murphy used similar language in his order. Although it allowed carve-outs that enabled some facilities to dodge the bullet, the mandate had disastrous impacts overall, with more than 5,000 deaths recorded in New Jersey’s long-term homes.
One of the worst is the state-run Veterans Home in Paramus, which has recorded at least 72 deaths. A man who lost his 91-year-old Army-veteran father there was quoted as saying the home should be demolished and replaced with a memorial park. “It’s like a mass shooting,” he said.
Despite the surging death count, Cuomo defended his directive for more than six weeks. He reversed himself only last Sunday, ruling that patients must test negative before hospitals can send them to nursing homes. Yet he insisted that the initial policy “worked.”
If more than 5,000 dead was success, what would failure look like?
Cuomo’s reversal included forcing nursing homes to test staff and administrators twice a week, at the homes’ own expense. There was no explanation why testing was not required all along, or how it would work when labs say they cannot process the needed 410,000 weekly tests.
Despite the enormous consequences of Cuomo’s arbitrary decision-making, only a few New York lawmakers have dared to call for investigations about what went wrong.
Nursing-home executives, meanwhile, complain privately that Cuomo should have known his mandate would be a killer, but they were never consulted and got no notice before being swamped with infected patients. As one owner put it, long-time residents began “dropping like flies” soon afterward.
These same executives will not go public with their complaints because they fear Cuomo will punish them with fines and take their licenses. Some see the sudden testing regime and a probe he started with the state attorney general as a way to blame them for his mistakes.
All the more reason why federal officials with nothing to fear must step in and find the facts. A designated US attorney, for example, could use a grand jury to demand answers about why so many elderly people were put in harm’s way despite the warnings and simple common sense.
As for witnesses willing and eager to come forward, the feds should start with grieving families. For each of the 28,000 dead, there are relatives whose stories of heartbreak and rage will move the nation.
The families want answers and they want action. They deserve both.
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