In Maryland, Gov. Larry Hogan (R) is sending “strike teams” to nursing homes composed of doctors, nurses, health officials and National Guard members who will administer speeded-up tests; ensure segregation of confirmed and suspected covid-19 cases; determine equipment needs; and provide on-site care and medical assessment.
Mr. Hogan’s move is far more proactive than most governors have managed, but it is late in the game given the devastation that has already befallen nursing homes in Maryland and nationwide. Forty infected residents of a facility near Richmond have died; 37 from the Life Care Center in Kirkland, Wash.; 18 at a nursing home in Carroll County, Md., northwest of Baltimore. In the New York City area, where the pandemic has beset virtually every nursing home, some distribute disposable ponchos to staff who lack proper protective gear, and refrigerator trucks acting as makeshift morgues are idling in some facilities’ parking lots.
Federal guidance issued last month recommended that nursing homes bar nearly all visitors and volunteers, scrap communal dining and other group activities, and screen residents and health-care staff for fever and respiratory symptoms. The stark reality is that in a crisis there is no way to monitor compliance at the nation’s more than 15,000 nursing homes, and quality control varies considerably from facility to facility. At best, states could follow Mr. Hogan’s lead as a means of enforcing quality control.
In the end, the burden will be on nursing homes themselves to improvise in an emergency in the face of staffing shortages and hundreds of other challenges that have overwhelmed them. They will need to communicate transparently with patients, relatives and officials. There can be no tolerance for homes that instruct workers not to wear protective gowns or masks for fear of alarming patients, as some have, or continue to blithely assure relatives that all is well even after the disease has broken out in a facility. More useful communication would convey specific information on mitigation efforts under way to contain the outbreak.
Unlike in some other parts of the world, relatively few elderly Americans live with their children and grandchildren. Many are out of sight, but that cannot be license to disregard and neglect them — still less in a pandemic whose particular lethality has fixed the elderly, more than anyone, in its crosshairs.