Unsurprisingly, Cuomo also became a target for Trump supporters. That New York had more deaths than any other state from covid-19, the disease caused by the virus, was certainly something of an asterisk that could be applied to the state’s response to the pandemic. What’s more, there were ongoing allegations that a recommendation from the state that nursing homes accept coronavirus-positive patients led to an increase in elderly deaths.
When New York Attorney General Letitia James (D) announced last month that her office had found that the state had apparently undercounted covid-19 deaths of nursing home residents, it seemed to bolster the idea that Cuomo and his administration were trying to bury the state’s poor protection of its most vulnerable residents. Cuomo’s attempts to dismiss questions about the numbers only helped to reinforce skepticism.
What happened, in short, was that the state only counted covid deaths in nursing homes and long-term-care facilities as such if the deaths occurred in the facilities — something about which it had been transparent. If a nursing-home patient was infected at his home but died in a hospital, it wasn’t counted. There’s no standard for how this reporting works and reporting varies by state, but this was not the expectation for how such deaths would be counted.
But there are important caveats to the updated numbers.
The first is that even with the adjustment, the percentage of total covid-19 deaths that have occurred in New York is still below the average for all 50 states and D.C., according to data compiled by the COVID Tracking Project. Before James’s report (and the state’s acknowledgment of it), the percentage of deaths for nursing home patients and staff in New York was among the lowest in the country — something Cuomo had bragged about. Now, it’s near the middle.
When considered as a percentage of the population of nursing home residents, the increase is sharper. In 2019, New York had about 90,000 people living in long-term-care facilities according to data from the Kaiser Family Foundation. That means that the number of deaths in those facilities increased from about 10 percent of the 2019 total to 15 percent, putting New York above the national average (among states which report this data).
Eighteen states, including New York’s neighbors, have had more covid-19 deaths relative to their 2019 nursing-home populations than has New York. Worth noting: New York’s data also include presumed covid-related deaths, something which other states don’t report.
Another critical factor in New York’s numbers is that the state’s deaths, overall and in nursing homes, largely occurred last spring at the outset of the pandemic. It has consistently been the case that criticism of the death toll in New York should be considered in the context of it being hit hardest before the virus was well understood and before testing (and therefore any effort at effective containment) was commonplace. The states where the numbers of deaths in nursing homes make up the highest part of the overall pandemic death toll are often those which, like New York, were hit quickly when the pandemic began.
Data from the Kaiser Family Foundation released last month shows that most other states saw deaths in long-term-care facilities peak later in the year — after the virus and its containment were better understood. It wasn’t until the winter, for example, that South Dakota had the most deaths in its long-term-care facilities, months after the need to protect nursing-home residents was apparent.
In an interview last week, South Dakota Gov. Kristi L. Noem (R) boasted of her state’s handling of the pandemic, including having been able to “protect people who might be vulnerable.”
The updated nursing-home data doesn’t resolve the other long-standing criticism of New York’s handling of the virus, that introducing infected patients to nursing homes exacerbated the death toll. As fact-checkers have determined, it’s tricky to link the state’s stated policy directly to deaths. A report from the State Department of Health last summer (cited in its defense to James’s announcement about the death toll) noted that the virus was already present in nursing homes before patients who had tested positive moved in and therefore “the patient admitted from the hospital did not introduce COVID-19 into the nursing home.” Which is a bit like implying that because you brought a torch into a room where there was already a small fire burning you can’t be responsible for anything catching on fire.
Data from New York is still incomplete, as is the case with every state. Even with the updated figures, though, it’s still not the case that the number of deaths in nursing homes in New York was particularly exceptional as a function of the total number of covid-19 fatalities.