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Better Safe Than Sorry

Published on May 3rd, 2020

In some cases, it means that organizations might get out ahead of CDC on some infection control practices,” Feifer said. “And in some cases, that may turn out to be unnecessary. But it’s better to risk overreacting in the face of this pandemic than to risk under-reacting, or being a little bit too late — because lives are at stake.”

 “We are learning on the fly; we’re sharing with one another across the industry in ways that are truly extraordinary, and we’re having to figure out answers to new problems on a minute-to-minute basis. Some of our biggest challenges right now involve access to testing patients with potential coronavirus disease, as well as the supply of personal protective equipment — especially masks and gowns to keep both the staff safe, as well as the residents.”

“We’re all struggling with the national shortage of PPE. Everyone’s experiencing that, and everyone’s dealing with it in somewhat different ways. Across Genesis, we’ve been able to maintain a supply of standard face masks, and N95s, for situations where there’s high risk and when they’re needed — and gowns, up until this point. And we’ve done that largely by going to various sources around the world to obtain supplies where we can, when we can, and by shifting supply around among our various facilities all around the country — from areas that don’t need quite as much, as they’ve been able to obtain, to facilities that do because they’re in hotspots.

That’s getting us by on a day-by-day basis. But that’s not sustainable. The nation’s shortage is going to reach a critical point at some point in the next few weeks, and then we’re going to be looking at alternatives that are certainly not preferable — but they may be necessary backup plans. So you mentioned using somewhat unusual coverings, whether it’s garbage bags, or raincoats, or what have you. We are not at that point yet, and we hope to not get there.”

“There is a huge gap related to the access of testing in skilled nursing facilities today — and any suggestion otherwise fails to see what’s actually on the ground in America’s nursing homes. And that gap is costing lives. I can’t say it any more clearly. This is deeply concerning.”

There is a shortage of the swab kits that the laboratory suppliers to nursing homes are telling us on a daily basis — and that shortage has been getting worse day by day, not better. And even when we can obtain the swab kits, the turnaround time for labs for nursing homes ranges from three days — that’s the fastest — up to 11 days. This is completely unacceptable. We need to sound the alarm nationally. One of the principles of epidemic management that we’re focused on is cohorting patients — cohorting patients who are positive for coronavirus disease away from those who are not. That’s optimal in separate facilities, where there’s no risk of spread within a facility. But cohorting is the principle, and you can’t cohort patients if you can’t know with reasonable certainty who has the disease and who doesn’t.

 We need to all be creative. We need to use our best judgment. We need to put safety and infection control first. That, right now, is all that matters. And in some cases, it means that organizations might get out ahead of CDC on some infection control practices. And in some cases, that may turn out to be unnecessary. But it’s better to risk overreacting in the face of this pandemic than to risk under-reacting, or being a little bit too late — because lives are at stake. It’s always easier to back off on an intervention if it turns out not to be effective or not practical or not necessary. But you can’t turn back the clock and start doing something a few weeks ago if we learn later how important it is, and we missed the boat.

 

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