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“This is basic public health – you track this, you study it, and you learn from it”

Published on April 20th, 2020

Why won’t the Trump Administration monitor and track nursing home residents with COVID-19?  Federal health officials are coming under increasing pressure to start publicly tracking coronavirus infections and deaths in nursing homes after criticism they have not been transparent about the scope of outbreaks across the country that have already claimed tens of thousands of resident’s lives.  Experts say the lack of tracking and transparency has been a dangerous blind spot, and that publicizing outbreaks as they happen could not only alert nearby communities and anguished relatives but also help officials see where to focus testing and other safety measures.  Transparency assists safety.

“This is basic public health – you track this, you study it, and you learn from it,” said David Grabowski, who specializes in health care policy at Harvard Medical School. He said it’s difficult to have confidence in officials’ ability to contain the virus if they aren’t tracking where it has struck and why.

Such an action by the agencies that oversee the nation’s 15,000 nursing homes is seen as long overdue, coming more than a month after a nursing home in Washington state became the first COVID-19 hot spot in the U.S. with an outbreak that ultimately killed 43 people and a near-daily drumbeat of new cases that in some cases has forced entire homes to be evacuated. Because the federal government has not been releasing a count, The Associated Press has been attempting to keep count but everyone agrees that is grossly underestimated.

“We recognize there should be more reporting,” said Seema Verma, head of the Centers for Medicare & Medicaid Services. Then why won’t she do it?  Verma did not provide details on how that would work or what information would be made public, other than to say her agency was “considering” requiring homes to disclose information to residents and their family members.

Many individual states have added to the lack of transparency by releasing only totals of infections and deaths and not details about specific outbreaks.

“It’s just scandalous not to tell the public which facilities have the virus,” said Charlene Harrington, a professor emerita at the University of California San Francisco and former state health official. “Even some staff members don’t know. They’re hiding it because it’s bad for business and it’s just horrible.”

“You’re not going to slow down the spread if you don’t know you have it,” said Julie Moore, a certified nursing assistant at a home in Philadelphia, where an outbreak has claimed multiple lives and sickened workers. To screen for infections, she said her home asks workers to fill out questionnaires about their symptoms and exposure. But she said “you could be asymptomatic and you could transfer the virus to the residents.” An AP report earlier this month found that infections were continuing to find their way into nursing homes because such screenings didn’t catch people who were infected but asymptomatic. Several large outbreaks were blamed on such spreaders, including infected health workers who worked at several different nursing home facilities.

 

 

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