Covid-19 in nursing homes- fatalities seem high

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    Coronavirus Covid-19
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Discussion Overview

The discussion focuses on the high fatality rates of COVID-19 in nursing homes across various regions, including New Mexico, Massachusetts, Canada, the UK, and Sweden. Participants explore the implications of these statistics, potential causes, and the effectiveness of reporting and response measures in these facilities.

Discussion Character

  • Exploratory
  • Debate/contested
  • Technical explanation

Main Points Raised

  • Some participants note that a significant percentage of COVID-19 fatalities in various states and countries are linked to nursing homes, with specific statistics provided for New Mexico, Massachusetts, Canada, and the UK.
  • Concerns are raised about the high death rates in nursing homes compared to the general population, with some estimates suggesting that residents are at a much higher risk of dying from COVID-19.
  • Participants discuss the potential impact of poor management and conditions in nursing homes, suggesting that these factors may contribute to high mortality rates.
  • There are questions about the accuracy and transparency of mortality data reporting, particularly in Pennsylvania, where privacy protections may obscure specific outbreak information.
  • Some participants express skepticism about the effectiveness of current measures to protect vulnerable populations in nursing homes, questioning the rationale behind broader confinement strategies without specific protections for these facilities.
  • Comparisons are made to historical responses to epidemics, with references to past practices in infection control.

Areas of Agreement / Disagreement

Participants express a range of views on the causes of high mortality rates in nursing homes, with no consensus reached on the effectiveness of current measures or the accuracy of reporting. Multiple competing perspectives on the management of nursing homes and the implications of data reporting remain evident.

Contextual Notes

Limitations in data reporting and the impact of varying state regulations on the transparency of nursing home fatalities are noted. Additionally, assumptions about the health status of nursing home residents and the implications of communal living during the pandemic are discussed without resolution.

  • #31
Hi russ, I think OmCheeto is trying say... I don't know. It's him who has to explain his opinion. He has only pointed out one fact about the elderly. Let's wait for his explanation.
 
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  • #32
russ_watters said:
Are the nursing homes housing the least healthy? Also, it isn't clear to me how those statistics define "nursing home",

There is a continuum from "community for active seniors" through "assisted living" and "nursing home" and finally "hospice". I suspect there is not a universal line one can draw around any of these.
 
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  • #33
After some thought I suspect that this is done by licenses - it's well defined, but not defined the same way everywhere. Probably 50 different definitions in the US.
 
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  • #34
Vanadium 50 said:
How can it skew the statistics? The data is what it is.
...
Good point. Perhaps what I meant to say was; "I'll have to research this further, to see how this skews my perception of the situation."
 
  • #35
skew: to cause something to be not straight or exact; to twist or distort.
e.g.: These last minute changes have skewed the company's results
OmCheeto said:
Good point. Perhaps what I meant to say was; "I'll have to research this further, to see how this skews my perception of the situation."
My point of view: the infection fatality rate is the rate of fatality per infection; it's a concept, a fact, that is straight, exact per se, by or of itself. Skew is to cause something to be not straight.
Nobody's perception should be affected by maths. Maths shows us, in this case, a fact. Hence, any elderly ifr is straight wherever elderly is at. Hope to have been reasonable. Greetings, anyhow, to those trapped at nursing homes, or elderly who are not at home, but some other strange place. Woldwide.
 
  • #36
Here in Aus the second wave in Victoria is hitting Nursing Homes hard:
https://www.abc.net.au/news/2020-07-31/aged-care-the-lessons-for-victoria-from-newmarch/12505710

It is being suggested the two main vaccines we have here in Aus, one of which has completed stage one trials (Flinders University vaccine), and the other (the UQ vaccine) soon well. The one that has completed stage one was shown totally safe with less or no side effects (eg sore arm, slight nausea etc) than other vaccines that has passed stage 1. The situation in Victoria is considered so bad in nursing homes it has been suggested as part of stage 2 trials to deploy the vaccine. It has some risk - the limited number used in phase 1 trials (120 I believe) does not show it 100% safe for all people, but is less of a risk than the bad death rate in such places. Do we have the leadership with the necessary courage and 'true grit'.

Thanks
Bill
 
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  • #37
The governor of Michigan just vetoed a bill banning sending Covid infected patients to nursing homes: " To ban transferring patients in a medical care facility who test positive for COVID-19 to nursing homes. State regulators would be required to create a “centralized intake facility” in each of the state’s eight “health care regions” to treat Coronavirus patients who are “ineligible for admission at a hospital”

Presently the policy is to send Covid patients to nursing homes, and this is incentivized to the tune of $5000 a head. However, it is also routinely ignored by some nursing homes - Michigan has a remarkably bimodal distribution: some have turned themselves into little fortresses and have zero cases, and others have records closer to New Jersey's. It is unclear whether the state will continue to look the other way at the "successful fortresses" or whether they will try and make them follow state policy.

The legislature is one vote short of a veto override.
 
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  • #38
60% of the Massachusetts fatalities are in nursing homes. Extrapolating from CFR's, that means 95 +/- 10% of the residents have been infected.
One case has resulted in criminal charges. Criminal Indictments Brought In Holyoke Soldiers' Home COVID-19 Deaths, https://www.wamc.org/post/criminal-indictments-brought-holyoke-soldiers-home-covid-19-deaths

In Illinois, Authorities Investigate Outbreak At Veterans' Home That Killed 27, https://www.wamc.org/post/illinois-authorities-investigate-outbreak-veterans-home-killed-27

Nursing homes and long-term care facilities are certainly problematic, but especially with the current pandemic, as most residents have one or more comorbidities. And beyond the elderly, those with disabilities are particularly vulnerable.

December 21, 2020 - Oregon Hospitals Didn't Have Shortages. So Why Were Disabled People Denied Care?


Concerns were raised back in March, when Washington and New York states started seeing a rise in COVID-19 patients. https://www.nytimes.com/2020/03/31/us/coronavirus-covid-triage-rationing-ventilators.html

In Louisiana, and apparently in New York City, some poor with COVID-19 were denied treatment and instead sent home, where they died.
https://www.propublica.org/article/sent-home-to-die
https://www.propublica.org/article/...na-legislators-are-demanding-an-investigation
 
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