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COVID-19: The Nursing Home Disease

By Phil Kerpen

recently testified before the House Select Coronavirus Subcommittee on the meltdown in nursing homes, which excluding New York (which deliberately underreports) now account for over 55 percent of deaths with COVID.  The House Democrats’ goal was to blame these high death rates on President Trump – but the blame should belong squarely to the handful of governors who presided over these disasters.

More than 60 percent of both nursing home deaths and total COVID-19 deaths occurred in just seven blue states with about 20 percent of the U.S. population: New York, New Jersey, Connecticut, Pennsylvania, Massachusetts, Illinois, and Michigan.  The governors in each of these states ignored federal guidelines and pursued some version of the policy of admitting infectious patients to nursing homes as soon as they were clinically stable.

Nationally about 2 percent of the long-term care population has died with COVID-19 – but over 12 percent in Connecticut, 10 percent in New Jersey, 9 percent in Massachusetts, and about 4 percent in Illinois.  Even New York’s dishonest underreported number is 4.4 percent of the state’s long-term care population.

Carnegie Mellon and University of Pittsburgh mathematicians showed back in March that efforts to shelter everyone would lead to a far higher death total than efforts focused on the elderly, but the liberal governors chose to ignore that reality – even as we’ve seen over 80 percent of COVID deaths among seniors.

New York’s policy was implemented via a March 25 advisory that said: “No resident shall be denied re-admission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”

AMDA – The Society for Post-Acute and Long-Term Care Medicine warned in response:  “Unsafe transfers will increase the risk of transmission in post-acute and long-term care facilities which will ultimately only serve to increase the return flow back to hospitals, overwhelming capacity, endangering more healthcare personnel, and escalating the death rate.”

This caution was ignored and the policy stayed in effect until May 10.  New York presently reports 6,413 deaths physically in long-term care facilities.  Adding hospital deaths, which the state refuses to report, would likely double or triple that number.

Similar policies in New Jersey, Massachusetts, Connecticut, Illinois, Michigan, and Pennsylvania – where the state health secretary moved his own mother out of a nursing home while sending infectious patients in – produced similar outcomes.

As Dr. Anish Koka, described it:  “Two weeks into the lockdown, Philadelphia hospitals had been emptied waiting for a New York-style surge that never came… But nursing home patients were treated like patients from the community who were too well to be admitted to the hospital – they were sent home.  The consequences of keeping these patients at the nursing home meant the health system had to eventually deal with the entire nursing home being infected.” 

Pennsylvania now reports 4,345 long-term care resident deaths; all others are 2,054.

It isn’t just state size.  California nearly adopted substantially the same policy as the meltdown states, but reversed it just two days later – they didn’t ignore the backlash.  With a markedly different policy in place, including sending COVID-negative nursing home residents out of Los Angeles area facilities to the USN Mercy hospital ship to establish COVID-only facilities, the state so far has lost only 1.1 percent of its long-term care population, fewer total deaths in this cohort than little Connecticut.

By prohibiting readmission without effective infection control and deploying the national guard, adequate testing, and PPE,  Florida reported long-term care COVID deaths at 1,664 as of June 21 – a quarter of New Jersey’s, and 1.1 percent  of the state’s large long-term care population.   Texas has fared even better, with less than half its COVID-19 deaths in long-term care and presently at only 0.6 percent of that population.

Most states are now finally making serious efforts to test their entire long-term care population.  That’s great, but if the CDC does not fix its definition counting any death in the presence of the coronavirus, nursing home residents with mild or asymptomatic infections will still show up in the count when they die of other causes. The median nursing home stay before death is just five months. If this definitional problem isn’t fixed, deceptive counts will add to the problem of misperceived public fear.

We need honest reporting and counting to understand the risk of serious illness or death with COVID, and we need policies targeted to protect the vulnerable – not to scare the public.  And the governors who presided over the carnage need to be held to account.

The Blue State Depression

Stephen Moore and Erwin Antoni, Committee to Unleash Prosperity

The new Department of Labor employment data confirms that when it comes to the economy, America is on two divergent paths. Blue states are losing jobs at record pace and red states are gaining them.

Ten states now had unemployment rates in May above 15 percent.  They are all states with liberal  governors. Ranked from highest to lowest they are Nevada 25.3%, Hawaii (22.6%), Michigan (21.2%), California (16.3%), Rhode Island (16.3%), Massachusetts (16.3%), Delaware (15.8%), Illinois (15.2%), New Jersey (15.2%), Washington (15.1%).

These are all states that have Democratic governors who kept their states locked down – and still are not entirely opened for business.

Nationally the unemployment rate is about three percentage points higher today in blue states than red states. 

The six states with the lowest unemployment rate are all red states – most of which never shutdown at all. These are Nebraska (5.2%), Utah (8.5%), Wyoming (8.8%), Arizona (8.9%), Idaho (8.9%), Montana (9.0%), and North Dakota (9.1%). 

The same pattern holds if we examine the states that saw the biggest INCREASE in unemployment. Some 15 states have seen their unemployment rates rise by more than 10 percentage points from May 2019 to May 2020. Fourteen of the 15 are states with Democratic governors.

This is not a Coronavirus recession. It is a blue state lockdown recession. Liberals say they have shutdown their economies for health reasons, but these are also the states that generally have had the highest death rates and the highest nursing home fatalities. So the blue states have not only failed to keep their citizens safe, they’ve ruined their economies as well. Liberals are promising that if they win, they will make America look more like New Jersey, Washington, and California. God forbid.

John Mueller says America has entered a ‘Jacques Rueff’ moment.

Policy and Government

The Economist reports on the 90% economy post lockdown:

In many things 90% is just fine; in an economy it is miserable, and China shows why. The country started to end its lockdown in February. Factories are busy and the streets are no longer empty. The result is the 90% economy. It is better than a severe lockdown, but it is far from normal. The missing bits include large chunks of everyday life. Rides on the metro and on domestic flights are down by a third. Discretionary consumer spending, on such things as restaurants, has fallen by 40% and hotel stays are a third of normal. People are weighed down by financial hardship and the fear of a second wave of covid-19. Bankruptcies are rising and unemployment, one broker has said, is three times the official level, at around 20%.

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Corona failures show folly of socialized medicine

By Phil Kerpen

The United States is in the process of destroying its health care system via lockdown; ordering that all but emergency medical treatments and procedures cease in the name of preserving health system capacity, we have emptied out hospitals to gird for a wave of COVID patients that never came. 

Now hospitals are laying off and furloughing by the tens of thousands – and liberal opportunists see this, somehow, as a market failure that would justify government directly seizing control of the medical system through a socialized, Medicare-for-all plan.  Somehow, liberals look at the virus response in Italy, Spain, France, and the United Kingdom and think – that’s what we need here.  But we don’t have to look to the catastrophic failures of single payer systems abroad as a cautionary tale, because here in America the two biggest failures in our coronavirus responses were failures of centralized government control.

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