New York City’s Nursing Homes Brace for Coronavirus

How are the city’s elderly homes and long-term care facilities preparing for a global health epidemic?

The elderly are among the most vulnerable populations amidst the coronavirus outbreak / Photo by Alex Boyd on Unsplash

Nursing homes in New York City are gearing up to protect their residents from the coronavirus, following the state health department’s advice to take preventive measures against the introduction of the virus in their facilities.

The rapid spread of the potentially deadly virus, and especially the pocket of fatalities in a Kirkland, Washington facility, has raised alarms over safeguarding the city’s and the nation’s most vulnerable populations: the elderly and those with underlying health conditions.

“If you haven’t dusted off your pandemic plans, now would be a good time to do so,” medical epidemiologist Joel Ackelsberg, M.D., told healthcare providers during a call held last week by the New York State Department of Health and the New York City Department of Health & Mental Hygiene.

There are more than 600 nursing homes in the state of New York. Recognizing the vulnerability of its elderly residents—21.2 percent of the population are aged 60 and older—state and city agencies are stepping in to provide guidance to healthcare facilities.

The combination of existing illnesses, a constant cycling in and out of visitors and staff members, and a common food distribution system, where all the food is prepared in one location, makes nursing homes “ripe for an epidemic,” explained Jack Caravanos, Doctor of Public Health and a professor at New York University’s School of Global Public Health.

The Department of Health has been hosting weekly calls to address questions by healthcare providers regarding preparations for the coronavirus in New York. Mary Foote, M.D., an infectious disease specialist at the city’s DOH, stressed last week why it’s important for nursing home facilities to do what they can to stop the introduction of respiratory germs by effectively communicating the danger to visitors and reviewing staffing plans.

The measures taken by the state come after the coronavirus struck the Life Care Center, a nursing facility in Kirkland, Wash., earlier this month, becoming what many call the epicenter of the COVID-19 outbreak in the United States. As of Tuesday, there were at least 27 coronavirus deaths in the U.S.—18 of which have been linked to the Life Care Center, Seattle authorities said. New York now has at least 173 cases, according to Gov. Andrew Cuomo, though there have been no reported deaths.

The novel coronavirus has proven especially deadly for the elderly. The mortality fate in China for those over 80 years old is an estimated 21.9 percent, according to the World Health Organization.

Around 2.5 million Americans live in nursing homes and assisted living facilities, and approximately 80 percent of seniors have at least one chronic health condition, according to the National Council on Aging.

Nursing homes and other long-term care facilities in New York are following the guidance of the Centers for Disease Control and Prevention and the state health department.

“We’ve put into action a comprehensive infection control program, educating the public, staff and families on the coronavirus,” said Jerry Enella, administrator at the Sapphire Center for Rehabilitation and Nursing in Flushing, Queens. The facility has also installed hand sanitizer dispensers throughout the building and have instated mandatory mask use and hand-washing upon entry.

Nursing homes must post signage addressing visitation restrictions at all public entrances to the facility, as well as on the nursing home’s website / Source: New York State Department of Health

Nursing homes must post signage addressing visitation restrictions at all public entrances to the facility, as well as on the nursing home’s website / Source: New York State Department of Health

Best practices provided by government officials aim to prevent the shortage of masks. Health facilities are instructed to keep close inventory of personal protective equipment, including masks and surgical gloves. They are also advised to keep them locked up in a secure place to ensure that only authorized staff members can access them, according to guidance posted by the New York State Facilities Association.

Nursing home leaders said on Tuesday that they are recommending strict limits on visits for these centers nationwide. At the Sapphire Center, visitors are permitted on a case-by-case basis for the time being. “If they’re showing any symptoms, they’re not coming in. The residents here are safe—it’s what the others are bringing in that’s the problem,” said Enella.

Some medical experts, like NYU’s Caravanos, believe that while these measures can be very effective, “we probably need to ramp up some of the practices.”

“I have to say that if my mother was in a nursing home right now, I don’t know whether I wouldn’t just take care of her privately, or take the chance that she may be infected [at a nursing home,]” said Caravanos. “It’s almost like a forest fire… That’s how I see nursing homes. It’s almost like a fire site ready to explode.”

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