As more details emerge of the early days of the Covid-19 outbreak in the United States, perhaps the most disturbing chapter is the tragedy that befell nursing homes. According to the Center of Infectious Disease Research and Policy, only 1 percent of Americans reside in nursing homes or long-term-care facilities (LTCFs), but this group accounts for 40 percent of all Covid-19 deaths. This high mortality rate can be explained, in part, by the reality that such populations are significantly more prone to the cardiac, respiratory, and renal comorbidities that predispose individuals to bad health outcomes. Tragically, however, a great deal of the nursing-home mortality rate is also due to a misguided—and arguably negligent—policy of discharging Covid-19 patients directly to these facilities.
The March 25 order by New York governor Andrew Cuomo and state health chief Howard Zucker mandated that nursing homes and LTCFs accept patients discharged from hospitals, even if they received only emergency care and were still infectious; it is now reported that 6,300 Covid patients were sent to nursing homes throughout the state. The motivation behind the order was understandable: in late March, public concern was high that Covid-19 cases would overwhelm New York’s hospital capacity. Yet, despite an impressive deployment of surge capacity from the federal government (much of which went unused), Cuomo’s order remained in place for almost two months, not being rescinded until May 10.
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