Patient Advocates Are Afraid of What’s Happening in America’s Nursing Homes
America’s nursing homes have been under intense scrutiny during the COVID-19 pandemic, with some of the country’s largest case clusters originating within their walls.
Under pressure and grappling with staffing and equipment shortages, nursing facilities are advocating—often successfully—for expanded legal protections for the decisions they make in response to this extraordinary public-health threat. The industry calls it necessary security in the face of an unprecedented pandemic. But patient advocates call it “a license for neglect.”
At least 18 states have granted nursing homes some degree of legal immunity related to the pandemic, making it more difficult for them to be sued for the way they treat residents. Industry groups are trying to secure similar protections in at least 10 additional states, reports TIME staff writer Abigail Abrams.
That’s making patient advocates, industry watchdogs and personal-injury attorneys nervous. As Abrams notes, nursing homes have struggled with issues like infection control and adequate staffing for years. These problems have been exacerbated by the pandemic, but they’re hardly new—and some advocates fear nursing facilities are using COVID-19 as a convenient cover for their shortcomings. “Now instead of [holding them] liable for the pain and suffering that they’re causing, we’re going to bail them out with a liability shield? That’s a horrible precedent,” health care lawyer Matthew Cortland told Abrams.
These protections also come at a time when long-term care centers have little oversight. On the premise that it would help stop the spread of disease, many have limited or entirely restricted visitor access (including, sometimes, state investigators). That’s sensible, but it also means family members—often fierce patient advocates—aren’t around to see their loved ones’ care up close. Without those outside voices, and with these new legal shields, many watchdogs fear what’s going on behind closed doors.
“Underlying the request [for immunity],” Richard Mollot, executive director of the New York-based Long Term Care Community Coalition, told Abrams, “is essentially an admission that nursing homes are not capable of taking care of their residents.”
More than 4.4 million people around the world had been sickened by COVID-19 as of 8 PM eastern time last night, and more than 300,000 people had died.
Here is every country with over 40,000 confirmed cases:
The Trump Administration has repeatedly criticized the World Health Organization (WHO), and its director-general Dr. Tedros Adhanom Ghebreyesus, for being too friendly toward China, often pointing to Tedros’ praise of the country’s coronavirus response in late January. A new Reuters report reveals that some WHO officials were afraid of exactly that perception, and urged Tedros to use less effusive language in his public comments during the early days of the pandemic. Tedros refused, in part because he wanted to ensure China’s cooperation with the WHO’s efforts—a necessity, since the WHO cannot enter countries without their explicit permission. The back-and-forth illustrates the tightrope walked by the world’s top global health authority.
American conservatives have found an unlikely muse in Sweden, which took a notably lax approach to coronavirus containment (and has seen death rates soar by 30% during the pandemic, compared to a normal spring). People protesting U.S. lockdowns often urge lawmakers to “be more like Sweden”—but, as NBC News reports, Swedes say these activists don’t understand the country’s strategy. While many in America see Sweden as an argument for prioritizing economic stability, many Swedish experts say their system is a public-health-minded approach tailored to a small country with universal health care.
Also in Europe, Russia is emerging as a new coronavirus hotspot, with more than 250,000 cases and 2,300 deaths in total as of yesterday. Precautions like lockdowns and stay-at-home orders came too late and have not been followed adequately, experts say, and the country was also slow to scale up its testing capacity. Protective equipment shortages and overwhelmed hospitals have also led to continued spread—but President Vladimir Putin is lifting lockdown measures anyway.
Coronavirus has made its way to the Rohingya refugee camps in southern Bangladesh. A widespread outbreak could be devastating for the 1 million people who live shoulder-to-shoulder in these camps, experts fear.
The Situation in the United States
The total number of COVID-19 diagnoses in the U.S. rose to more than 1,417,000 as of 8 PM eastern time yesterday, and the death toll neared 86,000.
New economic data released today show U.S. retail sales dropped by a record 16.4% from March to April. Meanwhile, the House of Representatives today moved closer to passing a massive new aid package: a $3 trillion coronavirus relief effort put together by Congressional Democrats. The House will also decide on a rule change that would allow lawmakers to vote on bills remotely during the pandemic. Both measures are expected to pass the House, but not the GOP-led Senate. President Donald Trump has also threatened to veto the bill.
As Texas—like many U.S. states, including hard-hit New York—continues to take steps in a process of reopening, discontent is brewing. In many cases, Democratic city leaders are calling for more stringent disease-management measures than have been recommended by Republican state leaders, causing tension at nearly every level of Texas government. Similar lines have been drawn in states like Georgia and Oklahoma.
New guidelines from the U.S. Centers for Disease Control and Prevention (CDC) may help, at least a little. The agency yesterday released much-needed guidance for schools, businesses and organizations wondering whether they’re ready to reopen. But the “decision tool” documents are shortened and condensed versions of the CDC’s full blueprint on reopening, which was reportedly buried by the Trump Administration. The new guidance, for example, does not include prior CDC recommendations for churches and religious groups.
The White House, which has often pointed to its robust internal testing regimen, is relying on a rapid test made by medical device company Abbott Laboratories. But research suggests the machine has a high rate of false negatives, and the FDA warned earlier today that secondary testing may be needed to confirm its results.
In a bit of optimistic news, Dr. Frances Collins, director of the National Institutes of Health, said today that he expects large-scale COVID-19 vaccine trials to begin by July, in pursuit of the “stretch goal” of having one ready by January 2021.
All numbers are from the Johns Hopkins University Center for Systems Science and Engineering, and are accurate as of May 14, 8 PM eastern time. To see larger, interactive versions of these maps and charts, click here.
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WHAT ELSE YOU SHOULD KNOW
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For Asylum Seekers In Mexico, COVID-19 Could Be ‘Devastating’
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What Jane Austen Can Teach Us About Staying Home
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Why the U.S. Should Function More Like a Hospital
Writing in the New Yorker, physician and author Dr. Atul Gawande argues that if Americans at large adopted infection-control practices used in hospitals, the country could set itself on a good path toward reopening. Read more here.
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Today’s newsletter was written byJamie Ducharme and edited by Elijah Wolfson.
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