A relative of ours was in a personal care facility in Pennsylvania when Covid hit and it meant our family couldn't visit her, and we were very worried since she was high risk (obesity and diabetes).
Many nursing home patients had a poor immune system due to cancer, age, obesity, diabetes, renal failure, etc. (which is why many die despite having the vaccine).
But early in the epidemic, isolation was the most important way to stop the spread. So visitors, who are much needed to keep up the morale of the elderly in these homes, were restricted.
So why did so many states push to allow post hospital covid positive patients to be readmitted?
It's complicated but it amounts to thinking that regulations make it safe, even when regulations are not followed.
The rational was that hey, the nursing homes could keep them safely isolated.
Yup. That's what the regulations and documents stated, but anyone who knows about nursing homes knew that, not only did many lack PPE early in the epidemic (blamed on Trumpieboy but actually because the administrators didn't want to spend money to stock up on these, and took their time in ordering more), but the staff didn't use them properly.
Indeed, the authorities knew that this was a problem: From March 2020:
In the initial wave of surveys during the week of March 30, CMS found that 36 percent of facilities inspected in recent days did not follow proper hand washing guidelines and 25 percent failed to demonstrate proper use of personal protective equipment (PPE). Both of these are longstanding infection control measures that all nursing homes are expected to follow per Federal regulation.
The background to this is that many of the staff were poorly trained and overworked.
So why insist that post hospitalization infectious covid patients be placed back into their nursing homes?
The regulation behind this is not new and the idea is to get long term patients out of expensive hospital beds into cheaper nursing home beds.
and the problem didn't start with Covid.
One of our nursing homes in Minnesota back in the late 1990s had an ongoing fight with the authorities who insisted we admit a patient with Vancomycin resistant Staph aureus, meaning that the germ was resistant to all antibiotics.
Now, this nursing home had many patients with diabetic ulcers who were there mainly because they couldn't travel during the wintertime to get daily treatment. If these wounds were infected with a resistant germ, it could lead to amputation or death.
But never mind: On paper the patient could be isolated and kept safe.
and that is the real problem: rules vs reality.
or as the scientist who cracked the facade about the Challenger disaster noted:
Regulations matter, but regulations not connected to reality are essentially CYA lies, meant to protect the bureaucrats, not the patients. So why didn't doctors or nurses working for the government point this out? Yes, it's hard to fire a government employee, but they can make your life hell until you quit.
I know: because I worked as a physician for both the state and the federal (IHS) systems and was always in trouble because I put the patient's welfare before the regulations.
But not everyone does this, which is why I suspect Dr. L managed to get her job: I suspect she was a team player. And of course, being a team player, she decided not to object to these dangerous regulations when it came to covid.
The governors could plead ignorance, because hey they are politicians, not doctors.
But what about doctors who go along with the regulations even though they knew it was nonsense? And indeed, their actions proved that they knew the practice was dangerous.
As this Newsweek article from May 2020 pointed out:
Pennsylvania Health Secretary Moved Mother Out Of Nursing Home As Coronavirus Death Toll Increased In State....
Yup. She put your relatives into danger while making sure her own mother was safe in a hotel.
Again from that May 2020 article in Newsweek:
Outbreaks in Pennsylvania long-term care facilities make up nearly 70 percent of the state's coronavirus-related deaths and 21 percent of the state's positive cases of the virus. In a Wednesday press conference, Levine announced that of the 58,698 confirmed cases statewide, 12,408 cases are among residents of long-term facilities, including nursing homes and personal care homes. Of the total 3,943 deaths in Pennsylvania, 2,705 have occurred in residents in long-term facilities....
In this article from a small town Pennsylvania newspaper in June 2020, she defends the policy:
Levine defends returning nursing home residents to facilities after coronavirus treatment: 'The virus was already there,' she says....
Pennsylvania Department of Health Secretary Rachel Levine on Monday downplayed a point that critics of the state’s coronavirus response in nursing homes and long-term-care facilities regularly make: that returning residents who had been treated in hospitals for the virus to their homes at the facilities helped speed its spread.
She said that the state followed federal Center for Medicare and Medicaid Services guidelines that if a resident has tested positive for COVID-19 at a facility and then required hospitalization, that when they recovered, they were returned home to their facility.
Italics mine. Has any reporter found out who in the vast Medicare bureaucracy put out that regulation?
She said the state instituted guidelines provided by the Centers for Disease Control and Prevention in early in March when the first cases were detected in Pennsylvania, including limiting outside visitors from entering long-term-care facilities. “They contracted the virus in the facility. So it doesn’t mean they were bringing it to the facility. The virus was already there,” she said Monday during her daily press briefing.
again italics mine.
This is an untrue statement, since the possibility of spreading infection goes higher with the increase in the number of people with the infection.
But it does recognize that many people with covid weren't sick enough to be placed in hospitals, so yes, they could spread it within the institutions, who did not have adequate PPE or isolation rooms or staff to handle these cases.
the smart thing would have been to designate one facility to handle these patients in proper isolation in a different facility in order to protect the other patients. In the past, this was done with TB, for example, and I am old enough to remember when Philadelphia had a TB hospital and an infectious disease hospital to isolate cases that needed care.
Putting covid positive post hospital patients in these homes should have been a viable option: but the dirty little secret is that the paperwork and regulations stopped that from becoming reality.
Hey, that would mess up the protocols of insisting they return to their usual nursing home bed.
So place the "Republican pounce" headline here.
However, others see it differently. State Sen. Doug Mastriano, a Republican from Franklin County, called for Levine’s resignation May 11, saying her actions were a major factor in the large number of COVID-19 cases and deaths in the state’s nursing homes. “These failings are compounded by being complicit in the virus spreading through our elder care homes, triggered by unscientific and illogical directives, forcing them to readmit COVID-19 patients,” he said in part, adding, “Let me state this clearly, this order by Secretary Levine is responsible for the deaths of approximately 2,500 of our citizens, and displays the gross incompetence of someone unfit for office. The bottom line is Secretary Levine has failed to protect our most vulnerable population.”
The failure of the CDC and regulatory bodies in the covid epidemic are legion, but hey the press just blamed Trump for the bureaucratic mindset that put following regulations as more important than fixing things.
So why is a physician who obviously put cooperation with regulations as more important than patient's lives being placed as head of the nation's public health service?
Partly because, as someone with a history of being a team player, one doubts she will do the needed firing and reforms needed to make the America public health system do their job.
But as you can see from the ecstatic headlines, the job was given to her, not for her competence (?/S) but because she used to be a man.
And to make things worse, it was nominating an outsider despite the fact that the PHS Commissioned Corps has many many well qualified minority physicians who could do the work, but I guess if you are a trans activist, it doesn't matter if you are white.
And it is politically correct to push trans rights, even if the nominee has been shown to be willing to let people die in order to be a team player.
I won't put up her photo: The right makes fun of her all the time for her appearance, but my only comment is that she needs a fashion makeover by Vice Ganda.
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