State Report: COVID-19 Brought into Nursing Homes by Staff

The Hamptons Center for Rehabilitations and Nursing in Southampton.

Data, analyzed by the New York State Department of Health, points toward the staff at nursing home for unknowingly introducing and spreading the novel coronavirus in facilities across the state.

The state health department conducted an in-depth analysis that concluded, in a report released Monday, that COVID-19 fatalities in nursing homes were related to infected nursing home staff. There are approximately 101,000 nursing home residents in 613 facilities throughout the state. Nursing homes accounted for about 21 percent of the state’s approximately 25,000 COVID-19 fatalities.

​”The data shows that the nursing home residents got COVID from the staff, and presumably, also from those who visited them,” Dr. Howard Zucker, the New York State Commissioner of Health, said in a statement. There was no data available to track how family visiting residents helped spread the disease.

“Unfortunately, we did not understand the disease early on, we did not realize how widespread it was within our community, and therefore, it was able to be introduced into a vulnerable population,” he said. “As best as we could, using the tools that we have, we looked to determine the relationships between timelines and outcomes, between infectivity and symptomatology, between onset of illness and death. We looked at the facts.”

The state’s report found that the timing of staff infections correlated with the timing of peak nursing home resident mortality across the state.

According to data submitted by nursing homes, approximately 37,500 nursing home staff members were infected with COVID-19 between March and early June 2020. That is one in four of the state’s approximately 158,000 nursing home workers who were infected.

Of the 37,500 nursing home staff infected, nearly 7,000 of them were working in facilities in the month of March, during which more than a third of the state’s nursing home facilities had residents who tested positive. “It is likely that thousands of employees who were infected in mid-March transmitted the virus unknowingly—through no fault of their own—while working, which then led to resident infection,” the report said.

In total, 6,432 nursing home residents in 509 facilities statewide died of COVID-19, according to a New York Times analysis referred to in the study. The total number of people infected was 7,177.

Infections among employees were in line with regions that were most impacted. The most impacted regions in New York State was the downstate region, which includes New York City and Long Island. Along with the Mid-Hudson region, the city and the island also had the highest nursing home fatality rates.

State data available through July 5 shows that, in Suffolk County, 549 nursing resident died of COVID-19, and another 228 are presumed to have died from the virus. Also, there were 32 confirmed deaths reported at assisted living facilities and another 13 presumed deaths in those facilities.

Six peopled at Peconic Landing in Greenport—one of the first places on the East End to experience an outbreak—with another three presumed to have died. A total of 17 died at the Westhampton Care Center and 15 died at the Peconic Bay Skilled Nursing Facility in Riverhead. The Hamptons Center for Rehabilitation and Nursing in Southampton reported six confirmed deaths and another 14 presumed deaths.

The peak of nursing home fatalities came in early April, and the report indicates that, given the incubation period for COVID-19, it is in line with when employees were unknowingly spreading the virus. The first case in a New York nursing home was on March 25 when a nursing home staff member tested positive.

In March, the U.S. Centers for Disease Control and Prevention did not suspect asymptomatic people of spreading the virus. “Moreover, CDC also issued guidance on March 7, 2020 that stated certain asymptomatic healthcare personnel exposed to others with the virus were ‘not restricted from work,'” the report said. “This early, and ultimately erroneous, understanding of viral spread allowed many nursing home COVID-positive employees to continue working. It was not until much later, as the true number of asymptomatic cases became clear, that evidence based upon contact tracing established definitively that asymptomatic people were in fact capable of spreading the virus.”

On March 13, the state DOH mandated staff have their temperature checked before each shift and ordered them to use face masks. Governor Andrew Cuomo also issued an executive order banning visitation at all nursing homes.

It was not until May 10, however, that the state mandated twice-weekly testing of staff, which was later knocked down to one weekly test as regions moved into Phase 3 and Phase 4. Between May 20 and June 16, approximately 9,000 staff tested positive.

The state shot down the possibility that residents were infected by other COVID-19 positive patients.

The report also found that peak nursing home admissions occurred a week after peak nursing home mortality, “therefore illustrating that nursing home admissions from hospitals were not a driver of nursing home infections or fatalities.” The report said, “Most patients admitted to nursing homes from hospitals were no longer contagious when admitted and therefore were not a source of infection.”

The full report can be viewed on the state’s website.

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