April 21 update: Michigan to identify nursing homes infected by the coronavirus
More than 2,200 coronavirus deaths have now been recorded in Michigan, and one recent trend has been stark: the rising age of people dying from the virus.
On April 1, the median age of Michigan COVID-19 deaths was 72. By Thursday, that number had risen to 75.
In the past week, fully 42 percent of Michigan deaths involved people 80 or older.
Anecdotal reports suggest the virus is exacting a grim toll in nursing homes across the state, with the most recent, by the Detroit Free Press, chronicling hundreds of confirmed cases and dozens of deaths. Michigan Gov. Gretchen Whitmer has taken note, stepping up coronavirus safety protocols in nursing homes and other long-term care facilities.
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“I will continue to do everything in my power to protect Michiganders everywhere from the spread of this virus,” she said in a statement.
Everything, that is, except tell the public which nursing homes are infected with COVID-19.
A growing number of states are now publicly listing the names of nursing homes where residents or nursing staff have tested positive for the coronavirus.
But as Bridge has reported, Michigan won’t say which of the state’s 450 nursing homes are battling infections. Whitmer’s office did not return Bridge inquiries this week asking about its policy.
It’s a void, critics say, that continues to keep nursing home residents and their families in the dark during a deadly pandemic.
“As long as it does not identify individuals in homes, I do not see a good reason for [the names of nursing homes] not to be made public,” said Sarah Slocum, co-director of the Program to Improve Eldercare, an Ann Arbor-based nonprofit research and advocacy platform.
“We are already seeing through media reports that certain nursing homes have become hotspots. That alone should make it a priority for public surveillance. This is data the public would want to track.”
Health officials have warned for weeks that elderly residents of nursing homes are at grave risk of contracting COVID-19 and dying. A report from China’s Center for Disease Control and Prevention found that nearly 15 percent of people in their 80s who contracted the virus died. Experts say that rate is likely higher for those seniors with underlying conditions like heart and lung disease and diabetes.
A national advocate for improved nursing home care has called the Whitmer administration’s failure to identify infected homes “a travesty.”
“This is a disservice to residents and health care workers and especially the families who are out there wondering if there is an outbreak in a loved one’s home,” Brian Lee, executive director of Families for Better Care, a Texas-based nonprofit advocacy group, told Bridge earlier this month.
Whitmer signed an executive order Wednesday in an effort to better protect residents and staff at long-term care facilities. Among other things, the order requires facilities to report confirmed cases of residents with COVID-19 to staff within 12 hours, and to the local health department within 24 hours. Facilities must also keep up-to-date records on supplies of personal protective equipment.
Michigan’s Department of Health and Human Services also added data to its website listing the number of “congregate settings” in Michigan by county with “respiratory outbreaks.” It’s unclear how many of those are COVID-19, and the department does not separate nursing homes from other group settings such as prisons or homeless shelters.
Bridge reached out to a spokesperson for MDHHS and asked if the department would disclose the names of nursing homes with COVID-19 cases or deaths. The spokesperson provided a link to the new "congregate settings" data and, after this article was published, sent the following statement:
"We are glad we could move forward this week with posting the number of congregate care facilities reporting cases of respiratory illness on our website, which would include COVID-19. Currently, not all nursing homes report to the local health departments regarding a case or outbreak, and therefore our current data reflects only those who have proactively reached out to report and request assistance. There are likely others who have not reported, and we are actively working on policy changes that would address that. We look forward to continuing to improve data reporting and sharing that information with the public."
Slocum, the Ann Arbor eldercare advocate, said that until recently the lack of statewide reporting on COVID-19 in nursing homes made it hard for public health officials to know where resources like masks and gowns are needed.
“For personal protective equipment, how do you effectively ascertain where that equipment is needed?” she said.
She said it’s possible Whitmer’s executive order could help health officials target possible nursing hotspots, given that it requires homes to report COVID-19 cases to local health departments.
Earlier this month, Detroit Mayor Duggan launched a plan to send medical students to test for COVID-19 in each of the city’s 27 nursing homes. But Vickie Winn, spokesperson for the Detroit Health Department, told Bridge it would not release the names of homes with positive tests or list the number of positive tests in those homes.
“To preserve the privacy of these institutions, their residents and staff, details of COVID-19 testing are not being shared publicly at this time,” she said in a statement.
That may be a moot point now, as Detroit officials have said that all the city’s nursing homes have confirmed or suspected cases of COVID-19.
On Friday, Duggan said at least 98 Detroit nursing home residents have died from COVID-19, out of more than 530 overall deaths in the city. He said 30 percent of nursing home residents tested so far were positive for COVID-19.
News reports and scattered public reporting suggest that number is rising.
In the meantime, the public is left with what seems like random disclosure of nursing homes with significant COVID-19 outbreaks. These reports could come from news stories, a local county health department – or the nursing home itself.
On April 10, the Wayne County Health Department reported 21 residents had died of COVID-19 at two nursing homes, with 46 other residents with confirmed cases of the coronavirus.
In Genesee County, health officials confirmed four COVID-19 deaths and 16 total cases at a Grand Blanc Township nursing home. In March, a Kent County nursing home issued a statement acknowledging that 31 residents and five staff members had tested positive for COVID-19. Six residents have since died.
On Friday, an official at Hillsdale Hospital in rural southern Michigan reported in a Facebook video that a county nursing home had 42 cases of COVID-19 among staff and residents, with seven nursing home deaths among 10 total coronavirus deaths in the county.
Other states are far more transparent than the Whitmer administration in identifying coronavirus deaths linked to nursing homes.
In Washington state, where the Life Care Center of Kirkland registered 167 infections and 37 deaths, the state Department of Social and Health Services earlier this month listed the names and locations of 137 long-term care facilities with COVID-19 cases, broken down by nursing homes, assisted-living centers, adult family homes and other facilities.
Connecticut lists nursing homes where residents test positive for the coronavirus, and breaks down state totals by residents who are sick, hospitalized or who have died from the virus. Tennessee recently began listing the names of facilities where there were confirmed cases of COVID-19.
While there’s no firm national data on the number of COVID-19 deaths tied to nursing homes, an NBC News investigation found the number of reported U.S. deaths in long-term care facilities doubled in a week, to 5,670 as of Wednesday. The report said the actual number is likely “significantly higher” because of incomplete reporting in many states.
An NBC News survey found that state health departments in 17 states disclosed the names of nursing homes with COVID-19 cases. (A Maryland publication, Baltimore Brew, put the number of states at 19.) Michigan was not among them.’
The federal government does not track nursing home residents who have died from the virus or the numbers of facilities that have had outbreaks.
Teena Chopra, a professor of infectious diseases at Wayne State University who leads infection control for the Detroit Medical Center’s eight hospitals, tied many of its COVID-19 deaths to a high rate of elderly patients sickened at area nursing homes. DMC does not publicly report the number of COVID-19 cases and deaths.
"We are seeing a lot of nursing home populations brought to us very sick, and coming to us with severe illness," she said.
Underlying health issues may make the symptoms of COVID-19 more difficult to detect in nursing home populations, she said, because "their biological age is different from their physical age."
"They have very subtle symptoms, because their immunity is lower and they may not mount a fever like others can," she said. It may be several days before caregivers suspect a COVID-19 infection "and by then it's too late.
Although the city of Detroit has begun a project to test nursing home staff and residents, Chopra expressed frustration that it hadn't happened sooner and also said it shouldn't be limited to Detroit.
"We need to test everybody in a nursing home and separate the positive cases from the ones who are negative," she said.
Bridge reporter Kelly House contributed to this report.
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