Why are nursing home COVID deaths doubling in Florida? Advocates blame testing

An alarming increase in coronavirus infections and deaths in nursing homes in Florida since October has warned advocates of geriatric care that the lack of a state strategy for accurate and immediate testing in nursing homes will mean this holiday season will be a heartbreaking one for many.
On Tuesday, AARP released a report showing that the COVID-19 death rate among Florida nursing home residents doubled in the three weeks surrounding Thanksgiving, and infections among the state's most vulnerable residents have continued to rise. The rise in the death toll was so alarming that AARP decided to report on the data instead of waiting for the scheduled January 10 monthly release.
"The underlying problem is the persistent inability to provide accurate and rapid results to everyone entering elderly care facilities - employees, visitors, family carers and salespeople," said David Bruns, spokesman for AARP.
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“Without a change in policy, this increase will increase. People are going to die, ”warned Brian Lee, director of Families for Better Care, a nonprofit that helps families of nursing home residents. "It is a total disaster because the governor and his team could have saved lives."
Also on Tuesday, Governor Ron DeSantis held a press conference at The Villages retirement community to announce that Floridians over 70 will be next in line to get vaccinated against COVID-19, before key workers and younger people join underlying health problems. On Wednesday, he said he would sign an executive order prioritizing vaccines for people over 65. He advocated this demonstration for one of five Floridians in the ongoing debate among public health experts about who should come first with the vaccine.
"If you're in the older population this is coming soon and just stick with it," DeSantis said Tuesday. "We're a lot further than we thought four months ago."
However, for advocates of elderly care, the focus on the vaccine is a positive move, but it shouldn't shift focus from the deadly numbers that occur in long-term care facilities.
"Gov. DeSantis is ignoring the infection surge by shifting the narrative to vaccine use, "Lee said.
According to the state's December 21 report, COVID-19 killed 7,938 Florida residents and elderly care facility workers for the first time since the summer surge, whose infections have exceeded staff.
"This is hardly unique in Florida," said Bruns of AARP. “Nine months after the pandemic emergency, we still cannot reliably identify who might be bringing the virus into these facilities and stop them at the door. This means the virus can continue to exploit longstanding infection control vulnerabilities that have weighed on the long-term care industry for decades. "
Optional testing does not work
When elders leave their homes to visit loved ones or to welcome visitors over the holidays, the state does not need to test anyone to prevent the infection from spreading. It allows each institution to set its own rules.
"Optional testing was a serious mistake," said Lee. When the state reopened visiting policies in October, Surgeon General Scott Rivkees suggested that tests should be required but did not request it, he said.
The result, he said, is that testing is optional and "the facilities are still in the dark".
"People who go to family vacations are not tested when they return," said Lee. "People don't know if you've come into contact with someone who doesn't show symptoms of the virus and can bring it back to the facility."
For months, Lee has been advocating rapid molecular point-of-care tests for visitors to the site as well as residents returning to facilities.
"A better strategy would be to support testing with the right equipment and testing along with the vaccine," Lee said. "Families who want to visit loved ones will not be vaccinated for months. There will be residents and staff who refuse to be vaccinated, so facilities still need robust molecular tests at the door."
DeSantis and state health officials have stated since March that their priority is "protecting the vulnerable," and they have stated that they have prioritized the distribution of testing resources and personal protective equipment to long-term care facilities.
According to industry reports reported to the federal government, more than 93 percent of Florida geriatric care facilities had at least one coronavirus case since January, and as of December one in seven Florida nursing homes said they had less than a week of valuable personal protective equipment for employees , Residents and visitors.
ALFs have to wait for the vaccine
Questions also arise about how long elders have to wait for the vaccine. When the governor watched The Villages age community members being vaccinated on Tuesday, ALF administrators were told they would have to wait for their residents to line up.
In an email on Wednesday from a sales manager at Omnicare, the CVS company that manages the vaccine in Florida nursing homes and assisted living facilities, an ALF official was told that the company “does not have ALF communities in Florida for plan for vaccine distribution ”but“ wait ”in the governor's office to activate ALF communities. "
Bruns, the AARP spokesman, said "Florida is way better than most states at dealing with pandemics." “Given the catastrophic failure of federal, state and industry governments to protect these vulnerable people and the fact that nearly 8,000 people died from infections that began in Florida elderly care facilities, there's nothing to celebrate here. No state protects frail elders well.
"We need a new vision for long-term care in the Sunshine State."
Meanwhile, the AARP, which has also emerged as a critic of the way the state manages its elderly care industry and people with disabilities, has partnered with other advocates like Families for Better Care to make a fundamental change in Florida's approach Call for nursing homes and long-term care.
Lost trust
"Consumer confidence in the large residential long-term care system has collapsed," the AARP website said. "Families are reluctant to put their loved ones in facilities that have become petri dishes for contagion and to greatly reduce occupancy rates in nursing homes and assisted living facilities."
Among the practices that have allowed COVID-19 and other infections such as flu, MRSA, staph, and strep infections to become entrenched in most nursing homes and many assisted living facilities, are evolving around meals and socializing. Residents are being taken from their rooms to gather for meals and activities.
Instead, AARP calls for residents and employees to be decentralized into smaller groups in order to limit the risk of infection and promote the health of residents.
"In many ways, the pandemic has forced us to face the challenges of caring for elderly Floridians," said Jeff Johnson, state director of AARP Florida. "It is clearly time for a better, more effective system that will help millions of elderly Floridians live in their homes and communities for as long as possible and then get the care they deserve when residential facilities are the appropriate environment."
The organization is calling for an end to the so-called bias in the Florida state budget that prioritizes home care funding and institutional nursing home placement, rather than empowering and assisting 2.9 million family caregivers to care for elders at home and home in their communities. "
Johnson said about 79 percent of Florida nursing home funding comes from public funds through Medicaid and Medicare programs. "But for years state and state governments have been tightening long-standing problems."
Although Florida lawmakers have remained on the sidelines as DeSantis has been overseeing the messaging and response to the pandemic, lawmakers have considered giving companies that operate long-term care facilities immunity from civil suits.
Johnson said AARP Florida firmly opposes such a proposal.
"Florida law already makes it difficult for families to bring nursing home operators to justice for negligent acts or omissions of their residents," he said. "Immunity would give these companies impunity to evade responsibility for the supplies that taxpayers and families have paid for."
The Tampa Bay Times Tallahassee reporter Lawrence Mower contributed to this report.
Mary Ellen Klas can be reached at meklas@miamiherald.com and @MaryEllenKlas

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