CALIFORNIA ORDERS NURSING HOMES TO ADMIT RESIDENTS WITH COVID-19; EXPERTS CALL DIRECTIVE A “DEATH SENTENCE”

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By Miriam Raftery

April 1, 2020 (San Diego) -- After weeks of warning Californians about the deadly threat the coronavirus poses to nursing home residents, the State of California on March 30th ordered California nursing home operators to bring the virus into their facilities, “knowing full well it is likely to kill many residents,” says Michael Dark, staff attorney at California Advocates for Nursing Home Reform (CANHR).

In an interview with ECM, Dark, said the California Association for Long Term Care Medicine, a physicians’ organization, has also adopted an emergency resolution opposing the move. 

“I think that there will be litigation if the state doesn’t rapidly clarify its position,” he told ECM, “ because it’s putting grave danger.” 

The order came after some nursing home residents admitted to hospitals for treatment of COVID-19 or other conditions were later refused readmission to nursing homes upon discharge from hospitals, leaving them potentially with no place to go amid the pandemic.

The March 30, 2020 directive from the California Department of Public Health to skilled nursing facilities states: “SNFs shall not refuse to admit or readmit a resident based on their status as a suspected or confirmed COVID-19 case. SNFs shall institute appropriate precautions to prevent the spread of infection to health care personnel and other residents,” the order continues.

California issued its directive while coronavirus outbreaks are spiking in dozens of nursing homes throughout the state, yet the state is refusing to identify nursing homes with outbreaks, leaving residents to worry that they are at immediate risk of infection and death.

Dr. Karl Steinberg, a nursing home and hospice medical director in San Diego’s North County, called the order reckless in an interview with KPBS.  “What responsible healthcare provider would willingly put somebody who has this deadly, contagious illness into a place where it doesn’t already exist?" he asked. "To me, that’s essentially being an accessory to homicide.”

He adds, “We know this is a virus that targets the elderly and the seriously ill and that is the population in a skilled nursing home.”

COVID-19 outbreaks in Europe, the state of Washington and elsewhere have swept through nursing homes, infecting and killing large numbers of residents. The New York Times reports today that nursing homes account for one in four coronavirus deaths in New York City.

“Sacrificing the lives of beloved nursing home residents is beyond unconscionable,” said Patricia McGinnis, CANHR’s executive director. “California’s directive is nothing less than a death sentence for countless residents. The State should instead look to alternative locations such as hotels and conference centers as much safer places to send COVID-19 patients for care.”

The state is talking about taking people well enough to be on their own out of hospitals, who could be sent to a hotel or conference center as New York and South Korea have done, instead of sending them to nursing homes.

The California directive further endangers residents by waiving both minimum staffing requirements and occupancy limits for skilled nursing facilities. Cramming infected patients into crowded, understaffed facilities with extraordinarily vulnerable residents is a recipe for disaster, states a press released issued by CANHR.

By any measure, California nursing homes are unprepared for this pandemic. There are shortages of personal protective equipment (PPE). Nursing homes are more understaffed than ever as caregivers stay home because they are ill with the virus or caring for out-of-school children. 

Routine inspections and investigations of nursing homes have been cancelled during the pandemic, leaving them essentially unregulated. Most inspectors have been reassigned to desk duties. Ombudsmen are locked out of facilities as are family members, friends and other visitors who might at other times sound the alarm when residents are neglected.  

“There are no witnesses to the suffering residents are enduring as they get sick and die alone,” CANHR’s release states.  “The lives of people in California’s nursing homes are as precious as any other. It is time for California to start treating them accordingly during this pandemic. CANHR calls on Governor Newsom to reverse the CDPH directive today before more harm is done and more lives are lost.”

 

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FEMA requests 100K body bags (partial order) . . .

The Federal Emergency Management Agency has requested 100,000 body bags, known as Human Remains Pouches, through an interagency group that directed it to the Defense Department. While the Pentagon works to buy more bags, it will draw some initially from a stockpile of 50,000 it maintains, according to people familiar with the request. . .The DLA’s Troop Support unit manages the Pentagon’s stockpile of the green nylon, 94-inch by 38-inch body bags that are typically distributed to war zones. The unit has been in contact with the current contractor to assess its manufacturing capabilities but hasn’t yet placed a formal order, according to one of the people. As many as 200,000 Americans are projected to die in the U.S. coronavirus outbreak, a top White House official said Tuesday, even with another 30 days of the most stringent public health restrictions in place. . . .here

The gov't knew in October they were short on supplies. . .

The Hill (from below). . ."National emergency stockpile of protective medical gear nearly empty: report . .The national stockpile of personal protective equipment (PPE) is nearly empty as federal officials scramble to acquire more essential items such as masks and gloves to deal with the coronavirus pandemic. . . .“The stockpile was designed to respond to a handful of cities. It was never built or designed to fight a 50-state pandemic,” one official with the Department of Homeland Security (DHS) told The Washington Post. . . .That's true, but they knew that in October. . .NYTimes, Mar 22. here . ."Before Virus Outbreak, a Cascade of Warnings Went Unheeded . . .Government exercises, including one last year, made clear that the U.S. was not ready for a pandemic like the coronavirus. But little was done.. . .That scenario, code-named “Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August. The simulation’s sobering results — contained in a draft report dated October 2019 that has not previously been reported — drove home just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed. . ."KEY FINDINGS . .p.3 . ."The current medical countermeasure supply chain and production capacity cannot meet the demands imposed by nations during a global influenza pandemic." . . .Draft Report here . . . .The US was not prepared, but other countries were including China, South Korea, Vietnam, Taiwan, Singapore and Russia.

Got PPE?. . Nope. . .Got trash bags. . .

The Hill. . ."National emergency stockpile of protective medical gear nearly empty: report . .The national stockpile of personal protective equipment (PPE) is nearly empty as federal officials scramble to acquire more essential items such as masks and gloves to deal with the coronavirus pandemic. . . .“The stockpile was designed to respond to a handful of cities. It was never built or designed to fight a 50-state pandemic,” one official with the Department of Homeland Security (DHS) told The Washington Post. “This is not only a U.S. government problem. The supply chain for PPE worldwide has broken down, and there is a lot of price gouging happening.”. . .Hospitals across the country have been working to supply doctors and nurses responding to the coronavirus epidemic with proper protective gear, though news reports and social media postings have shown medical professionals wearing trash bags or ponchos over their regular attire. Hospital officials have also acknowledged difficulties in acquiring PPE. . . here

It doesn't look good. . . .

re: "California nursing homes are unprepared for this pandemic. There are shortages of personal protective equipment (PPE)". . .that can be said about hospitals and clinics also, and other public health entities. There are shortages of PPE for everyone, of test kits (especially the liquids), and also of ventilators and the teams (several doctors) necessary to operate them. The failure to protect medical staff in hospitals augmented by the other shortages will be our downfall. . . . .The other big problems will come in the military/naval area where group activities take precedence, and there is a historic disdain for members that actually do the work. There's an aircraft carrier with a crew of thousands laid up at Guam (western Pacific) currently, and more to come. . .The head virus guy Dr Fauci has said that we need to TEST and TRACE, i.e. find out who's infected and then learn where the victim might have caught it. That's a large enterprise which they did in China but the US is just not capable of it. . . Already at the national level the big thinkers and manipulators are blaming. . .China!. . .Yes, China is to blame, for various reasons. And the warmongers are sounding the alarums .