EDITORIAL: Vulnerable

Nursing home outbreaks show safety measures need review

As in many other parts of the country, Rio Grande Valley nursing homes have been hit hard by the COVID-19 pandemic.

The prevalence of illness there shows a clear need to review and restructure measures to ensure the safety of some of our most vulnerable Americans.

Dozens of residents at local nursing homes have contracted the virus, and a large number of local deaths to the disease are concentrated there. It reflects a nationwide trend; more than 40% of all U.S. COVID-19 fatalities have occurred at nursing homes, although only 0.6% of the nation’s population lives there. Analysts warn that the actual numbers might be even higher, as many nursing homes, and many states don’t report health problems at those facilities. Many of those that do only report deaths that occur at the facilities; if a resident was taken to a hospital and died there, the nursing home might not include that death in its reports.

Clearly, something must be done.

That need goes beyond addressing the current plague of viral cases. The federal government has targeted nursing homes for increased testing and other procedures.

Texas Gov. Greg Abbott has mobilized the Texas National Guard to clean and disinfect nursing homes across the state.

Outbreaks of disease can occur anywhere people spend large amounts of time in closed atmospheres — schools, jails, even airplanes and buses.

And indeed, elevated rates of illness, most often simple colds, flu and stomach viruses, are reported in such environments.

Surely some people are asking how such things can happen at nursing homes, which promise around-theclock vigilance and medical attention.

The truth is that nursing homes are businesses like any other, and face pressure to keep costs down and residency rates competitive. Most meet state minimums for staffing that might be fine under normal conditions but can easily be overwhelmed by an extraordinary situation such as a major viral outbreak.

Many facilities have only one RN, who is on site only during the 40-hour work week.

This means the people who most often deal directly with residents have a lower level of training and experience, as well as lower levels of authority and decisionmaking ability at times of crisis.

Complacency can be another factor; when nothing goes wrong for a long time, people become less vigilant.

The Government Accountability Office reports that 40% of nursing homes inspected over the past two years were cited for problems with disease prevention and control.

The problems ranged from workers and residents not washing their hands every time they should to a failure to isolate sick residents from the rest of the population.

Most nursing home residents are there because they already are in fragile health and need more attention than they or their families can provide. No one should fear that the decision might lead to a preventable tragedy.

We hope we never face another medical crisis of this magnitude.

But officials still need to review the problems that were created — or exposed — by this pandemic. States and Congress members should impanel review boards to assess the problems and recommend protocols that can improve performance and reduce the chance of similar outbreaks in the future.