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April 24, 2020
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Policy brief calls for ‘tangible action’ to protect older Americans from COVID-19

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The American Geriatrics Society, or AGS, recently issued a policy brief to urge the federal government to take action to protect some of the most vulnerable Americans against COVID-19 — patients in nursing homes.

Numerous reports have shown the devastating impact of the pandemic on the elderly. The New Jersey state attorney general is currently investigating a Sussex County nursing home where 17 bodies were recently found in a makeshift holding area, thought to be linked to the COVID-19 pandemic, northjersey.com reported. As of April 20, 682 of Pennsylvania’s 1,204 COVID-19 deaths occurred in nursing homes or personal care facilities, that state reported. A quarter of residents in a nursing home in Seattle — a city one doctor described to Healio as “ground zero” for the U.S. outbreak — have died from COVID-19, according to the CDC.

Reports like these will likely continue for the foreseeable future, Richard Baron, MD, president and CEO of ABIM, told Healio Primary Care.

“That is an illustration of how vulnerable [older] folks are,” he said of the New Jersey tragedy. “The vulnerable and those who are institutionalized are less likely to survive. Death in this population is foreseeable.”

Source: AGS COVID-19 policy brief offers roadmap to government action for a critical group: older adults in nursing homes. https://www.americangeriatrics.org/media-center/news/ags-covid-19-policy-brief-offers-roadmap-government-action-critical-group-older.

Mindful of how COVID-19 affects the elderly, AGS outlined five “tangible actions” to protect them:

  • President Donald J. Trump should exercise his full authority under the Defense Production Act.
  • Providers should “carefully” consider transfers between nursing homes, hospitals and other health care settings.
  • More must be done to integrate key players in public health, including geriatric and palliative care experts and nursing home administrators.
  • Congress should advance paid family, medical and sick leave for the entire health workforce and enhance COVID-19 screening and training to protect staff.
  • Legislators should consider supportive tax relief and payment opportunities targeting long-term care.
Annie Medina-Walpole
Annie Medina-Walpole

“We hope this brief can help .... prioritize the innovation, collaboration and compassion that can put key patients and public health first,” Annie Medina-Walpole, MD, AGSF, AGS president-elect, said in a press release.

Baron said the COVID-19 pandemic should prompt physicians to discuss advanced care planning with patients and their caregivers.

Richard Baron 2018
Richard Baron

“In the same way that that soldiers who get called for deployments are instructed to put their affairs in order before they go ... this is a really good time for families with relatives in facilities to be thinking about under what circumstances would I want them to go to the hospital — particularly given the fact that the survival rates for these folks on ventilators are not that high.”

The CDC also offers guidance to avert “substantial morbidity and mortality” at long-term care facilities, including identifying and excluding symptomatic staff members, restricting visitations except in compassionate care situations, and strengthening infection prevention and control guidance and adherence. – by Janel Miller

References:

AGS. AGS COVID-19 policy brief offers roadmap to government action for a critical group: older adults in nursing homes. https://www.americangeriatrics.org/media-center/news/ags-covid-19-policy-brief-offers-roadmap-government-action-critical-group-older. Accessed April 20, 2020.

McMichael TM, et al. MMWR Morb Mortal Wkly Rep. 2020;doi:10.15585/mmwr.mm6912e1.

NorthJersey.com. NJ sends team to help Andover nursing home where bodies piled up after coronavirus deaths. https://www.northjersey.com/story/news/coronavirus/2020/04/16/coronavirus-nj-state-sends-team-help-andover-nursing-home/5144923002/. Accessed April 21, 2020.

PA.gov. Department of Health provides update on COVID-19, 948 positives bring statewide total to 33,232. https://www.media.pa.gov/Pages/Health-Details.aspx?newsid=779. Accessed April 20, 2020.

Disclosure: Baron reports no relevant financial disclosures.