Inside the pandemic’s most deadly targets: Nursing homes

As nursing homes across the country continue to emerge as the most deadly hotspots of coronavirus infections, the Leonard Davis Institute of Health Economics (LDI) convened a virtual seminar of top experts to discuss why this is happening and what can be done to prevent it in future epidemics. 

Empty hallway in a nursing home with an electric wheelchair and a walker by a sunlit door

Titled Caring for Patients After Hospital Discharge During a Pandemic, the session was the fourth in an ongoing series of LDI “Experts at Home” seminars bringing together scientific authorities to discuss various aspects of the current COVID-19 crisis.

“When we decided to host this event,” said seminar moderator and LDI Policy Director David Grande, “we were a bit hesitant to use the word crisis but I do think that is where we are today. The World Health Organization has announced that up to half of those who have died from COVID-19 in Europe were residents in long-term care facilities. We’ve heard similar numbers, even from one of our nearby counties here in the Philadelphia region.”

Currently, coronavirus deaths among residents of nursing homes are reported to constitute about half of Pennsylvania’s known fatalities from the disease. In New Jersey, more than 95% of long-term care facilities report positive cases. Nationally, a New York Times analysis calculates that 10,500 nursing and long-term care facility patients have died of the virus so far.

“This infection,” said panelist, geriatrician, and medical director of a local skilled nursing facility Joshua Uy, “has been like no other infection we’ve ever managed in a nursing home setting. Its key feature is asymptomatic spread—the infection is really contagious in both staff and patients who have no symptoms. 

“Social distancing isn’t possible in nursing homes,” explained Uy, who is also an associate professor of clinical medicine at the Perelman School of Medicine. “The patients require hours of daily care in very close quarters, and no nursing home has enough testing, personal protective equipment, or staffing to deal with this infection that actually takes out a lot of the staff just as the facility is trying to increase its capabilities.”

Read more at Penn LDI.