opinion
Iowa is losing its war with COVID-19 in long-term care facilities. This week, the state reported that more than 1,400 nursing facility residents had become infected with COVID-19. More than half of the Iowans dying from COVID- 19 lived or worked in nursing facilities. Both the state and long-term care facilities are doing their best to protect residents, but they must do more to save lives. Some states have developed and implemented comprehensive battle plans to stop the spread of the virus in long-term care facilities. Iowa can and should do the same by:
1. Publicly sharing data for all types of long-term care facilities, not just nursing facilities.
The state recently expanded the information it publicly shares about COVID-19 cases in nursing facilities. Still missing, however, is information about positive cases and deaths in other types of long-term care facilities, such as assisted living facilities, residential treatment facilities, and intermediate care facilities for individuals with intellectual/developmental disabilities. Individuals in those facilities are becoming infected, too. The State is also underreporting the spread of the contagion by providing information only on “outbreaks,” where three or more residents or staff have been infected. Residents, families and the public should be informed whenever there is one confirmed case in a facility. The state, moreover, needs to separately track and report on the number of residents versus staff infected at each facility. Only in this way can the public understand how COVID-19 is spreading within a facility and whether mitigation measures have been appropriately targeted.
2. Testing all residents and staff in long-term care facilities, regardless of whether there is a confirmed case.
The governor and lawmakers must ensure that all residents and staff in long-term care facilities are tested soon, regardless of whether there is a confirmed case. According to the Centers for Disease Control and Prevention, such diagnostic testing not only describes the scope and magnitude of confirmed cases, but also helps inform additional prevention and control measures. The governor has stated at her news conferences that 95% of individuals in nursing facilities have been tested, but there are many unanswered questions: Is testing available only upon request of the facility? What conditions trigger facility-wide testing? Have both residents and staff been tested? Is there periodic testing? Iowa needs to share its written testing plans and protocols with the public. Other states, such as Maryland, Minnesota, Tennessee, Texas and West Virginia are requiring that all residents be tested. Why is Iowa holding back when there are so many confirmed cases and deaths in long-term care facilities? Iowa needs a testing surge to prevent a virus surge.
3. Strike teams need to be proactive, not reactive.
The state has, commendably, started sending “strike teams” composed of a nurse and other health professionals after there is a COVID-19 outbreak in a long-term care facility. However, strike teams should be proactively educating facilities and testing all residents and staff before an outbreak occurs The state needs to also publicly share information about what the strike teams are doing, including what facilities the teams visited, when these visits occurred and whether the teams are conducting diagnostic or immunity testing.
4. The state should better support direct care workers.
Direct care workers in long-term care facilities are on the front line in the battle against the spread of COVID-19. The governor and the Legislature should use some of its CARES Act funding to provide hazard pay and childcare. The state should also ensure that direct care workers have sufficient personal protective equipment. Finally, the state should create a centralized direct care worker database system from which support teams of well-prepared direct care workers could be deployed to assist facilities and residents during the current pandemic and in the event of future disasters.
Without question, the governor and the Legislature want to protect Iowans in long-term care facilities. State officials deserve praise for all they have already done to stop the spread of COVID-19, but they can and must do even more to save lives of residents in long-term care facilities. Iowa needs to immediately develop and publicly share a comprehensive written battle plan, as other states have done. Action is needed now. Together, we can win this war.
Jane Hudson, J.D., is the executive director of Disability Rights Iowa, the congressionally mandated protection and advocacy system for Iowans with disabilities.
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Iowa needs to do more to save lives in long-term care facilities - Des Moines Register
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