No Surprise

David Posnett — Sat, 18 Apr 2020 17:49:31 +0000

From Southampton Press: No Surprise

For those of us inclined to pay close attention to the Trump administration, this aspect in particular stands out: the undoing of all varieties of federal regulation. Environmental, banking, consumer and health regulations have been targeted for extinction or reduction. In the words of former Trump advisor Steve Bannon, “Our job is the deconstruction of the administrative state.”

Deconstructing important parts of the “administrative state” increases the threats to our health and safety, with loss of life an all-too-common outcome.

Shortly after President Trump was inaugurated, he issued an executive order directing federal agencies to use their administrative powers to begin dismantling the Affordable Care Act “to the maximum extent permitted by law.”

Last July, the federal Centers for Medicare and Medicaid Services, or CMS, proposed a reversal of Obama-era rules that aimed to protect nursing home patients by requiring all nursing home facilities to hire at least one full-time specialist in infection control. Seema Verma, the CMS administrator and a presence at President Trump’s daily coronavirus briefings, expressed concern about not “micromanaging the process.”

It should come as no surprise to learn that a nursing home lobbying group has contributed to the Trump campaign (New York Times, “Regulator Intends to Relax Oversight In Nursing Homes,” March 16, 2020).

The first novel coronavirus hotspot in the United States occurred at the Kirkland Life Care Center for the elderly in Washington State. In neighboring New Jersey, COVID-19 is running through St. Joseph’s Senior Home in Woodbridge Township. And, closer to home, Peconic Landing, an elderly community on the North Fork, is experiencing a heartbreaking toll of infected COVID-19 patients.

Is there a direct cause-effect relationship between regulatory rollback and any one positive COVID-19 case? No, but having a full-time infection control specialist knowledgeable about the science of infectious disease and vector control would have established policy and protocol ready to take the most efficacious approach to life-saving measures.

Mike Anthony

Westhampton

Mr. Anthony is a former Southampton Town Democratic Committee chairman — Ed.

Are we Failing our Seniors by not Providing COVID-19 Testing?

David Posnett — Thu, 16 Apr 2020 17:02:58 +0000

Laura Ahearn just released the following:

STATEMENT FROM STATE SENATE CANDIDATE DEMOCRAT LAURA AHEARN (SD-1)

Nearly Half of Suffolk County COVID-19 Deaths Occurred at Nursing Homes and Assisted Living Facilities

– Transparency Will Bring Needed Resources –

“On Monday April 13th state health officials released the COVID-19 county-level death toll in assisted living facilities and nursing homes. The coronavirus has killed more than 2,722 people living in such facilities, or about 27% of all virus-related deaths (10,056) statewide as of that date.

According to state health officials, 252 people died at either a nursing home or an assisted living facility in Suffolk County as of Monday April 13th. There were a reported 529 total deaths in Suffolk County as of that date which means that nearly half of all coronavirus deaths in Suffolk County (47.6%) were people living in nursing homes and assisted living facilities.

Our most vulnerable population, our parents and grandparents, are being attacked by a vicious killer and the percentage of deaths in these facilities compared to hospital deaths is disproportionately increasing at an alarming rate. In fact, according to the Governor’s reports, COVID deaths in hospitals and nursing homes on March 20th indicated that 1.4% of overall deaths were occurring in nursing homes but by April 13th that number jumped to 17.1%.

Patient advocates and families with loved ones in these facilities are asking the state to release the total number of deaths and positive cases for each facility across the state. According to Elder Care advocates, disclosure of this information is a public health necessity to raise public awareness so that we can properly gauge the scope of the problem and direct the resources needed to stop the spread and to save lives. Families of loved ones and folks living in these facilities themselves are desperately seeking expansive testing not only of residents but also of staff working there who come and go on a daily basis. If private companies can access testing tools it seems that nursing homes and assisted living facilities who care for our most vulnerable can and should too.

Vaccines are reportedly 12-18 months away, new medical treatments are being explored and discussions are beginning about how to build the bridge to reopen our lives and the economy. Let’s not forget our seniors, one of our most vulnerable populations right now in nursing homes and assisted living facilities that need our immediate help. The very first step is to understand the scope of the problem which begins with releasing the total number of deaths and positive cases for each facility across the state so that policy and lawmakers can direct the appropriate resources to help our most vulnerable.”

Commentary (by D. Posnett MD):

There is no reason for the absence of testing in nursing homes and senior assisted living comunities! Not when there is an ongoing out break in a home like Peconic Landing in Greenport. Not when I can get a test for myself. Not when local physicians in Suffolk are getting tests for their patients. Yes, I know first hand, it is a pain in the neck and may involve hours on the phone or in line at a drive through. But it is feasible.
Why is it important to test everyone at Peconic Landing? They are the largest job provider in Greenport. Some 300-400 people work there and they go home every night to their families. Regardless of whether they work in direct patient care or in the kitchen or on a maintenance crew, they are at risk of bringing the virus out of the facility and spreading it in the community. I am worried about the elderly frail and susceptible residents at Peconic Landing, but I am also concerned about the entire community. Ultimately I am worried about the economic disaster that may follow.
What would we do differently if we had test results? Workers that test positive would have to stay home under strict quarantine, regardless of whether they have symptoms or not (see below). Residents that test negative would have to quarantine, but they might be able to leave the facility after 14 days if symptom free. That is what occurred with passengers on the cruise ships. Workers who develop antibodies (a different kind of test) will likely be safe to return to work, as they may be immune. Finally, we are heading towards massive tracking of positive cases as already done in other countries. Tracking allows one to identify contacts that are in danger of getting the disease. It is useful to start with the origin and in Greenport that would be Peconic Landing.
For every symptomatic person, there are 7 asymptomatic people out there! Note a recent study that just appeared in the New England Journal of Medicine. They tested all women who came in to Labor and Delivery at New York Hospital (Weill Cornell). Only 1.9% (4 patients) had symptoms of COVID-19 and all 4 tested positive by RT-PCR. But 13.5% had NO symptoms and yet tested positive. This means that a lot of people are infectious and spread the disease without even knowing it. That is why EVERYONE NEEDS TO BE TESTED!
In Florida, nursing homes are petitioning the Governor to be shielded from law suits! It sure looks like they are running scared. Perhaps they should be, if they refuse to test when tests are available:

“Ron DeSantis Has No Power to Shield Florida Health Care Providers From Coronavirus Lawsuits“
The Florida governor is mulling an unconstitutional order that would protect negligent medical professionals. Read in Slate: https://apple.news/AMjfN9BVfSoaCZtukOcphTQ

nursing homes – R&R – Reachout and Rebuild

No Surprise

From Southampton Press: No Surprise

Are we Failing our Seniors by not Providing COVID-19 Testing?