Staff, Visitors Brought Coronavirus To Nursing Homes: DOH Report

SUFFOLK COUNTY, NY — Staff and visitors brought the coronavirus into nursing homes across New York State, a new report by the Department of Health concluded.

According to the report, "Factors Associated with Nursing Home Infections and Fatalities in New York State During the COVID-19 Global Health Crisis," which was released on Monday, several factors were clear after examining the data — and they indicated that the spread of coronavirus was related to staff or visitors, not patients transferred from hospitals or other facilities.

At Peconic Landing in Greenport, for example, a per diem employee tested positive for the coronavirus in March.

About 6,432 coronavirus deaths have been reported in nursing homes in New York, or 21 percent of the total number of deaths, the report said.

"Employee infections were related to the larger community spread and employee transmission has the strongest correlation to nursing home fatalities," the DOH report said.

According to data submitted by nursing homes, 37,500 nursing home staff members — one in four of the state’s approximately 158,000 nursing home workers — were infected with COVID-19 between March and early June 2020, the study said.

The data also suggests that nursing home quality and admissions policies were not a factor in mortality from COVID.

"Comparing nursing home policies and mortality rate timelines suggests COVID-19 transmission is strongly correlated to nursing home employees entering the facility. Early in the COVID-19 pandemic, the consensus among public health experts suggested asymptomatic people did not spread the disease and asymptomatic positive or presumed positive employees were allowed to continue to work," the report said. "Later in the crisis, public health experts were forced to reverse this position as it became clear from the data that asymptomatic people could transmit the disease."

NYSDOH also analyzed the timing of the COVID-positive staff infections and the timing of nursing home deaths, the study said. "Based on published data, the average length of time between COVID-19 infections to death is between 18 to 25 days. Therefore, the link between the timing of staff infection and nursing home mortality is supported by the fact that the peak number of nursing home staff reported COVID-19 symptoms on March 16, 2020 — 23 days prior to the date of the peak nursing home fatalities, which occurred on April 8, 2020. It is likely that thousands of employees who were infected in mid-March transmitted the virus unknowingly — through no fault of their own — while working, which then led to resident infection."

In addition, the report said, independent testing done by BioReference in May showed 29 percent of nursing home employees surveyed had COVID antibodies.

"Extrapolating the data means that approximately one in three nursing home workers were infected," the report said. "Such a high percentage of employees having at one time been positive for COVID-19 suggests a strong correlation to contributing to the spread to patients. Our analysis brings to the forefront the possibility of transmission from staff as an important mode of transmission. If states had accurate information about COVID transmission at an earlier time and had the testing capacity to detect asymptomatic but infected individuals, other procedures might have been taken," the report said.

For example, all asymptomatic employees should have been barred from facilities as if they were symptomatic, which is the current policy, the report said. If widespread testing was available earlier, all employees could have been tested earlier, the report concluded.

Some have protested that those with coronavirus should not have been admitted, or re-admitted, to nursing homes, and questioned if that might have caused the spike in deaths; the report, however, refuted those concerns.

Speaking on the report at a press briefing Monday, Gov. Andrew Cuomo said visitors were not initially barred from nursing homes; that did not happen until mid-March, he said. "By that time, the virus was in the nursing homes," he said. "At that time we weren't testing anybody, testing was just starting and if you look at when the visitors were allowed in, up until about mid March the spike in the nursing homes was seven days, 14 days after that," Cuomo said. "The report said between family coming in and the staff — they were the transporters of the virus."

He added that from "Day 1, we all knew that nursing homes were the most vulnerable place," which is why, Cuomo said, he made the decision to ban visitors despite how difficult it was for seniors in nursing homes not to see loved ones for months.

The report concluded that the issues faced are national issues that must be addressed through, for example, better training of staff, enhanced and rapid testing, and better coordination with other healthcare facilities. "Nursing homes and other congregate settings will pose a continued risk for the coronavirus or another public health threat in the future that attacks older adults," the report said.