The forgotten front lines of the virus: nursing homes


The battle against COVID-19 in America’s nursing homes is a war against an invisible enemy.

In preparing for battle, we wrote policies, increased our supply orders in an attempt to stockpile, and prepared our staff with weeks of education as we knew the enemy was getting closer. By the beginning of March, the nursing home industry was ready to fight.

Some facilities closed their doors to visitors even before mandated by governmental agencies. We separated residents from each other in dining rooms, canceled group activities, and did our best to socially distance our residents from each other — all in the hopes of keeping COVID-19 out of our buildings. We took temperatures and oxygen levels of every single resident three times a day, trying to catch signs and symptoms before it was too late.

We had prepared, we had planned, and we were ready to execute. Unfortunately, none of it would matter.

From the beginning of March through the middle of April, the nursing home industry was pure hell. One way or another, COVID-19 made its way into many — if not all — of the nursing homes in New York City. In most cases, it started as a fever. The resident would be placed in isolation, staff would gear up, and continue to provide the vital care that was needed for the country’s most vulnerable population.

Patients would take Tylenol to help control the fever. Some would start antibiotic treatments and, when necessary, oxygen. Some responded to the course of treatment, and some would not. Those that didn’t respond were then transported to the hospital for a higher level of care in hopes of saving lives.

Some were saved, some were not. At the same time, panic began to take over.

On cable news, it was all COVID-19 all the time. A diagnosis of COVID was being portrayed as a death sentence, and staff reacted, which resulted in staffing levels plummeting. Community doctors were automatically telling staff members (some of whom didn’t have symptoms) to stay home for 14 days, even though guidance from the state’s health department for essential workers was a different set of guidelines.

At the same time, other staff were also legitimately getting sick, which added to what was already a staffing crisis.

Staff worked double shifts, monitoring, treating, and caring for 16 hours straight to ensure their residents were well taken care of. Staff donned and doffed personal protective equipment multiple times throughout the day in an attempt to care for those most in need while keeping the others healthy.

People took on roles outside of their normal responsibilities in order to keep facilities going. Staff in nursing homes got sick as a result of their tireless efforts, and some staff lost their lives. However, because of the extraordinary efforts of nursing home workers, resident lives were saved.

Many residents with COVID who were identified early due to proactive monitoring were treated in the nursing homes, got better, and made full recoveries — never even needing hospitalization.

By the end of April, the numbers started to be released, and they were heartbreaking. We see 30, 40, and even more than 50 deaths in some facilities. The negative press coverage was overwhelming, and was the straw that broke the camel’s back.

We had been in the trenches for two months — preparing, treating, getting sick, and dying for our residents — and what was never once mentioned was the concept of asymptomatic carriers in health care facilities.

The fact that a resident or staff member could have the virus that causes COVID-19, show no symptoms, and unwittingly spread it around a facility was what made the fight even harder.

However, now with the high death toll, everyone was looking for someone to blame.

With a week of death tolls being reported, the governor announced he would use the power of the state attorney general’s office to investigate nursing home deaths and compliance with the ever-changing rules (some of which the governor was very publicly unaware of).

Let it sink in. The attorney general’s office investigates crimes, and that is who the governor announced would be looking into nursing home deaths.

We are not criminals. We are health care workers performing the essential job of caring for COVID-19’s most vulnerable population during the most challenging public health crisis of the last 100 years. The hospitals get food delivered, parades, and hailed as heroes in local and national media.

In turn, nursing homes get investigations by the attorney general’s office. We are truly the forgotten front line.

The author is an administrator at Park Gardens Rehabilitation and Nursing Center on Broadway.

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Adam Geller,