The leader of the state’s pandemic response effort said Massachusetts is far better prepared now than it was eight months ago to fight COVID-19′s deadly rampage through nursing homes.
Health and Human Services Secretary Marylou Sudders said during an online legislative hearing that Massachusetts now has “the building blocks in place to respond to a very evolving pandemic,” including a comprehensive testing program for nursing home staff and residents, a significant stockpile of masks and gowns, and strict infection-control requirements.
“What we know today about this virus is completely different than what we knew in February and March,'' said Sudders, who Governor Charlie Baker tapped eight months ago to run the COVID-19 Response Command Center. "And it continues to evolve.''
"We are vigilant, we are prepared,'' she said.
Sudders’s comments came during a hearing on Zoom organized by the Legislature’s Joint Committee on Elder Affairs to examine why so many nursing home residents died from the virus in Massachusetts, which has suffered one of the highest death tolls in the country.
A Boston Globe Spotlight Team’s three-part series, Last Words, published last month found that the Baker administration’s early response to the nursing home crisis was chaotic and unfocused, as the virus infiltrated facilities between mid-March and early April, eventually killing 6,209 long-term care residents as of Tuesday. Nursing homes struggled to secure personal protective equipment for staff and testing for staff and residents, as the state made helping hospitals its top priority.
Even as hospitals were an understandable priority as COVID-19 cases were surging last spring, many elder care advocates say nursing homes were given far too little attention amid strong early evidence that seniors were highly vulnerable.
Long-term care facilities account for nearly 66 percent of COVID-19 deaths here, far higher than the national average. About one in seven Massachusetts long-term care residents have died from COVID-19.
"There has been a tragedy in our nursing homes,'' said Representative Ruth Balser, a Democrat from Newton who is cochair of the committee. "We come together today to examine why that happened. We are all worried about a second wave.''
Balser, and her cochair, Senator Patricia Jehlen, a Democrat from Somerville, called in a wide range of people to discuss lessons learned during the pandemic, including nursing home residents and family members who are part of a new coalition called Dignity Alliance Massachusetts. Representatives of senior care associations, unions, and researchers also spoke.
Daniel Zotos, director of public policy and advocacy for the Alzheimer’s Association’s Massachusetts/New Hampshire chapter, said the “devastating reality” of nursing home deaths in Massachusetts has been well-documented, including in the Globe’s Spotlight Team report. He criticized the state for failing to release more complete information to the public about virus infections and deaths in long-term care facilities, despite a new law requiring it to do just that.
"We see the state’s ongoing failure to comply with this law as wholly unacceptable and the families we serve certainly deserve better‚'’ he said.
Zotos called for rapid on-site testing of visitors, residents, and staff to make it easier for in-person visits to occur — easing residents' isolation.
Sudders said “point of care” tests are not reliable but that the state’s current testing program gives nursing homes results in less than two days, a notable improvement from the early days.
“We have the capacity to actually process more than 100,000 tests a day in Massachusetts'' she said. "But more important for nursing homes specifically, we have surveillance testing across every nursing home in the Commonwealth, residents and staff.”
She said nursing homes also have far greater access to masks and gowns.
“The reality is we have enough in the stockpile across health, human services, first responders, not just through the end of this calendar year but through the spring. So we have PPE like we have never had PPE. ''
And, Sudders said, an aggressive onsite inspection program to oversee nursing homes' adherence to infection prevention standards has led to a dramatic decline in cases and deaths.
"The pandemic has laid bare the unique vulnerabilities of nursing homes and their residents,'' she said. "Other states . . . say they are looking to Massachusetts, which . . . makes me nervous because we are very much a work in progress and always learning. I think we are prepared, given what we have learned, as we come into the fall.''
In another issue related to nursing homes, Attorney General Maura Healey told the Globe last week that her office is looking into potential Medicaid discrimination at nursing homes, an issue raised in one part of the Spotlight Team series. Her team said the office plans to follow up with at least one of the facilities named in the undercover investigation.
"We take discrimination in all forms seriously and I would invite the public if they suspect anything to report it,'' Healey said. "This kind of discrimination would be illegal under Massachusetts law and we are prepared to take action where we find it.''
Meanwhile the virus remains a serious threat. Baker on Tuesday acknowledged that cases are rising statewide, but said the state is ready for the fall and winter. The seven-day rolling average of daily confirmed coronavirus cases climbed last Tuesday and Wednesday to 588, then dipped in the next few days, but it since ticked back up, reaching 601 on Tuesday.
Also, state data show that nursing home residents continue to represent the vast majority of COVID-19 deaths in Massachusetts, even in the past two months when coronavirus cases here have been relatively low. From Aug. 13 to Oct. 13, for example, figures show a total of 840 deaths in Massachusetts due to confirmed or suspected cases of COVID-19. Of that number, 588 — or 70 percent — were among nursing home residents.
Elissa Sherman, president of LeadingAge Massachusetts, an association of nonprofit providers serving elderly residents, said during the hearing that even the best new safety practices within nursing homes can’t eliminate the possibility of an outbreak. She said troubling signs of more COVID-19 in the community and in hospitals could easily show up in long-term care facilities.
“So we can’t separate what’s happening inside a long-term care facility from what’s happening outside,” Sherman said.