Op-Ed: As Coronavirus Looms, Nursing Homes Must Take Strict Precautions

From the perspective of those who do the lion’s share of direct, hands-on care, there are a few key areas of concern
Credit: Amanda Brown
Milly Silva

As coronavirus edges ever closer to becoming a global pandemic, it is essential that New Jersey’s nursing facilities be prepared to protect their residents and caregivers from potential exposure. By all accounts, seniors are especially vulnerable to this new viral strain. A recent study from China found mortality rates reaching 8% for those over 70, and 15% for those over 80. As of this writing, a nursing home in Washington state is the epicenter of a coronavirus outbreak that has already taken the lives of several patients and sickened many others.

Taking into consideration the unique vulnerabilities of seniors who already require 24/7 care, an outbreak at any one of our state’s 370 nursing homes could spell disaster. So we need to be proactive and make sure that nursing homes and their staff are fully equipped and trained — now — to head off a sudden crisis.

New Jersey, perhaps more than anywhere else in the United States, knows the terrible consequences of viral spread in a nursing home. In 2018, an outbreak of adenovirus at Wanaque Center in Haskill, New Jersey, took the lives of 11 medically-fragile children and infected dozens of others. The tragedy was worsened by what government inspectors found to be glaring lapses in infection control policies at the facility and a delayed response in isolating infected residents.

If there is ever a time for nursing homes to show that they have taken to heart the lessons of Wanaque and make sure that such a tragedy never happens again, it is now. From the perspective of the members of our union who do the lion’s share of direct, hands-on care in their nursing facilities, there are a few key areas of concern.

Adequate supplies and training

First, it is crucial that nursing homes maintain adequate supplies of personal protective equipment, soap, and the sanitary and cleaning products necessary for proper resident care. Of course, this should always be a basic expectation, but it is alarmingly common for workers to report supply shortages, whether it’s of soap, masks, gloves, towels, diapers, or other essentials. This is especially true during the “off-season” of nursing home inspections — when state inspectors have finished their yearly examination of a facility and management grows lax about keeping materials well-stocked.

Second, it’s important for there to be consistency and quality to the in-service trainings that workers receive on infection control techniques, including the very basics such as handwashing. The NJ Department of Health has just released directives for coronavirus infection control in long-term care facilities, which include a training component. Nursing homes must take these recommendations very seriously. It is not enough for facilities to simply pass out an informational leaflet and ask for everyone’s signature that they have “taken” a training, yet this is the bare-bones approach that many nursing homes have used in the past to meet training obligations. Instead, trainings should take the form of formal meetings where workers have the opportunity to freely ask questions and share concerns. Even as the crisis at Wanaque was unfolding, our members asked management for this very thing and were ignored.

Third, facilities must ensure an adequate staff complement at all times. Studies have found a direct link between a facility’s nursing aide staffing levels and the number of infection-control lapses uncovered during government inspections. Caregivers must be given the time they need to provide safe care without feeling pressured to cut corners while making their rounds.

Sick leave

Lastly, no health care worker should feel compelled to come in to work when they are feeling ill. But the reality is for many, their sick leave benefits are meager. Indeed, at this very moment, members of our union are involved in negotiations with nursing home employers who are seeking to reduce sick leave benefits. Tens of thousands of health care workers in New Jersey do not earn a living wage and many earn the minimum wage; for these workers it can be an extreme financial hardship to miss even just one day’s pay.

Thankfully, in 2018, Gov. Murphy signed into law legislation that requires all employers to provide at least 40 hours of yearly sick leave to their employees — an important step that will undoubtedly help mitigate a community spread of coronavirus in our state. But at a time when we should be taking all available precautionary measures, health care institutions should commit to moving significantly above this 40-hour minimum so that workers don’t feel the need to come in to work when they should be recovering at home.

Public health crises like the one that may be coming to New Jersey require a full team effort to prevent. Government authorities, health care providers, caregivers, unions, and the public at large must work in tandem to keep our communities safe. At this critical time, we must make sure that our frontline health care workers have the information, resources and support they need to protect the most vulnerable.