Nursing home workers had one of the deadliest jobs of 2020

When you think of the most dangerous jobs in the United States, you might imagine something like felling, fishing or trucking. But by 2020, one of the most deadly professions of all was caring for the elderly rather than manipulating heavy equipment, bravery of elements, and driving big rigs.

When COVID-19 swept the globe last year, nursing home staff mortality was the highest in any job in the United States. Scientific American Analysis of data from Medicare & Medicaid Service Center (CMS) and Labor Statistics Bureau.. However, the CMS, which sets quality standards for skilled nursing homes, began requiring nursing homes to report such deaths in May 2020. This is shortly after the catastrophic peak of COVID deaths in parts of the country last spring. Therefore, the calculated mortality rate is arguably underestimated, says Judith Chevalier, a professor of financial economics at Yale University who helped analyze the data.

High pandemic victims among nursing home residents are well known, but the impact on staff is much less noticeable. At least 80 skilled nursing facility workers died last year for every 100,000 full-time employees. This estimate is Total Nursing Home Staff Deaths Reported to CMS According to the BLS report, from May 17th to December 27th, 2020, it depends on the total number of people working in such facilities. By comparison, the death toll of fishermen and related workers in 2019 was 145 per 100,000. Data from BLS.. Loggers died 68.9 per 100,000 in the same year. Given that 2020 CMS data were reported only after May last year, the actual full-year mortality rate for nursing home staff may have approached or exceeded that for fishermen.

Accurate comparisons are difficult because CMS data on the deaths of nursing home workers comes from patchwork of reporting standards that vary by state and facility. Chevalier said authorities have not made it clear whether the cumulative mortality should be reported when the nursing facility begins collecting data in mid-May, or whether counting should begin at that point. It is also difficult to collate individual nursing home statistics with state-level data, as facilities may have started reporting at different times. “”It’s a mess, “says Chevalier. In addition, she states that the CMS data includes only those who worked in certified and skilled nursing homes, not those in many other types of long-term care living facilities.

A CMS spokesperson states that patient safety, access to care, and data transparency are agency priorities. A spokeswoman said some of the initial data could be inaccurate, as some nursing facilities may have had difficulty submitting information to the reporting program at the start of May last year. Stated. In addition, some facilities may have opted to report cumulative data up to January 2020. Doing so may increase the number of cases or deaths compared to facilities that have just reported data since May last year. I was asked to quote in the background.

Inside a nursing home, a certified nursing assistant, or CNA, performs some of the most important and often thankful tasks. This includes feeding, bathing, and flipping nursing home residents to prevent bedsores. However, many of these workers are paid a minimum wage and often have little or no sick leave, and are co-founders and chief executive officers of the National Association of Health Care Assistants, the leading organization of CNA. Said Lori Porter. In addition, nursing homes were chronically understaffed and underfunded, even before the pandemic. Therefore, many of them were very unprepared when the COVID hit. They lacked personal protective equipment (PPE), proper infectious disease training, access to frequent tests, and backup staff to cover sick employees. As a result, these facilities have become one of the most devastated communities in the pandemic.

“If the COVID is positive [effect] In any case, what we don’t care for the old man is that it’s no longer a dirty little secret in a nursing home, it’s not an American secret, “says Porter. “That’s the real story ….. why do we keep old people in human filing cabinets?”

Last summer, a former CNA himself, Porter Coronavirus Commission on Safety and Quality of Nursing Homes, CMS was tasked with assessing the response of such facilities to the pandemic. And last July, she co-authored an editorial at The Washington Post. Risk of becoming a nursing home worker during COVID.. “I know the rewards are too low, but no one was able to cope with it,” she says. “A pandemic has occurred, but the number was too small. [people] take [it on].. There were many fears and many deaths around me. “

There are many possible reasons why nursing home workers are dying from COVID at such a high rate. For example, many facilities lacked high-quality face masks, face shields, gowns and other protective equipment, especially in the early days of the pandemic. Also, due to the nature of nursing home care, close contact with residents is prolonged, making it almost impossible to stay socially distant.

Nursing homes couldn’t do all the COVID tests they wanted in the early days of the pandemic, Chevalier says. Such tests were important to identify staff with asymptomatic or presymptomatic infections. And even if employees could take the test and it was positive, many of them probably refused to stay home because they couldn’t afford to give up their income because they didn’t have sick leave. Says Porter. CNA sets median wages About $ 14 per hour.. Porter and her colleagues say that they work 40 hours a week and their wages reach less than $ 600 a week as an additional unemployment allowance that many people received last summer.

On top of that, many nursing homes were already in serious shortage before the pandemic, so too few people filled out when they got sick.Some nursing staff and contractors Work in multiple nursing homes It may carry the virus and was discovered in a study by Chevalier et al. Also, some nursing home workers have low incomes and cannot seek proper care on their own. They may also have an existing condition that puts them at risk of developing severe COVID.

“Long-term caregivers endanger their safety by coming to work every day to care for those who are most vulnerable to this virus. They are our forgotten health care heroes. We are committed to providing the highest quality care in the midst of a pandemic, “said a spokeswoman for the American Healthcare Association, a non-profit organization that represents nursing homes and other life support facilities. ..The· AHCA states that research suggests Outbreaks in nursing homes were correlated with epidemics in the surrounding area. “Even the best nursing homes with the strictest infection control practices couldn’t stop this highly contagious and invisible virus,” said a spokesman.

David Grabowski, a professor of health policy at Harvard Medical School, said: Washington post An editorial with Chevalier states that he is “not at all surprised” by the high mortality rate of nursing home staff. “Society has never actually invested in these workers,” he says. They are primarily women, people of color, and immigrants, “we have been using that workforce for a long time,” he says.

Grabowski hopes that one lesson that society can learn from this pandemic is that the US long-term care system is broken. To fix that, he says, nursing homes must be able to hire and maintain the necessary staff and pay appropriately. In addition to COVID, there is also a need for better infection control measures that can help with influenza outbreaks. Better data collection helps to ensure transparency and accountability. Ultimately, all of these require more money than the current Medicaid rates can offer, says Grabowski. Nursing homes also need better federal regulation to provide adequate care, which requires investment, Porter points out.

Nursing homes are still a dangerous place to work, although PPE and testing have become somewhat available. COVID vaccines are currently being deployed at these facilities, but there are some important ones Vaccine hesitage of nursing home staff.. Much of that reluctance stems from the lack of trust in the government that they feel they are ignoring them, Porter says. She recently funded the CMS to establish a national CNACOVID-19 education portal developed by her organization and specially designed for nursing assistants, including information on the importance of vaccination. I resubmitted my proposal. Porter believes that providing this guidance directly from a group dedicated to CNA is more effective than providing it from the government. The message she wants to send to all CNAs is: You are important We are protecting you. “

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