I’ve gotten some really good feedback on my email about testing all staff and I’d like to make some points very clear.
1. Geriatricians, advance practice nurses, geriatric pharmacists and post acute and long term care physicians around the country care about one thing. To care for and protect older adults.
2. There has not been readily available testing for the post acute and long term care continuum.
3. There has not been sufficient PPE available for the post acute and long term care continuum.
4. Once the virus has gotten into a nursing home or assisted living facility, without adequate PPE, frail and vulnerable older adults will die.
5. In communities where the virus hasn’t reached a certain prevalence, widespread testing of staff, if available, coupled with sufficient PPE, will save lives.
6. Everyone is at a different place along the curve, and we can’t allow that to be used against us as we make the case for doing the right thing.
7. Very few people seem to understand supply chain dynamics during a pandemic, and because of this many older adults will die.
8. When the epidemiologists unpack this a year or two from now, I believe that the number of older adults who will have succumbed from COVID-19 will exceed 250,000.
9. There are still many communities throughout the country where COVID-19 infections are not prevalent enough to “storm the walls” around NHs and ALFs, but that window is closing fast.
10.If we have readily available testing and sufficient PPE, we still need stellar infection prevention, which is why we’ve held to our proposal that every nursing home in the country make sure that their already designated Infection Preventionist is full-time during this crisis. Every other Infection Prevention resource needs to be sent out to ALFs, which have no one in this capacity.
11. Every organization, from nursing homes to government agencies need to better understand the command structure during a medical emergency. There MUST be experts in geriatrics and post acute and long term care medicine on every incident command team in the country during the COVID-19 pandemic. There are geriatricians, advance practice nurses, geriatric pharmacists and Certified Medical Directors who stand ready to be part of local, state and federal decision making. We’ve been the ones predicting everything that’s happened for close to two months now. The clock is ticking and it’s time the experts were let into the room!
12. There are very few nursing homes, if any, in the country that are truly prepared to be COVID-19 facilities without a true paradigm change in how they operate. There is considerable thought put behind the Quadruple Aim and White Paper posted on the CALTCM website (https://www.caltcm.org/assets/WHITE%20PAPER%20A%20Plan%20to%20Protect%20Our%20Nursing%20Home%20Residents%20.pdf) (https://www.caltcm.org/assets/CALTCM%20COVID19%20QUADRUPLE%20AIM%20FINAL.pdf).
We stand ready to be part of the effort to protect and save the lives of older adults across the country.
Respectfully,
Mike Wasserman, MD, CMD
President,
California Association of Long Term Care Medicine
Medical Director,
Eisenberg Village
Los Angeles Jewish Home
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