Dr. Joshua Uy: Philadelphia nursing homes need help, not blame

Dr. Josh Uy has been recognized as a leading medical professional around the country for his efforts to combat the COVID-19 pandemic. He provides his opinion on the impact of COVID-19 in nursing homes and the most effective ways to control the spread of the virus.

Note: This was originally published in the Philadelphia Inquirer.

On Sunday, The Inquirer published the number of documented COVID-19 cases in nursing homes within the city of Philadelphia. The data paints a staggering, grim picture of the toll this pandemic has taken on our elderly: At least 25% of all nursing home residents are infected, leading to more than 500 long-term care facility deaths that account for more than half of the city’s coronavirus fatalities.

The extreme challenges that nursing homes — whether for-profit or nonprofit, high Medicaid or high private-pay — face in controlling COVID-19 is well-documented: Elderly residents with multiple conditions are particularly susceptible to this virus, and the low-tech, high-touch care that makes quality of life for our residents as good as possible is exactly what allows it to spread. Social distancing is not an option.

I am the medical director at Renaissance Healthcare and Rehabilitation Center in West Philly. Even before we had any suspected cases, our entire building had to be treated. Staff have to don face masks and eye protection as they enter and keep it on all day. Residents have to stay in their rooms with all group activities canceled. But even with the very best protective measures in place, the virus is aggressive, and it may enter and spread. Although we restricted visits, ended group activities, and barred any outside vendors or workers from going beyond our lobby, we became the first nursing home in the city with a reported COVID-19 case.

As a geriatrician who has worked in nursing homes for almost 20 years, for me, the case numbers have names. At Renaissance, staff members and I have had to mourn the loss of those who have been in our care for years. We know their families. We know what makes them laugh and when they like to nap. When they die, we cry with the family, and we feel the loss as an irreplaceable, empty hole in our community. Then we continue to show up and care for the patients who we have grown to love. But to continue doing so, we need your help.

Being the city’s first nursing home with a reported COVID case, we were able to get immense support from the Philadelphia Department of Public Health and Penn Medicine for adequate testing, PPE, and clinical support. With this support, we could control our outbreak, and have not had any additional deaths or positive cases in over a month.

However, other nursing homes have not had the same successes, and they need more coordinated government and local support than ever before. Nursing homes need adequate testing, personal protective equipment, and staffing support. The scope of the problem should lead to action that can still save lives. This is not going to be a short pandemic for nursing homes. As long as there is community spread, nursing homes will have to stay locked down and get help when outbreaks occur.

In addition to support on a systems level, the incredible staff that work inside nursing homes also need appreciation. Nursing home staff are health-care heroes. We must not forget that these hardworking staffers are frontline heroes who deserve recognition and support.

Donate PPE to nursing homes, or write notes of encouragement. Donate funds to allow staff to use private transportation instead of public transportation to decrease exposure. Repurpose a hobby, like sewing, to provide gowns for nursing home staff. If you are a small business like a restaurant, donate goods or services like meals. This would mean so much to nursing home morale.

When you read a number like 544 confirmed long-term facility resident deaths, as the city reported Thursday, I hope that instead of shaking your head and placing blame, you instead think, “How can I help?” to turn this disaster around. Now, more than ever, nursing homes need your compassion.

Joshua Uy is an associate professor of clinical medicine at the University of Pennsylvania’s Perelman School of Medicine. joshuauy@pennmedicine.upenn.edu