ARI SHAPIRO, HOST:
We've been reporting that more than 250,000 people have died of COVID-19 in this country. And here's another grim statistic. More than 100,000 of those deaths are people who live and work in long-term care facilities. That's according to the Kaiser Family Foundation. Priya Chidambaram is a policy analyst there. She's been tracking COVID-19 in nursing homes. Welcome to ALL THINGS CONSIDERED.
PRIYA CHIDAMBARAM: Hi, Ari. Thanks so much for having me.
SHAPIRO: Can I just start by asking what your thoughts have been this week as you realized that 40% of the deaths from the coronavirus in this country - more than a hundred thousand people - are the most vulnerable citizens and those who care for them?
CHIDAMBARAM: Yeah. I mean, this has been really, really shocking. If you had told me over the summer that we were going to be sitting here over Thanksgiving weekend talking about how over a hundred thousand people have died in these facilities, I would have been very skeptical to say the least because we did see new cases and new deaths over the summer decrease in long-term care facilities. So there was reason to believe that what these long-term care facilities were doing was working.
SHAPIRO: I mean, one of the reasons I found this figure so shocking is that at the start of this epidemic in the U.S. back in March, we knew that nursing homes and long-term care facilities were a problem. And across the country, those homes put safety protocols in place. They barred family members from visiting. They took other steps. Your findings make it sound like that didn't work.
CHIDAMBARAM: I think one of the things that we've realized is that it's less related to the specific protocols that nursing homes have put into place but more related to community spread. And so when there are cases in communities, there will be cases in nursing homes. And that's something that we have seen over and over again. When we saw the surge in cases in the spring, where we saw long-term care cases and deaths were in the Northeast. Over the summer, we saw long-term care cases and deaths in the Sun Belt states. And right now we are seeing surges of long-term care cases and deaths in the mountain and Midwest states, where we're seeing community spread.
And so all along, the story has been where there are community cases, there will be long-term care cases and deaths. And so not to undermine the importance of the protocols that nursing homes have taken, but ultimately, reducing community spread is the most effective way of reducing cases and deaths in nursing homes.
SHAPIRO: But the flipside of that is it sounds like you're saying if there are high rates of COVID-19 in a community, there may be nothing that long-term care residents and staff can do to prevent it from spreading in their facility.
CHIDAMBARAM: So what long-term care facilities themselves can do is implement similar measures to what communities can do. And what that means is facilities themselves can test and isolate and contact trace. So if they can rapid test their residents multiple times a week, they will be able to isolate those that test positive and, you know, hopefully prevent the virus from spreading.
SHAPIRO: Many of the workers in these facilities are low-wage employees. What role does that play in the high death rates?
CHIDAMBARAM: Absolutely. So when someone is a low-wage employee, they don't necessarily feel like they can take time off if they get sick. They feel like they have to continue to go into work. And especially when you're talking about a setting like a long-term care setting where the people that long-term care workers are working with are at high risk, that can be deadly.
SHAPIRO: Can you tell what percentage of these deaths are people who would likely have imminently died of another cause anyway? - because many people who live in long-term care facilities are near the end of their life and might be suffering from a fatal illness that would have claimed their life in the near future even if COVID did not.
CHIDAMBARAM: You know, many residents have these underlying conditions and have chronic conditions. And while many of these residents might be towards the end of their life, COVID-19 ultimately was the cause - that, like, final cause of many of their deaths. And that was entirely preventable had there been a national strategy to prevent it.
SHAPIRO: Priya Chidambaram is a policy analyst with the Kaiser Family Foundation. Thank you for speaking with us.
CHIDAMBARAM: Yeah, sure. Thanks so much, Ari.
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