According to new data, COVID care home deaths in the United States are influenced by race – with majority non-White care homes experiencing 3.3 times more deaths
Recently, Governor of New York, Andrew Cuomo was found to have made poor decisions in sending COVID positive patients back to care homes. Naturally, these individuals began large chains of transmission that claimed highly vulnerable lives. In the UK, Prime Minister Boris Johnson similarly supported the transfer of positive patients back to care homes. This move was made early on in the UK’s handling of the pandemic, but created several questions about social care decisions that remain open to this moment.
While age is an undeniable factor for COVID vulnerability, race is clearly understood to be a demographic that is linked to other risk factors. For instance, intergenerational homes with more likelihood of COVID and low-income work.
A research team at The University of Chicago examined care homes with race in mind. For instance, why was their data connecting race with increased deaths in a care home environment? This connection makes sense in the world outside, where work and comorbidities align to create a higher likelihood of infection.
In the US, between 35% and 40% of COVID-19 deaths have been associated with long-term care facilities.
In an enclosed space, same as the space experienced by the white ageing population, why are there still racial differences in death?
‘We saw some striking relationships’
Senior author Dr Tamara Konetzka, the Louis Block Professor of Public Health Sciences and the College at UChicago: “Very early on, we saw some striking relationships with the racial composition of a nursing home, where nursing homes serving more Black and brown residents seem to have more COVID cases and deaths.
“There were theories floating around that maybe Black and brown residents are just sicker or are in low-quality homes, but we wanted to dig beneath these really alarming statistics and analyze why these outcomes were happening.”
Dr Konetzka testified before the Senate Special Committee on Aging on why nursing homes were suffering from COVID, and how to change their outcomes.
Pushing aside the available answer of comorbidities (conditions like diabetes and heart disease), the team examined overall patient health, facility size, chain membership, ownership type, number of nursing hours, COVID in the local community, and facility star rating.
In the end, they found that two elements really influenced COVID deaths in care homes.
Firstly, population size in the home. Secondly, the impact of COVID in the local community.
Dr Konetzka further explained: “Black and non-White people in general tend to live in neighborhoods that have a high prevalence of the virus and even the staff who work in these facilities are more likely to live in these neighborhoods. It’s about location and size, more than anything else.”
3.3 more COVID-19 deaths in non-White care homes
In the end, the team found that care homes with large populations of non-White residents have 3.3 times more death than homes with majority white populations. Pre-existing health conditions, like diabetes, didn’t explain this fact away.
Dr Konetzka draws the attention of care home professionals to their general protocol for infection control, and how well they are implementing this: “I think it was surprising to everyone that low quality of nursing home care wasn’t at the root of this. In fact, a few years prior to the pandemic, a lot was made of the fact that the majority of nursing homes had regulatory deficiencies in their infection control procedures. The whole sector was just unable to deal with a crisis of this magnitude.
“The coronavirus can be spread asymptomatically and is airborne. Large nursing homes can have several residents per room and staff must go room to room to give care.
“COVID-19 is a perfect storm where it doesn’t matter if a nursing home is high- or low-quality; all patients are at risk.”