After a rocky start, Massachusetts has scored some significant victories in the battle against COVID-19, most notably the success of our vaccination efforts. Today, Massachusetts is one of the most highly vaccinated states in the country, and efforts targeted at the most difficult to reach populations are ongoing.
Transparency is, unfortunately, an area where the state Department of Public Health (DPH) has had a consistent problem. Early in the pandemic, the Commonwealth had to be pressured to go beyond county-wide reporting and instead specify cases and deaths by city. This type of transparency proved crucial during the hardest days of the pandemic, and also during the first phases of vaccine distribution.
Sadly, communication of crucial information on COVID-19 deaths and cases in nursing homes and assisted living facilities has been lax. To remedy that, the DPH needs to resume regularly publishing data on both recent and overall case and death counts.
At the start of the pandemic, the Commonwealth took many months before publishing actual case numbers for nursing homes. When it did, it limited its reporting on cases at individual nursing homes, providing numerical ranges such as “less than 10” or “more than 30.” The DPH would sometimes show that a home had “more than 30” cases when, in fact, that home had 120 cases.
The DPH was no better when it came to assisted living facilities, again publishing insufficient data, only listing case numbers by range and even failing to publish the number of deaths.
While the state was relatively quick to lock down homes and prohibit visitors, lack of transparency slowed the flow of information on efforts to test residents and staff, implement appropriate infection control and prevention protocols, and secure the safety equipment resources necessary to prevent the quick spread of COVID-19. When the Commonwealth sent in the National Guard to help test nursing home residents beginning on March 31, 2020, it was not clear whether all residents and staff had been tested. To this day, we don’t know how frequently testing has been done since the Spring 2020 push.
Facing alarming levels of death in nursing homes, the DPH ultimately initiated a more robust nursing home inspection program and leveraged funding to force homes to implement more rigorous infection prevention and control protocols.
It was not until spring of this year that the DPH began publishing both recent and total numbers of deaths and cases at each nursing home. This information was published in a “Weekly Report” and made available through the state’s COVID Dashboard. It enabled families, hospital discharge planners and consumers to know the current and cumulative COVID-19 status in each home and to make decisions accordingly.
In late June 2021, the state abruptly discontinued this publication which, in its most helpful format, was only available for a brief period.
With cases in nursing homes on the rise again and a significant subset of nursing home workers still unvaccinated, the public has no way to know the risk profile or vaccination rate in specific homes. At this point in the pandemic, a lack of transparency for such a vulnerable patient population is inexplicable.
COVID-19 killed at least 6,000 nursing home residents — nearly 16% of the Commonwealth’s nursing home population. Now, as we are in what we hope is the homestretch of the pandemic, the DPH must value and make available the COVID-19 data that residents need to make responsible decisions for themselves and their loved ones.
The Department of Public Health should resume publishing the Weekly Report of recent and cumulative case and death counts for nursing homes and begin to do the same for assisted living facilities. Massachusetts residents should not have to beg state regulators to make transparency of information at our eldercare facilities a priority during COVID-19.
Barbara Anthony is Senior Fellow in Healthcare at Pioneer Institute, a Boston-based think tank.
