Nursing homes need tests with instant results!

Otherwise, viral spread with a high fatality rate is a matter of “when” not “if”.
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Let’s connect a couple of dots today…

First, the obvious has suddenly become evident: nursing homes (and other long-term care facilities) are sitting ducks for the coronavirus.

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Why is that?

Nursing homes present a “perfect storm” challenge: highly vulnerable, cloistered patients in close, constant contact with non-resident shifts of care-givers.

Let’s unpack that description and its implications …

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The elderly patient populations in nursing homes are loaded with comorbidity factors and weakened immune systems. So, they are more vulnerable to getting infected … and their outcomes are more likely to be terminal.

Nursing homes’ cloistered environment provides caretaking efficiency and, in normal times, some degree of sequestered safety — shielding patients from external dangers.

The caretakers are, in my opinion, doing “God’s work”.  Day-in-day-out they provide unglamorous, hands-on care to difficult patients … and witness death with an emotionally draining frequency.

The caretakers rarely reside at the facility.  They go home at the end of their shift and return the next day to do it all again.

That last point may sound incidental, but it may be the pivotal threat to the system.

Each time a caretaker leaves and returns to duty, the protective shield around the patients is breached.

The stark fact is that each time a caretaker returns to action — after having been exposed to the outside, virus-infected world — they are a potential virus spreader — a “super spreader” who may be  carrying the virus symptom-free.

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Now, the second dot to be connected: testing.

As the headline above submits: more testing is required “to detect and curb outbreaks”.

I agree, but I don’t think that the current tests are up for the task.

To keep the environment sterile, the caretakers must be tested every time that they enter the facility.

Being virus-free today is no guarantee of being virus-free tomorrow.

Keeping in mind that the virus is highly infectious — the “one bad apple” dynamic is in play.

So, all caregivers must be tested every day.

That raises logistic issues.

The standard lab test returns results in 48 hours.

What if a caretaker tests positive?

That means that they’ve exposed patients to the virus for 2 days … or, if they’ve been sidelined, they may have gotten infected while waiting for the test results.

Either way, there’s a potential outbreak.

So, what about the Abbott rapid test that gives an answer in 15 minutes?

Rephrasing, each Abbott machine can only provide test results for 4 caretakers per hour.

So, even if a facility bites the bullet and buys, say, 1 machine for every 4 caretakers … it would take an hour to staff up for a shift.

That might work for smaller facilities with few caretakers, but won’t work for high population facilities — facing either too much investment required or too much caretaker time wasted.

Bottom line: The key to keeping nursing homes really safe are tests that gives instant results.

Otherwise, it’s “when” not “if”.

One Response to “Nursing homes need tests with instant results!”

  1. Do Americans really care about nursing homes? | The Homa Files Says:

    […] See: Nursing homes need tests with instant results! […]

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