Sarah Ravani, San Francisco Chronicle, April 24, 2020
As deaths from the coronavirus rise, topping 1,500 across California, families are left in the dark about how many of those occur in the nursing homes, where their ill parents and others they love remain isolated, because the state Department of Public Health has so far declined to say.
In Santa Clara County, which does disclose the data, nearly 30% of all coronavirus deaths have occurred in nursing homes.
Now, advocates for residents say the lack of data on nursing home deaths hides how widespread and deadly the virus is in those settings, and withholds critical information from people who have to decide whether to move into a facility or remain in one.
“You won’t know if you’re being sent to a trap, into a building where the virus is already killing people because that information is not being made public,” said Michael Dark, a staff attorney at the California Advocates for Nursing Home Reform. “It’s the state and the counties choosing not to look a crisis in the face. They’re covering their eyes.”
Each day, California’s public health officials report the number of deaths across the state due to COVID-19, the disease caused by the coronavirus. They also report a daily total of positive coronavirus cases, and break out those that occur in hospital patients and health care workers statewide. But they do not break out the number of nursing home deaths.
“The state is not including information on skilled nursing facility deaths at this time,” the Public Health Department’s information office told The Chronicle, adding that it will release the information “in the future.” No one responded to further inquiries, however.
Some counties release the number of deaths and infections at nursing homes. Santa Clara County reported 98 deaths from the coronavirus — 29 of which occurred in nursing homes, or nearly 30%. The county does not say at which of its 17 facilities the deaths occurred.
Most Bay Area counties decline to release the number of nursing home deaths, citing privacy concerns.
“Health care privacy laws, of course, do not prevent releasing aggregate numbered data that don’t have names attached,” Dark said. “This is not personal health care information — that is just a ruse.”
Liability may also be a concern.
On April 9, health care industry representatives — including those representing nursing homes — sent a letter to Gov. Gavin Newsom asking him to sign an executive order protecting nursing homes, senior care facilities, doctors and hospitals from lawsuits and prosecutions during the pandemic.
Nursing homes, also called skilled nursing facilities, are distinct from assisted-living places where residents need basic help with daily living. Nursing home residents generally have more complex health conditions and may require around-the-clock care.
Union City Councilman Jaime Patiño said it is crucial for nursing homes to inform family members about coronavirus outbreaks and deaths.
Patiño’s 84-year-old grandmother died April 13 after she tested positive for the coronavirus while at Gateway Care & Rehabilitation Center in Hayward. That nursing home has come under scrutiny after 13 people died, and 42 residents and 26 staff members tested positive.
Patiño said the facility notified his family after one person at the facility had tested positive for the virus. Two weeks later, he found out about more infections from a news article.
“For the families of people that aren’t infected, they need to make a decision, do we move them to another facility? Do we bring them home? Do we leave them there?” he said. “Had we had information sooner, we probably would have moved her.”
On April 19, the state’s Public Health Department asked all skilled nursing facilities to submit daily updates on current staffing levels, the number of COVID-19 patients and equipment availability. The survey that facilities must fill out does not ask about deaths.
The threat of the coronavirus is particularly concerning in congregant settings like nursing homes where social distancing and separation from workers and residents isn’t an easy option, said Jessica Lehman, executive director at Senior and Disability Action.
Nursing home residents are acutely vulnerable to the virus due to their age and underlying medical conditions, health experts say. This week, an official from the World Health Organization said that as many as half of the people who died in Europe from the coronavirus may have lived in either nursing homes or assisted living facilities.
“It has been very difficult to get information from the state or from the city and county,” Lehman said. “We don’t know how bad things are, and we don’t know how many people have been tested and we know a lot of people aren’t being tested.”
Similar transparency issues have surfaced with testing. The California Department of Public Health each day says how many tests have been conducted statewide to date. But it does not break down testing data by lab. This means that when there was a major testing backlog — at one point, 64% of the tests conducted in the state were pending, though the backlog has since been cleared — it was impossible to tell at which labs the pending tests were held up.
Also, the number of health care worker deaths isn’t reported on any state list. Rather, that information has to be requested and is otherwise folded into the daily death count. A total of 22 health care workers had died from COVID-19 as of Friday, said Kate Folmar, deputy secretary for external affairs for California Health and Human Services Agency.
Folmar said The Chronicle would have to file a public records request to get a breakdown of health care worker deaths by county and facility.
On Friday, Gov. Gavin Newsom said 522 skilled nursing facilities and senior care centers across the state have had at least one person infected with COVID-19. More than 2,700 staffers and patients currently have the coronavirus, he added.
San Francisco Chronicle staff writers Catherine Ho and Mallory Moench contributed to this report.