Nursing homes with COVID-19 outbreaks should be named

By TIM KALICH,

Dr. Thomas Dobbs is a smart and earnest public servant. When I have heard Mississippi’s chief health officer speak about the  COVID-19 pandemic or read what he has to say, I have found him reasonable and mostly persuasive.

You want to follow Dobbs’ guidance — first when he tells you that you don’t need to wear a mask in public, then again when he adjusts to changing scientific study and says you should — because he seems so genuinely concerned and sincere.

There is, though, one area where he has been consistently wrong: withholding the names of nursing homes and other long-term care facilities with outbreaks of the new coronavirus.

This past week, Dobbs tried to explain why the Mississippi State Department of Health doesn’t think publicly identifying the infected facilities is a good idea, even while his agency provides daily county-by-county counts of the outbreaks, residents infected and deaths.

He said that he and others in the Health Department fear that naming the facilities could stigmatize them and possibly worsen their employee shortages.

It’s also been said that such transparency is medically unnecessary since residents and their family members are informed of any outbreaks, since visitation is currently banned at them, and since employees are being screened daily with temperature checks, so as to reduce the risk of transmission.

The steadily growing number of outbreaks, however, is prima facie evidence that the precautions are not keeping the infection out. At last count, 104 nursing homes or other long-term care facilities in Mississippi have at least one active case of COVID-19. If they can’t keep the infection out, it’s also certain they aren’t keeping it in either.

As Dobbs and other health officials have repeatedly reminded us, an infected person does not have to have symptoms to transmit the disease to others. Thus, although the temperature checks of employees might be prudent in deciding who needs to be quarantined or tested, they don’t eliminate the risk.

We need to be concerned foremost about the vulnerability of nursing home residents, who are the most prone to die from the disease. So far, nearly 40% of the deaths in Mississippi have been to people living in long-term care facilities.

But secondly,  we need to be concerned that when an infection takes hold and multiplies in a nursing home, it then becomes a toxic factory for potentially spreading the disease out into the community, whether through its employees or those whose jobs take them there, such as delivery drivers.

To best protect those inside an infected nursing home and those outside of it, full disclosure is required. Not just news media groups are calling for it either. So have families of nursing home residents. So have groups that represent senior citizens, such as AARP.

The nursing homes with good infection controls should want transparency, too. The way it currently works, once a county gets on the list for having an outbreak, there is no way to know for certain which facilities have COVID-19 infections or how serious the situation is unless they voluntarily provide the information. That leaves all of the nursing homes stigmatized, an outcome that the Department of Health presumably would want to avoid.

A number of other states also resisted identifying facilities at first, but they have given into pressure, and mounting nursing home deaths, to release the information. At least 10 states do so now in full or in part.

Dobbs has shown in the past an admirable willingness to reconsider his positions when the evidence suggests a different response is needed. The evidence on nursing homes is clear. In the interest of public health, there is more to be gained than lost by specifying where the problems are.  

Contact Tim Kalich at 581-7243 or tkalich@gwcommonwealth.com.