NYS nursing homes are required to report COVID deaths, but not deaths from dementia or failure to thrive. It is the increase in those two causes of death that we refer to as "isolation deaths." Nursing home physicians, administrators and families all know dementia and failure to thrive cases and deaths are up during COVID isolation. The question is "by how much?"
Our group has used available data to estimate risk of death from isolation during COVID. This page details our work. It should be noted that even reported NYSDOH COVID deaths are estimates, as it is unclear whether some residents died "from COVID" or "with COVID."
According to an article in the Wall Street Journal, 100,000 people died from Alzheimer’s and dementia from February through May, a fatality rate that is +18% higher than average for those disorders in previous baseline years.
Nursing home residents ordinarily have a 13% risk of dying from Alzheimer’s or dementia (50% incidence rate; 25% mortality in first year) and a 6% risk of dying from failure to thrive (40% incidence; 16% mortality rate), for a total risk of 19%. Applying the +18% factor above, that risk would increase to more than 22%. That means an additional +3% of a nursing home population could be expected to die from increases in cases of dementia and failure to thrive, caused by isolation.
In the previous section we demonstrated that, during isolation, an additional +3% of the resident population could be expected to die, due to increased cases of dementia and failure to thrive (when compared to an ordinary, non-isolation period).
In New York State's nursing home population of 100,000, a +3% increase in mortality rate would translate to an additonal + 3,000 deaths annually, or about 60 more deaths every single week. Just due to the effects of isolation.
In the latest reporting period, when the COVID positivity rate was <1%, NYS nursing homes reported 10 COVID deaths for the week ending 31 August, 2020.
Clearly, with COVID positivity risk so low, the risk of death from isolation (+ 60 deaths per week) far exceeds the risk of death from COVID (10 deaths per week). By a 6-to-1 ratio.
With COVID positivity <1% in NYS, there is clearly a much greater risk of death from isolation than from COVID. On that basis, we call on NYSDOH to allow resumed visitation of our loved ones immediately.
For every week that passes during isolation, another + 60 residents will die needlessly from increased risk of dementia and failure to thrive. Texas, Florida, Michigan and Pennsylvania all have more accomodative visitation policies despite higher COVID positivity rates. They understand the essential role that loved ones play in the health of the resident.
Our advocacy group strongly believes that there should always be a visitation policy that allows for some level of esseential care from family members, regardless of COVID positivity. Not socially-distanced care - but care that affords family members the same level of interaction that staff have. So that we have the ability to touch, hug, feed, and be close to our loved ones.
We ask Governor Cuomo and Commissioner Zucker to show that they understand our essential role as family caregivers. It's time to let us visit again.