New York’s deadly nursing home scandal: Politics overruled science

Ida Zelcer, 92 years old and a survivor of the Holocaust, lives in Lake View Care Center in Delray Beach, Fla. She is paralyzed from the waist down, has Parkinson’s, mild dementia, a feeding tube and is extremely well cared for. 

Last spring, I interviewed some of the staff in this home and I was impressed with their transparency and commitment to the residents. 

Whenever someone at Lake View turned COVID-19 positive, they were immediately isolated or sent to the hospital and all family members were notified. The staff said that Florida’s Gov. Ron DeSantis (R) had made certain there was sufficient personal protective equipment (PPE) for the staff and sufficient testing for all contacts of positive cases, with the staff being tested regularly.

I contrasted this with what was happening in New York and other states lacking the same focus on protecting nursing home staff and residents, where staff weren’t as well protected or weren’t consistently sharing information with families. 

Last March, New York’s Gov. Andrew Cuomo (D) infamously signed an order directing that COVID-19-positive patients be readmitted to nursing homes. From a medical point of view, this made no sense whatsoever since other patients in long-term care facilities had many risks for severe cases, including age and pre-existing health conditions such as obesity, diabetes, heart disease and emphysema. Plus, nursing home staff are not always trained to handle a highly contagious disease and they are not always able to provide emerging treatments, including dexamethasone. Nursing homes are hardly an ideal place for COVID-19 patients.

At the same time, we had the USNS Comfort, one of the Navy’s high-capacity hospital ships with over 1,000 beds, anchored and virtually empty of patients in New York Harbor — not to mention the Javits Convention Center, which was converted into a field hospital. Both of these easily could have been earmarked for COVID-19-positive elderly patients, instead of placing those vulnerable and infectious patients in nursing homes. 

I could never understand why only 7,000-plus deaths were listed as occurring in New York state’s nursing homes when the national average for nursing home fatalities was closer to 35 percent of total COVID-19 deaths and New York had more than 40,000 total deaths from COVID-19. New York’s reported numbers just didn’t jive with the national figures. How could its percentage be so low when the risks of readmitting COVID-19 patients to nursing homes was so high? 

In California, by contrast, of 151,525 cases in long-term care facilities, there have been 12,509 deaths — a whopping 8 percent of cases. Compare that with the national death rate from COVID-19 — approximately 1.7 percent, and probably much lower, actually, when you add in mild or asymptomatic cases that are missed. Nursing homes clearly are very risky places for COVID-19 patients.

The truth came out in stages, as it always does. 

It was hardly a surprise to discover that the real number of New York nursing home deaths was at least twice what was reported, and that there was a Nixonian-style coverup by the governor or his staff. The politics of fear and control contradicting strict science is one of the most disturbing outcomes of this pandemic. 

Meanwhile, Zelcer in Delray Beach’s Lake View nursing home got her first Pfizer vaccine shot — and then she got COVID-19. But her limited illness — three days of fatigue and cough, at the age of 92 and with her underlying conditions — probably means that the vaccine saved her life. The Lake View home’s staff isolated her in its COVID-19 ward as a precaution and provided her son, Alan, a cardiologist, with updates almost every day. I can’t guarantee that such expert care would happen in New York City, sadly.

I would not encourage Zelcer to get the second vaccine shot, at least not right away, because the combined antibodies from having had both COVID-19 and the first dose should be enough to protect her. This is something we should look at further: Since the vaccine is still such a scarce resource, should everyone have their COVID-19 antibodies checked before receiving the first dose and only have the second dose if the antibodies are low or zero? 

Gov. Cuomo, this is called “following the science.” You should try it.

Marc Siegel, M.D., is a professor of medicine and medical director of “Doctor Radio” at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID: the Politics of Fear and the Power of Science.”