Has the nursing home model failed in the pandemic?

The deadly pandemic has laid bare the deficiencies of the modern nation-state model and its governments. This has been particularly stark in the most developed economies like the US, the UK and France. 

The poor care of the elderly population — the segment most vulnerable to the threat presented by the coronavirus pandemic — in nursing homes across several countries has become a shocking reality, eroding citizens’ trust in their governments.  

“We think, ‘these people are going to die anyway’,” said Charlene Harrington, a professor at the nursing school at University of California, San Francisco, speaking of the elephant in the room. 

According to the World Health Organisation (WHO), nursing home deaths in Europe account for half of the countries’ total deaths linked to the virus as New York reports nearly 5,000 deaths in their long-term-care facilities. 

Total deaths in the American financial capital currently hover around 20,000, leading all other states as the US tops all other countries with a staggering 74,000 deaths. 

In the UK, according to some researchers, nursing home deaths could be 40 percent of the total fatalities while those facilities are home to less than 1 percent of the country’s population.

In Spain, where a fiasco regarding nursing homes emerged at the beginning of the pandemic in March, nursing homes deaths stand at 16,000 more than half of the country’s nearly 26,000 fatalities. 

But experts doubt the accuracy of the reported fatalities regarding nursing homes across Europe and the US as many older citizens have been found dead in their beds in Spanish care facilities and makeshift morgues in New Jersey. 

Nursing home model 

Professor Harrington thinks that the way the nursing home business has been conducted in the US and some other places has facilitated “a disaster in the making.” 

“Nursing homes are the weak link in our healthcare system, and we’ve allowed it,” the professor told the Financial Times. 

Hans Kluge, the WHO’s top official for Europe, also drew a “deeply concerning picture” of the  death rates in nursing homes across Europe. 

“This is an unimaginable human tragedy,” Kluge said in a press conference in late April. 

But the tragedy has been ensured under an ill-regulated free market model, where profit comes first.

Harrington and other experts think that profit-seeking owners of nursing homes have mostly been concerned about increasing their income at the expense of residents, cutting essential staff and employing people with less medical skills and low wages. 

Researchers from Harvard and Vanderbilt universities have found in a study that three-quarters of American nursing homes were short on staff before the deadly pandemic. 

In Spain, where most of the nursing homes are run privately, their understaffed reality is almost the same as the US. 

"The amount of messages we were getting those days was insane. I was thinking: You can't let these people rot," said Carmen Flores, who leads the Patients' Defenders ombudsman group, a Spanish organisation. 

Flores had previously warned Spanish authorities “about precarious conditions in some of Spain's 5,417 care homes,” according to the BBC. 

“Care homes are places where physical distancing is almost impossible,” said Adelina Comas-Herrera, who co-authored an influential London School of Economics (LSE) report, showing how devastating the virus has been in nursing homes across Europe.  

“It’s like a perfect storm: a susceptible population, not being able to implement the measures and the staff are not well supported and trained enough. Many of the staff are care assistants with very little medical knowledge,” Comas-Herrera observed. 

In addition to that, many European countries have deliberately ignored testing in care facilities, directing those resources toward hospital patients and personnel. 

"I think there was a lot of wrongdoing. These people couldn't shout or say they were unwell. They died in silence and alone," said Rosana Castillo, who lost her mother in a nursing home in the Spanish capital of Madrid.