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The Real Scandal of the Pandemic: Our Terrible Care for the Elderly

A huge number of the dead are coming from nursing homes.

This May is Older Americans Month, as declared by President Trump on April 30, in accord with the tradition established by President Kennedy in May 1963. In his declaration, Trump calls “upon all Americans to honor our elders, acknowledge their contributions, care for those in need, and reaffirm our country’s commitment to older Americans this month and throughout the year.”

You’d be forgiven for having never heard of Older Americans Month and for not being aware of Trump’s declaration. The welfare of the elderly is not considered a major civil rights issue in our national story, so, despite its place on the calendar, it just doesn’t get the play.

One hopes that will change. The timing of President Trump’s declaration, however accidental, is good. Among all the horrors that have visited us during this pandemic—mass unemployment, impoverishment, hunger, sickness, death—we can be thankful that, amidst this, American hearts have united in love for the elderly. As Governor of New York Andrew Cuomo put it on March 24, “My mother is not expendable. And your mother is not expendable.”

As early as March 9, before social distancing was nationally recommended and state lockdowns were mandated, Dr. Anthony Fauci was on Fox & Friends warning about the seriousness of COVID-19: “We know that the most vulnerable people in our society right now are those people with … underlying conditions, particularly the elderly.”

Fauci has been proved right. As Scott Atlas, Hoover Institution Senior Fellow, recently wrote, in an effort to make the case for reopening the economy, “Of Empire State fatalities, almost two-thirds were over 70 years of age.” That’s over 12,000 deaths in NYC alone. Statewide, that number is shooting up, with the recent reporting of 1,700 “previously undisclosed deaths” at nursing homes and other care facilities. 

America went into lockdown to reduce as many such fatalities as possible. Saving the elderly and infirm was the logic of our collective action—and rightly so, for a good society protects its vulnerable. Still, passionate words are ringing hollow. When a government defends a key population from menace and its protective actions prove ineffective it should adjust its approach and provide the manpower and resources lacking in the defense. But this is not happening. Our leaders are failing.

Consider the case of Cuomo. Despite his own stated purpose for the shutdowns, he resisted sending protective equipment to nursing homes—”it’s not our job,” he said. He refused to establish guidelines that would make them safer, some as simple as requiring the ill to be quarantined. He declared himself unwilling to send elderly patients to the USNS Comfort, the naval hospital ship which has since departed from New York, where they might have received treatment. Shockingly, he has even mandated that nursing homes re-admit COVID-19 patients, with full knowledge of its potential effect. As if to put a grim point on it, despite absolving himself from the need to provide PPE, he made sure to send the readmitted patients with their very own body bags. (Similar mandates were established in California and New Jersey, but without the callousness.)

The result is predictable, and the scandals are mounting. The elderly are dying in New York nursing homes at catastrophic rates and the places ostensibly set aside to shield our precious loved ones have been used as trash heaps to throwaway the disposable. Tears fall when reading of the Isabella Geriatric Center in Manhattan, where, as of last count, 98 have died. The mass grave on Hart Island is being filled with our elderly. On a national level, Phil Kerpen’s research, which synthesizes the latest in state-level data, shows that, of the nearly 76,726 deaths nationwide, 32,204 can be shown to be nursing home deaths. And this with certain states lacking in punctuality and some not reporting at all. That’s 42 percent of deaths with incomplete reportage. In reality, the number is far higher.

On April 28, 2020, The New York Times ran a revealing op-ed by Richard Mollot of the Long Term Care Community Coalition, which argues that neglect and deteriorated conditions in nursing homes made fertile ground for infection. According to Mollot, “one million to three million serious infections occur every year in nursing homes and other long-term-care facilities, and as many as 380,000 people die of those infections every year.” In other words, we regularly subject our elderly—grandmothers, grandfather, mothers, fathers, aunts, uncles, brothers, sisters, loved ones—to conditions so horrendous that there was no way a virus could be stopped. That neglect has become a political problem. Or, really, it always was and the pandemic is only revealing it. 

But festering wounds do not absolve our elected officials of their current failures. Governors should not “ration” equipment and should instead take responsibility for the provision of gear that dampens the spread of the virus. When in nursing homes, elderly who are ill with COVID-19 must be immediately quarantined and not left among those who do not have the virus. And fellow community members and their families have a right to be alerted to the presence of the ill. This should be obvious.

I do not intend to single out Cuomo or absolve the president. In President Trump’s recent townhall before the Lincoln Memorial, he was asked, based on the declared reason for our lockdowns, perhaps the key question: “what will be done, both in the short-term and in the long-term, to protect the vulnerable in nursing homes, senior housing, and assisted living centers?”

Trump’s answer was dodgy. He began strongly, by calling these places “ground zero” for the virus, a phrase he repeated. He commented on the ferocity and contagiousness of COVID-19. He mused about the deadliness of the Spanish Flu and how the subject of the 1918 pandemic is hot right now. And then he concluded by saying that responsibility falls to the governors.

This may, technically, be true. The governors run the hospitals and state-run nursing homes, and have near-total authority over the running of private business, including private care facilities. But the president can leverage funding in forthcoming legislation. And though he doesn’t run the states, he casts a national vision over them. 

For example, in the case of Opening Up America Again—well received by both left and right—Trump’s guidelines for “reopening the economy” create a standard by which the actions of the governors can be judged. Now that we are certain that nursing homes are the key battleground in the effort to defeat the virus, one would think that steps to “reopen the economy” would require specific preparations for making such facilities safe. Yet, in Opening Up America Again, only social distancing and shelter in place are recommended for the vulnerable. But these have already proven to be insufficient measures to protect nursing home residents.

What’s going on here? Why the hard neglect of the same communities we are supposedly moving heaven and earth to protect? 

Old negligence dies hard. I’m not a conspiratorial type, so, in seeing the sheer mismatch between image and reality, I sense no plot afoot. Even with this stirring of national conscience, the elderly are just not that meaningful to a society that values efficiency and power above all else. So, despite their speechifying, it appears our leaders wrote off the nursing homes as lost from the get-go. Some mothers, it turns out, are more expendable than others. 

It’s not too late. Course correction is possible. We must fight off moral inertia by providing our nursing homes with the materials and personnel they need. Give them the PPE. As rapid tests become increasingly available, prioritize their use at these facilities. Above all, collaboration between the governors and the president in outfitting and securing them should match the high pitch of urgency with which they supported our hospitals. Nursing homes are, after all, ground zero.

But let our ambitions be higher still. As the year progresses, let’s be creative in how we use rapid tests to serve our elderly, who languish in isolation and fear. Instead of consigning them to endless quarantine, let’s give them a social and even a public life. 

Here’s an idea, and likely not the best. For those who are mobile, set aside areas in public parks and beaches for their use, places where the virus has difficulty surviving. Using rapid test to confirm their health, admit them as well as loved ones. Give them healthy drivers who can take them to and from. If we can build a hospital in Central Park in the span of a weekend, we can do this, too.

We cannot leave our elderly locked away. We just need the political will and enduring love to make this happen. Our mothers deserve nothing less.

Michael Toscano is executive director of The Institute for Family Studies.



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