Guest Opinion | Erika Foy: We are Failing Patients and Staff at Pasadena Nursing Homes

As the City of Pasadena grapples with how to safely re-open local businesses, decision-makers seem to be ignoring one of their biggest problems and opportunities in the battle to control COVID-19: long-term care facilities. Currently, Pasadena Health Department is reporting 63% of the city’s coronavirus cases and 88% of deaths from the disease are linked to nursing homes. One area facility had an astonishing 128 confirmed-positive residents and staff and 16 deaths.

These statistics are shocking enough on their own, but they are downright chilling when you realize that there are 217 cases still under review that are possibly linked to these same businesses. There are also 268 confirmed cases among the staff within these facilities. These cases are only included in the health department’s overall numbers if the infected person lives in Pasadena. Many of these employees live outside of Pasadena’s city limits and therefore are not counted in the health department’s numbers, even though they spend a significant number of hours in our city. If the city accounted for all of the employee cases within Pasadena’s nursing homes, as well as for the cases that are still under investigation, nursing facilities could easily account for over 75% of all cases in the city. Let that sink in.

L.A. County’s public health director, Dr. Barbara Ferrer recently suggested that it would be “appropriate” for families to take care of their loved ones at home if possible. On June 11, there was a state-mandated mass evacuation of 63 patients from a skilled nursing facility on Fair Oaks. Pasadena spokesperson Lisa Derderian told Pasadena Now that the evacuation was ordered “due to lack of patient care including response to COVID.” It is time to ask hard questions about how we are protecting our vulnerable nursing home patients and staff, and why we have allowed this disease to fester specifically in this type of medical facility.

I’m personally alarmed by what I’ve learned about the management of nursing facilities. My father recently had to be removed from a skilled nursing facility in Los Angeles County that is currently suffering an outbreak of 38 cases of COVID-19 and 6 resulting deaths. His facility didn’t quarantine patients until after they showed symptoms (even if they had already been exposed to the virus), they had limited testing capabilities, they were understaffed because employees were understandably calling in sick, there were no temperature readings at the back entrance to the building, and social distancing protocols were not being maintained. I never saw staff wipe down the facility iPad being passed from room to room, nor I did see staff wash their hands as they entered my dad’s room. He was even brought out of his room without a mask to visit with me through a window.

The fact is that COVID-19 is currently concentrated in what should be highly controllable medical environments. And yet, social distancing practices, enforcement strategies, testing protocols, and accurate statistics about infection rates and deaths are all frustratingly vague. As the LA Times reported on June 5th, David Grabowski, a professor in the Department of Health Care Policy of Harvard Medical School said, “California [is] advocating for testing programs that lack ‘teeth,’ because they are largely left to local health authorities and the facilities themselves.” I witnessed this toothless policy first-hand: even with so many common-sense precautions missing, my father’s facility was still technically in compliance with the health code. How many facilities in Pasadena are operating with the same anemic approach?

In stark contrast, the precautions LA County has outlined in the new best-practices manual for the restaurant and bar industry is so stringent it borders on the absurd. “One of the ‘onerous’ restaurant guidelines requires servers to wear a plastic face shield in addition to a face mask if customers seated at tables are not wearing face masks,” said Robin Salzer, a former Pasadena restaurant owner, as quoted in Pasadena Now. The county has also requested that restaurant patrons only remove their masks when taking a bite of food.

How do we have the time and energy to offer guidance on mask usage while eating when we can’t even be bothered to fully publicize and stress to the community how bad the situation is within our nursing homes? And practically speaking, why are we placing this incredible burden on our local businesses and restaurants when the issue seems to be almost entirely contained within these facilities? We are making it hard for businesses to reopen as a way to ensure that germs aren’t easily spread from one person to another in an enclosed public space. Why can’t Pasadena create and enforce similarly rigorous guidance to make it difficult for the virus to spread in nursing homes?

The patients, residents, and staff at long-term care facilities deserve to be protected by the most stringent safety protocols. Enforcing social distancing measures in combination with quick and universal testing where our most vulnerable residents are at the highest possible risk of illness and death seems like it would be a much more effective way to protect both the health of the general population as well as that of the economy.

If we can be more proactive in helping prevent the spread of COVID-19 by putting stringent protocols in place for these nursing facilities, we can drastically reduce our infection rates overall and finally get back to work and play. Pasadena has an opportunity and responsibility to do better. Nursing homes need a safety and infectious disease overhaul and the time for this now. Our physical and economic health depends on it.

Erika Foy is a Pasadena resident who is also a Vice President for Membership of the Madison Heights Neighborhood Association