A heavy toll on older adults in nursing homes
Over the course of the pandemic, nursing homes have emerged as outbreak hot spots. Elderly residents—many of whom also have underlying health conditions—are at a particularly high risk of infection and complicated cases of COVID-19. And shared living spaces are a perfect environment for the coronavirus to spread. In European countries, among the first that were hit hard as the pandemic spread worldwide, MSF assisted the elderly in nursing homes in Belgium, France, Italy, Portugal, and Spain. We are now applying a similar model to our work here in the US.
MSF sent a team to Michigan, where one out of every three people who died due to COVID-19 was a nursing home resident. By the end of July, there were 78,000 confirmed cases and over 6,100 deaths statewide, and nursing home residents accounted for 7,500 of the cases and 2,000 deaths, according to the Michigan Department of Health and Human Services. Additionally, there have been more than 3,700 cases of COVID-19 among staff working in long-term care facilities, and 22 deaths. With such a heavy toll on the residents and essential workers at these facilities, MSF began working in Detroit in coordination with the city and state health departments to provide health education, IPC trainings, and mental health workshops to staff of nursing homes and residents and staff at adult foster care facilities.
“This outbreak has laid bare a shocking disinterest our society has for some of our most vulnerable people—the elderly—and those who care for them,” said MSF nurse Karin Huster, who served as emergency medical referent in Michigan. “After a four-hour session with our IPC expert, [one] housekeeper started crying. She said no one had ever paid any attention to her in all her years working there. It was then that I knew our team was right where we needed to be.”
Native American communities in the Southwest have also been among those hardest hit by COVID-19. For example, Native Americans make up nearly 10.5 percent of the population of New Mexico but accounted for half of the 12,147 cases confirmed there by the end of June, according to the state department of health.
In April, MSF began working in partnership with local officials, community leaders, health care workers, and others from the Navajo Nation and Pueblo peoples in New Mexico and Arizona. Led by veteran MSF nurse and midwife Ruth Kauffman, our team provided guidance on infection prevention and control measures for reducing the transmission of the coronavirus in households, community centers, health and care facilities, and correctional facilities. We also provided logistical support to implement these recommendations, and technical support for health and isolation centers.
Nurses are trained to treat people not just as individual patients but as members of communities, taking a holistic view of the factors that affect their health. “Addressing the outbreak at the community level is essential,” said Kauffman. “In the US, like many places, the main focus of the health system at the beginning of the COVID-19 outbreak was on preparing for a potential ‘surge’ [of cases] in hospitals and making sure beds and ventilators would be available. But in this area, the vast majority of patients are cared for in the community, rather than being admitted to hospitals as inpatients. So we focused on community response and connecting communities to hospitals when needed.” MSF developed a program called “Teachers of IPC” and has since handed over the IPC trainings to a local organization, Community Outreach and Patient Empowerment (COPE).