Michigan: Curbing the spread of COVID-19 in nursing homes

MSF provides infection prevention and control trainings for staff

Detroit, Michigan, June 17, 2020—Doctors Without Borders/Médecins Sans Frontières (MSF) is running COVID-19 health education and infection prevention trainings in Michigan nursing homes to help prevent the spread of the virus, the international medical humanitarian organization announced Wednesday.

On Monday, the Michigan Department of Health and Human Services (MDHHS) released new COVID-19 data that recorded 66,000 confirmed cases and over 6,000 deaths. Nursing home residents accounted for 7,100 of the cases and 2,000 deaths. Additionally, more than 3,100 staff working in long-term care facilities have fallen ill from COVID-19. With such a heavy toll on the residents and the essential workers at these facilities, MSF has also begun working in coordination with the Michigan Department of Health and Human Services and the Detroit Health Department to quickly identify which nursing home facilities are in need of infection control measures.

“Much of the early focus during this outbreak has been on protecting hospitals from COVID-19, but what we see is that the virus has proven to be especially deadly for elderly people in nursing homes,” said Heather Pagano, emergency coordinator for MSF in Michigan. “We are providing hands-on, in-person training and guidance to staff to prevent the spread of COVID-19 in these facilities. Feedback from the trainings has been especially positive from the non-medical staff–cleaning and kitchen workers–who are less likely to have previous training about the virus, how it spreads, and how to best protect themselves and others.”

As the novel coronavirus has rapidly spread across the world, older people have suffered the highest rates of death as a result of the pandemic. Older adults living in long-term care facilities, or nursing homes, are at an even more heightened risk of infection and complications due to shared living spaces and underlying medical conditions. The Kaiser Family Foundation has reported the average percentage of COVID-19 deaths in long-term care facilities in states across the US at about 45 percent. More than 217,000 residents in nursing homes have contracted COVID-19, and 43,000 have died.  

“The emotional toll on the workforce has been immense,” said Pagano. “Every day, they face the full weight of working and caring for residents in an epidemic that doesn’t seem to have an end. Some express their grief at having lost many residents –who they had long cared for– in a short period of time. They also experience heightened stress and fear of bringing the virus home and infecting their family members.”

In Michigan, African Americans make up 14 percent of the population, yet represent one-third of positive cases and 40 percent of deaths, according to the Michigan Department of Health and Human Services. Racial health disparities in access to health care and health outcomes have been exacerbated by COVID-19, which is disproportionately affecting African Americans.

“As the state begins reopening, in order to prevent new and severe infections, hospitalizations, and preventable deaths, decision makers need to remain vigilant and commit to developing and adhering to a comprehensive COVID-19 response plan that addresses racial health disparities, and supports facilities to address the problems of understaffing and increased workload, especially when personnel fall sick or have to self-isolate,” said Pagano.

In European countries, among the first that were hit hard as the pandemic spread worldwide, MSF has responded by prioritizing infection prevention and control (IPC) assistance to health care workers and staff in nursing homes to curb new infections and, by extension, reduce hospitalization and preventable deaths among the elderly. MSF assisted the elderly population in nursing homes in Belgium, France, Italy, Portugal, and Spain. It has now brought a similar approach to its work in the United States with the launch of its COVID-19 project in Michigan.

MSF is bringing a similar approach to its work in the US with the launch of its COVID-19 project in Michigan. The team is offering three sets of activities to help protect residents and staff: assessments and general guidance to improve infection prevention and control practices, technical on-site support and training, and mental health workshops to address the high level of stress and grief that the frontline staff face every day.

MSF is an international medical humanitarian organization with programs in over 70 countries. MSF teams are preparing every project where they work to be COVID-ready as the pandemic sweeps the globe. In the United States, MSF’s COVID-19 response teams worked with migrant farmworkers in Florida; helped people who are homeless and housing insecure in New York City; supported Native American communities in the Navajo Nation and Pueblos; and trained essential workers in nursing homes and adult foster care facilities for the elderly in Michigan. In Puerto Rico, MSF has two mobile medical teams to provide care at patients' homes or at pop-up clinics and is forming a third team to handle the rise in cases. These teams are also monitoring COVID-19 patients who are asymptomatic or have mild or moderate symptoms. MSF has started a new program in Texas providing IPC trainings to staff and residents in nursing homes and assisted living facilities.