WEBVTT - Nursing Home Deaths Become a Political Football 0:00:03.560 --> 0:00:08.200 Welcome to Prognosis. I'm Laura Carlson. It's day three hundred 0:00:08.240 --> 0:00:12.240 and fifty four since coronavirus was declared a global pandemic. 0:00:13.360 --> 0:00:18.160 Today's main story. Some Democratic governors have been under fire 0:00:18.480 --> 0:00:23.800 for mishandling nursing home outbreaks as the pandemic surged last spring. 0:00:25.000 --> 0:00:31.000 There are Republican critics see that as an opportunity. But first, 0:00:31.840 --> 0:00:49.680 here's what happened in virus news today. Federal health officials 0:00:49.720 --> 0:00:54.240 called on Texas and Mississippi residence to keep wearing masks, 0:00:54.880 --> 0:01:01.080 even as governors there lift COVID nineteen restrictions. Rochelle Wilenski, 0:01:01.320 --> 0:01:04.760 director of the Centers for Disease Control and Prevention, says 0:01:04.880 --> 0:01:09.880 it's premature to abandon mitigation efforts and that the virus 0:01:10.000 --> 0:01:15.360 can still erupt again. Texas Governor Greg Abbott said Tuesday 0:01:15.400 --> 0:01:18.840 that the state would lift its mask mandate and reopened 0:01:18.880 --> 0:01:24.160 businesses next week. He has also banning counties from finding 0:01:24.480 --> 0:01:29.560 or jailing people who disregard local measures defining previous warnings 0:01:29.760 --> 0:01:36.279 from Woolenski and others. South African authorities said they ceased 0:01:36.319 --> 0:01:41.280 about two thousand, four hundred doses of fake coronavirus vaccines. 0:01:41.600 --> 0:01:45.360 After following up on a global alert issued by Interpol. 0:01:46.240 --> 0:01:49.480 The bogus shots were found at a warehouse in Germiston's 0:01:49.720 --> 0:01:53.920 near Johannesburg, and three Chinese nationals and a Zambian national 0:01:54.120 --> 0:01:59.600 were arrested, according to the police in a statement. Finally, 0:02:00.000 --> 0:02:05.160 at another vaccine in development is showing promising results. Bahara's 0:02:05.360 --> 0:02:12.600 covaccent demonstrated interim efficacy after two doses. Those early results 0:02:12.639 --> 0:02:18.280 come from phase three clinical trials involving thousand, eight hundred patients. 0:02:19.000 --> 0:02:22.080 The study is still ongoing and the company will release 0:02:22.200 --> 0:02:25.720 a final analysis after there are a hundred and thirty 0:02:25.960 --> 0:02:37.280 confirmed coronavirus cases. And now for today's main story. In 0:02:37.360 --> 0:02:42.679 recent months, GOP lawmakers have keeped criticism on Democratic governors 0:02:42.720 --> 0:02:46.280 for how they handled outbreaks at nursing homes early in 0:02:46.320 --> 0:02:51.160 the pandemic. Michigan Republicans, who have been hostile to Governor 0:02:51.200 --> 0:02:55.160 Gretchen Whitmer throughout the crisis, are now asking the state's 0:02:55.200 --> 0:02:59.760 attorney general to investigate how she coped with that challenge. 0:03:00.960 --> 0:03:05.679 Republicans say that people died unnecessarily thanks to Whitmer's order 0:03:06.040 --> 0:03:10.120 that nursing homes readmit residents with COVID nineteen if they 0:03:10.160 --> 0:03:16.080 had capacity and quarantine capabilities. I spoke to Detroit Bureau 0:03:16.160 --> 0:03:20.840 Chief David Welch, who says Michigan's fatality rate was lower 0:03:20.880 --> 0:03:23.840 than the national average and that many of those on 0:03:23.880 --> 0:03:34.840 the pandemics front lines dispute the assertions. Governor Gretchen Whitmer 0:03:34.920 --> 0:03:39.120 has recently faced several critiques regarding how she handled Michigan's 0:03:39.240 --> 0:03:42.080 nursing homes during the COVID crisis. I was just wondering 0:03:42.120 --> 0:03:46.360 if you could maybe outline some of those criticisms she's faced. 0:03:47.480 --> 0:03:52.960 The primary one is affected during the summer when COVID 0:03:53.080 --> 0:03:57.400 was really spreading heavily in Michigan, actually spring um, she 0:03:57.800 --> 0:04:01.120 issued an order saying that nursing homes could and in 0:04:01.160 --> 0:04:05.600 fact should, take COVID positive residents back into the homes 0:04:05.720 --> 0:04:09.040 or accept them in u Now, her order did say 0:04:09.120 --> 0:04:11.200 as long as the nursing homes had a place where 0:04:11.200 --> 0:04:15.240 they could quarantine them and and proper equipment in place 0:04:15.320 --> 0:04:19.040 so that everybody could take care of these patients without 0:04:19.440 --> 0:04:22.200 the virus spreading all of the place, then fine. However, 0:04:23.520 --> 0:04:26.640 the Republicans jumped on that immediately, and they pushed her 0:04:26.720 --> 0:04:30.440 to open nursing open up field hospitals and convention centers 0:04:30.440 --> 0:04:35.720 and places like that. And despite lasted all throughout where 0:04:35.760 --> 0:04:38.120 the Republicans wanted her to put them someplace else, and 0:04:38.240 --> 0:04:43.320 as nursing home deaths from COVID kept rising, the criticism 0:04:43.400 --> 0:04:47.480 got hotter and hotter. In reality, Luchi and actually did 0:04:47.520 --> 0:04:50.640 better in terms of percentage of deaths and nursing homes 0:04:50.960 --> 0:04:53.760 than the average state, and actually did quite a bit 0:04:53.800 --> 0:04:56.800 better than neighboring Ohio, which as a Republican governor and 0:04:56.880 --> 0:04:58.760 did kind of the same thing that Whitman did, which 0:04:58.760 --> 0:05:01.800 was allowing people back into nursing homes with COVID as 0:05:01.839 --> 0:05:04.480 long as they could be quarantined somehow. So you can 0:05:04.560 --> 0:05:07.840 see how political this got. The Republican is jumping all 0:05:07.839 --> 0:05:11.320 over her for it, and uh and Witmer standing her 0:05:11.360 --> 0:05:14.159 ground and saying this is this is the best way 0:05:14.160 --> 0:05:17.080 to handle them. It came back up again in the 0:05:17.080 --> 0:05:20.880 wake of Governor Cuoma in New York, Governor Newsman California, 0:05:21.200 --> 0:05:23.720 Governor Wolf in Pennsylvania getting a lot of criticism from 0:05:23.720 --> 0:05:27.039 Republicans and their states over this. Quoma situation is obviously 0:05:27.080 --> 0:05:29.880 different because there are allegations that he actually tried to 0:05:29.960 --> 0:05:32.960 hide numbers. No one has suggested that Whitman did that, 0:05:33.160 --> 0:05:36.240 but once that came up, the Republicans asked the Democratic 0:05:36.240 --> 0:05:40.000 attorney general in Michigan to investigate her over this. So 0:05:40.480 --> 0:05:43.400 what started to the last April May as a big 0:05:43.400 --> 0:05:46.560 controversy and heated up later in the summer has come 0:05:46.600 --> 0:05:51.520 back up again, you know, almost a copyhead calls for 0:05:51.600 --> 0:05:54.120 investigation that we've seen in a handful of other democratic 0:05:54.160 --> 0:05:58.520 states around the US. And as you've already pointed out, 0:05:58.560 --> 0:06:03.880 there is a very significant political angle here. What do 0:06:04.000 --> 0:06:08.279 you see as the perhaps broader national political agenda to 0:06:08.360 --> 0:06:12.720 these critiques. This is very similar to how the Democrats 0:06:13.320 --> 0:06:15.480 got Donald Trump out of the White House. There were 0:06:15.480 --> 0:06:19.680 a lot of things that the Democrats used against Donald Trump, 0:06:20.960 --> 0:06:23.680 issues of race and gender and so forth, But really 0:06:24.000 --> 0:06:29.479 his his response to COVID, and they're alleged in the 0:06:29.520 --> 0:06:33.160 alleged inadequacy of it, really kind of did Trump in 0:06:33.200 --> 0:06:36.480 with a lot of swim voters. So Republicans are trying 0:06:36.520 --> 0:06:38.800 to tear a page out of that same book. They 0:06:38.839 --> 0:06:42.839 see an opening with these nursing home deaths in Michigan, 0:06:43.160 --> 0:06:45.280 and they're going after wit before in the same way 0:06:45.320 --> 0:06:48.040 they have in other states. The reason I brought up 0:06:48.040 --> 0:06:51.920 Ohio earlier is you have in Michigan about thirty three 0:06:51.920 --> 0:06:55.360 percent of COVID death from nursing homes. Patients were allowed 0:06:55.400 --> 0:06:57.920 and if if the nursing home had the space, had 0:06:57.920 --> 0:07:00.599 the equipment to quarantine those people. I had a pretty 0:07:00.640 --> 0:07:04.120 similar set of rules for its nursing homes. Of the 0:07:04.160 --> 0:07:07.320 state's death from COVID. We're in nursing homes, and they 0:07:07.360 --> 0:07:09.200 had a couple of thousand more of them in the 0:07:09.279 --> 0:07:11.600 nursing homes as well. And none of the Republicans have 0:07:11.680 --> 0:07:14.760 gone after Mike Dwine, a Republican for the same thing. 0:07:14.840 --> 0:07:17.560 So there are some obvious political things. There are also 0:07:17.640 --> 0:07:21.280 some legitimate questions about this is how nursing homes were handled, 0:07:21.280 --> 0:07:23.520 and this is the best way to do it, uh 0:07:23.520 --> 0:07:28.480 and we're there potentially better choices, But it doesn't look 0:07:28.520 --> 0:07:32.120 like that's what's going on here. Because this this whole 0:07:32.160 --> 0:07:34.160 thing came up, it had kind of gone quiet for 0:07:34.200 --> 0:07:36.680 a while and then came up again once it became 0:07:36.720 --> 0:07:41.640 controversial in New York and in California, and exactly right, 0:07:41.680 --> 0:07:45.360 I mean, with the recent accusations against Governor Cuomo. As 0:07:45.400 --> 0:07:49.560 you outline that there has been some um suggestion that 0:07:49.600 --> 0:07:52.960 there has been let's say, mishandling of the data or 0:07:53.000 --> 0:07:56.000 even hiding of numbers. I mean, when we look at 0:07:56.280 --> 0:07:59.720 Michigan's numbers, um, I mean, is there any reason not 0:07:59.800 --> 0:08:05.560 to trust the data that Michigan is reporting potentially and 0:08:05.920 --> 0:08:09.440 look at you know, I want to give some of 0:08:09.480 --> 0:08:12.600 the Republicans at least who are questioning this their due. 0:08:13.640 --> 0:08:16.560 Data from nursing homes is not great, and there wasn't 0:08:16.640 --> 0:08:20.840 a great system for gathering that data because we didn't 0:08:20.880 --> 0:08:24.360 have a pandemic like this before. And what's what's what 0:08:24.440 --> 0:08:26.960 was supposed to happen If a nursing home had a 0:08:27.000 --> 0:08:30.800 resident who caught COVID and they got sick enough that 0:08:30.840 --> 0:08:34.680 they had to go to a hospital. If that resident 0:08:35.080 --> 0:08:38.520 had a room still reserved for them in the nursing home, 0:08:38.559 --> 0:08:41.120 but they passed away in the hospital, the nursing home 0:08:41.160 --> 0:08:45.840 was supposed to count that death in their facility. If 0:08:45.880 --> 0:08:48.240 they weren't holding the room, then the hospital would count it. 0:08:48.480 --> 0:08:51.080 Arguably was still a nursing home death. What we also 0:08:51.160 --> 0:08:54.120 don't know is how consistently nursing homes were actually doing this. 0:08:54.840 --> 0:08:56.840 Some of the employees I talked to said that nursing 0:08:56.880 --> 0:09:00.600 homes were actually trying to kind of key the case 0:09:00.800 --> 0:09:03.200 and death count low because they didn't want to be 0:09:03.240 --> 0:09:06.520 seen as a COVID institution. One of the things that 0:09:06.559 --> 0:09:12.640 happened during the pandemic was nursing home capacity rates are say, 0:09:12.720 --> 0:09:16.080 occupancy rates fell from about you know, typically eighty four 0:09:16.120 --> 0:09:19.040 percent to as low as seventies and nursing rooms needed 0:09:19.040 --> 0:09:22.680 patients are needed residents. Is not a great way to 0:09:22.679 --> 0:09:25.320 make a lot of money in that business, so they, 0:09:25.679 --> 0:09:27.920 you know, there was an incentive to try to keep 0:09:27.920 --> 0:09:31.440 the numbers low. Is this something Whitman did? Is something 0:09:31.480 --> 0:09:34.240 that state did know that the residencies were supposed to 0:09:34.240 --> 0:09:37.800 report this stuff and reported accurately. It hasn't been audited. 0:09:37.880 --> 0:09:41.800 No one knows how accurately they were reporting it. Now. 0:09:42.160 --> 0:09:45.319 Robert Gordon, who's the let's say passed head of the 0:09:45.360 --> 0:09:48.400 Michigan Department of Health and Safety, he said he couldn't 0:09:48.400 --> 0:09:51.240 stand by the data for those reasons because they just 0:09:51.280 --> 0:09:54.160 don't know. Now, if you want to say that Michigan 0:09:54.200 --> 0:09:56.960 State is no good and therefore the comparison that a 0:09:57.000 --> 0:09:59.760 third of its death with for from COVID is not 0:09:59.800 --> 0:10:03.040 really valid. That presupposed other states had a great system 0:10:03.120 --> 0:10:05.040 for collecting this data as well, and it's not really 0:10:05.040 --> 0:10:07.480 clear that they did. In fact, we talked to the 0:10:07.559 --> 0:10:11.839 Kaiser Institute well reporting this out and they said, look, 0:10:11.840 --> 0:10:15.320 it is really hard because not every state reports the 0:10:15.360 --> 0:10:17.520 same way and out every state has great data collection. 0:10:17.600 --> 0:10:20.719 It's you know, it's it's not a terrible number to use, 0:10:20.800 --> 0:10:22.920 but it's never going to be perfect. So yeah, there 0:10:22.920 --> 0:10:24.720 are questions about this, and you would you would only 0:10:24.800 --> 0:10:27.000 know what if you audited it. You know, maybe that's 0:10:27.000 --> 0:10:28.880 one thing the Republicans would like to see. It's not 0:10:28.920 --> 0:10:31.040 a bad idea because then again, we're gonna assess the 0:10:31.040 --> 0:10:33.200 extent of the problem in nursing homes and try to 0:10:33.240 --> 0:10:36.120 have them prepared for the next time around. It's it's 0:10:36.160 --> 0:10:40.880 not that's not an unreasonable request. And when we look 0:10:40.920 --> 0:10:44.640 at the situation that's happening in Michigan and kind of 0:10:44.679 --> 0:10:47.880 these accusations and finger pointing, I mean, is it something 0:10:47.920 --> 0:10:50.800 that you would see is is perhaps a more fundamental 0:10:50.840 --> 0:10:55.040 divide between say Republicans and Democrats about how to stem 0:10:55.400 --> 0:11:00.200 COVID spread, whether to focus on say hot spots like 0:11:00.320 --> 0:11:04.400 nursing homes, or for example, introducing stricter measures at the 0:11:04.440 --> 0:11:09.360 community levels, such as shutting down restaurants or gym's. This 0:11:09.440 --> 0:11:11.240 is a big issue in Michigan and it's one of 0:11:11.280 --> 0:11:13.400 the reasons we really focused on the nursing home and 0:11:13.559 --> 0:11:16.360 COVID issue here because the politics have been so divisive. 0:11:16.880 --> 0:11:20.520 You had people armed, protesters marching on the capitol over 0:11:20.600 --> 0:11:24.200 Governor Woodman, shut down orders of gym's, restaurants, bars, and 0:11:24.240 --> 0:11:27.920 so forth. There was a lot of accusation by Republicans 0:11:27.920 --> 0:11:30.599 over the past year that she was overreaching and what 0:11:30.760 --> 0:11:33.480 she was shutting down, and there were probably similar She 0:11:33.520 --> 0:11:38.920 had criticisms there that that businesses like construction contractors that 0:11:38.920 --> 0:11:42.040 that had to down their tools for a little bit, 0:11:42.559 --> 0:11:44.880 you know, they were by that by the spring would 0:11:44.880 --> 0:11:47.720 have been working outdoors. That didn't last long though She 0:11:47.800 --> 0:11:50.040 kind of got things going back up pretty quickly. But 0:11:50.080 --> 0:11:52.800 a lot of these other issues, and including mask wearing 0:11:52.840 --> 0:11:55.400 in some cases where the subject of the protests from 0:11:55.400 --> 0:11:59.160 Republicans and from conservative groups. They didn't like the fact 0:11:59.160 --> 0:12:01.280 that the governor had executive orders to tell them what 0:12:01.360 --> 0:12:03.560 to do and what to wear and when to work 0:12:03.559 --> 0:12:06.720 and what could be open. And the biggest indicator of 0:12:06.760 --> 0:12:09.320 whether a nursing home has a serious issue with COVID 0:12:09.400 --> 0:12:11.560 or not is what's going on in the outside community, 0:12:11.559 --> 0:12:13.640 because what the health care studies are saying is that 0:12:13.640 --> 0:12:17.040 the employees bring it in. People are out at restaurants, bars, 0:12:17.160 --> 0:12:20.320 or just from family members, they get COVID symptoms are 0:12:20.360 --> 0:12:22.679 mild in the early days. Testing was really bad in 0:12:22.720 --> 0:12:25.640 the first six months of the pandemic hit, and they 0:12:25.679 --> 0:12:28.760 go to work anyway, and then they spread it around 0:12:28.800 --> 0:12:31.439 the nursing home. You know, the nursing homes are places 0:12:31.440 --> 0:12:33.720 where people are kind of close together, a lot of 0:12:33.720 --> 0:12:36.560 people in a small facility. You know, a lot of 0:12:36.559 --> 0:12:38.480 the people who work there couldn't afford to take paid 0:12:38.559 --> 0:12:40.920 time off. So even if they had mild symptoms, didn't 0:12:40.960 --> 0:12:43.600 know they had COVID. They certainly weren't being that cautious 0:12:43.840 --> 0:12:47.720 in all cases. And that's a big issue. So, you know, 0:12:47.720 --> 0:12:49.640 the Republicans saying, well, these you know, there are other 0:12:49.640 --> 0:12:53.480 ways to manage the nursing homes, and there may have been, 0:12:53.840 --> 0:12:58.000 but none of the solutions were great. But really the 0:12:58.000 --> 0:12:59.679 best way to keep nursing hose from getting it was 0:12:59.720 --> 0:13:01.599 to protect at the outside community. And though and and 0:13:01.840 --> 0:13:04.080 and the measures to protect communities are the things that 0:13:04.120 --> 0:13:07.560 they fought the most. And speaking of nursing homes, let's 0:13:07.679 --> 0:13:10.000 let's look at it from the employee side. I mean, 0:13:10.360 --> 0:13:13.760 how were they supported in Michigan. The employees were not 0:13:13.800 --> 0:13:15.920 equipped and they know. I talked to a number of 0:13:15.960 --> 0:13:18.200 people who work in the nursing homes. They were doing 0:13:18.200 --> 0:13:21.320 things like if they had a mask and the band broke, 0:13:21.360 --> 0:13:23.640 they were stapling it back on. Some of them told 0:13:23.679 --> 0:13:25.960 me that if they had the basic surgical mask, let 0:13:26.000 --> 0:13:28.560 alone in the nine had a basical surgical mask, they 0:13:28.559 --> 0:13:31.480 were doing pretty well. So they were not equipped at all. 0:13:31.520 --> 0:13:33.960 And the other problem is they make about thirteen hours 0:13:34.000 --> 0:13:36.600 an hour. Governor Whitmer eventually ordered a two doll an 0:13:36.640 --> 0:13:38.560 hour raise to give these people a little bit of 0:13:38.559 --> 0:13:41.480 breathing room. But a lot of them didn't have paid 0:13:41.480 --> 0:13:44.200 time off. The nursing home Reunion, the s c IU 0:13:44.400 --> 0:13:47.240 was negotiating a new contract during the pandemic to try 0:13:47.240 --> 0:13:48.760 to get paid time off, trying to get a raise, 0:13:48.800 --> 0:13:52.040 to get better healthcare because a lot of the workers, 0:13:52.120 --> 0:13:54.880 if they had some symptoms, they were only being tested 0:13:54.920 --> 0:13:56.880 every seven days and it took another week to get 0:13:56.880 --> 0:13:59.800 the test back, so they could have COVID symptoms or 0:13:59.840 --> 0:14:02.920 be symptom free, and the test would take six or 0:14:02.960 --> 0:14:05.439 seven days to come back, and they would be working 0:14:05.480 --> 0:14:09.320 with and amongst intreating nursing home residents while they may 0:14:09.360 --> 0:14:12.320 have had the virus in the early and most contagious stages. 0:14:12.880 --> 0:14:15.200 So when you can't afford to take time off, you 0:14:15.280 --> 0:14:17.560 go into work, and these people had to be there. 0:14:18.920 --> 0:14:22.600 And people are also quitting nursing homes because they didn't 0:14:22.600 --> 0:14:25.680 want to catch COVID during the pandemic, so you had 0:14:25.720 --> 0:14:28.040 fewer and fewer people. They were working long hours, some 0:14:28.080 --> 0:14:31.760 of the moonlight in different nursing homes, so it really 0:14:31.840 --> 0:14:34.000 was a bad situation. They didn't have the equipment, they 0:14:34.040 --> 0:14:36.080 didn't have the training, and there were too few of 0:14:36.120 --> 0:14:39.560 them working long hours um and they were either afraid 0:14:39.680 --> 0:14:41.680 or couldn't afford to take the time off if they 0:14:41.720 --> 0:14:51.160 had some symptoms. It was quite a bad situation. That 0:14:51.520 --> 0:14:54.000 was David Welch and that's it for our show to Day. 0:14:54.520 --> 0:14:57.240 For coverage of the outbreak from one and twenty bureaus 0:14:57.280 --> 0:15:02.640 around the world, visit bloomberg dot com slash coronavirus and 0:15:02.840 --> 0:15:05.160 if you like the show, please leave us a review 0:15:05.240 --> 0:15:09.000 and a rating on Apple Podcasts or Spotify. It's the 0:15:09.000 --> 0:15:12.040 best way to help more listeners find our global reporting. 0:15:13.160 --> 0:15:16.920 The Prognosis Daily edition is produced by Top for foreheads 0:15:17.040 --> 0:15:21.720 Magnus Henrickson and me Laura Carlson. Today's main story was 0:15:21.760 --> 0:15:26.320 reported by David Welch. Original music by Leo Cedrin. Our 0:15:26.520 --> 0:15:30.560 editors are Rick Shine and Francesco Levi. Francesco Levi is 0:15:30.600 --> 0:15:33.800 Bloomberg's head of podcasts. Thanks for listening.