The Cost of Social Isolation

Pandemic Isolation

Howard Gleckman wrote a great article for Forbes about nursing home Covid survivors. It is complex and confusing because of the inherent pre-existing health conditions of vulnerable adults. Severe staffing shortages and the absence of family to assist and supervise care caused negative outcomes.

“A study by Michael Barnett of the Harvard T. H. Chan School of Public Health and colleagues (paywall) finds that residents of nursing homes with active cases of Covid-19 not only died more frequently but while living suffered greater functional decline, weight loss, and depression, compared to pre-pandemic times. Perhaps more striking, the study found that even in nursing homes with no identified Covid-19 cases, residents lost more weight and were more depressed during the worst of the pandemic.”

“The study, published in August at the Journal of the American Medical Association (JAMA), had two other important results: Hospital visits declined among residents of all the facilities studied, whether they had Covid-19 outbreaks or not. And in facilities with no Covid-19, deaths declined as well.”

“The new study found residents in Covid-19-positive facilities lost an average of 3.1 pounds more than before the pandemic. The share of residents with increased depression increased from about 27% to 32.5%. Even in facilities with no Covid-19 outbreaks, residents lost an average of 1.8 pounds more and the share of those with more serious depression increased to 30.2%.”

GAO

The pandemic highlighted long-standing problems with unsafe staffing and infection prevention and control in nursing homes. The Government Accountability Office reported indicators of resident mental and physical health worsened during the pandemic.

However, GAO found areas where CMS could take additional actions, including:

• Strengthening oversight of the infection preventionist role. GAO identified ways CMS could strengthen oversight of the infection preventionist role, such as by establishing minimum training standards. CMS could also collect infection preventionist staffing data and use it to determine whether the current infection preventionist staffing requirement is sufficient.
• Strengthening infection prevention and control guidance. GAO identified how CMS could strengthen this guidance by providing information to help surveyors assess the scope and severity of infection prevention and control deficiencies they identify. For example, CMS could add COVID-19-relevant examples for scope and severity classifications to its State Operations Manual—the key guidance state survey agencies use for conducting nursing home surveys.

The U.S. economy lost an astonishing 22 million jobs in the first two months of the pandemic. It has gained them all back, plus half a million more. Long-term unemployment is as low as it has been in 20 years. The overall unemployment rate hasn’t been lower than this since the 1960s. Defying claims that “no one wants to work anymore,” 80.2 percent of Americans in their prime working years had jobs in September, above the rate in the years before the pandemic.