As COVID-19 infections rise, public reporting of data decreases
Over the past two weeks, the daily average of newly reported infections in Iowa has increased 163% and hospitalizations are up 57%. (Credit: National Institute of Allergy and Infectious Diseases, Rocky Mountain Lab)
With the number of COVID-19 infections now on the rise, Iowa officials are reporting less information on the spread of the virus and federal authorities have yet to make good on their promise of increased public reporting.
The Iowa Department of Public Health last updated its webpage on nursing home infections four weeks ago, on July 9, when there was a total of two Iowa nursing homes with COVID-19 outbreaks: the Iowa Veterans Home, with 10 infections and the Marian Home in Webster County, with five infections.
That type of detailed information is no longer being posted to the IDPH website.
Instead, the agency now reports only the total number of nursing home outbreaks in Iowa, with no indication as to where the outbreaks are, or the number of people infected. And even that information is only being updated weekly, rather than daily.
John Hale, a consultant and advocate for older Iowans, said Iowans are being kept “in the dark about COVID-19 rates in Iowa’s long-term care facilities. Everywhere they turn for information and help in state government, they’re being referred somewhere else. That’s unacceptable.”
Joel Olah, executive director of Aging Resources of Central Iowa, one of a network of agencies that helps deliver services to older Iowans, said the current lack of accessible information on nursing homes – where half of all COVID-19 deaths have taken place – is concerning.
“Our state’s health-related agencies and their staff members have failed to provide essential and timely information on COVID-19 and its variants to the public,” he said. “Consumers need to know positivity rates, locations of outbreaks, incidences of COVID-19 break-throughs among the vaccinated, and how to protect themselves and their loved ones from the consequences of exposure.”
On July 1, IDPH issued a written statement saying it would “focus COVID-19 case investigation on outbreaks and vulnerable settings like long-term cares” and would be posting virus data weekly rather than several times per day. By late summer, the agency said, it planned to “decommission” its coronavirus website. “Should it be necessary, we stand ready to reinstate operations to meet the needs of Iowans,” the agency reported.
IDPH will disclose the location of COVID-19 outbreaks in nursing homes if asked. For example, the agency acknowledged last week that the one Iowa nursing home with a current outbreak is the Montrose Health Care Center, which has a total of seven staff and resident infections associated with that outbreak.
But other COVID-19 information – such as positivity rates and daily infection counts – remains hard to come by.
In January, for example, the Capital Dispatch made a standing request of IDPH for its cumulative list of nursing home infections and outbreaks so that the list would be publicly available as it was updated by the agency. Since then, IDPH has disclosed only one such update, and that was in March.
On July 29, the Capital Dispatch asked IDPH for a copy of the most recently updated version of the list. The agency has yet to respond to that request.
Federal website omits data on specific care facilities
The website of the Iowa Attorney General’s Office correctly advises nursing home residents and their families that “as soon as even one case of COVID-19 is confirmed at a nursing home, the facility will have to alert its residents and their families or representatives by 5 p.m. the next calendar day. The information will also have to be reported to the Centers for Disease Control and Prevention and be made public.”
The CDC’s facility-specific data are reported through the Centers for Medicare and Medicaid Services’ main consumer website. However, the site reports only cumulative data on deaths, infections and vaccination rates for specific facilities. It doesn’t include facility-specific information on current infections, active outbreaks or recent positivity rates.
The Iowa attorney general’s office tells consumers that “you can contact the nursing home to ask if it’s had cases and deaths.” The CDC gives the same advice: “We encourage consumers and other stakeholders to contact nursing homes directly to inquire about the current status of COVID-19 in the facility,” an agency spokesman said.
The Iowa Capital Dispatch contacted 14 Iowa nursing homes over the past week and asked for either their most recent positivity rate or the number of currently infected residents and staff. In every case, the homes declined to disclose the information.
“If the facility is not forthcoming, contact the State Long Term Care Ombudsman’s Office,” the attorney general’s office suggests.
But neither the long-term care ombudsman’s office nor the Iowa Department on Aging maintains or posts facility-specific data on outbreaks, infections or vaccinations in the facilities they help oversee.
Under CDC regulations announced in May, nursing homes have to inform residents and their family members of any COVID-19 cases. But they are not required to inform the public or even prospective residents who are considering locating there.
In a conference call with reporters in May, the head of the federal Centers for Medicare and Medicaid Services said the infection data on specific homes would soon be shared with the public in some fashion, probably through the agency’s Nursing Home Compare website.
However, a check of that site shows that much of the information there is inaccurate or outdated and still includes no facility-specific data on COVID-19 infections or outbreaks, either current or cumulative.
When asked about that, a CMS spokesman said consumers can go to the agency’s COVID-19 Nursing Home Data Webpage and search for data on a specific nursing home – but he acknowledged the data offered there doesn’t include any current numbers on infections.
CMS does offer a downloadable database that includes dozens of bits of COVID-19 information collected from every nursing home in the nation. However, the database is updated weekly, not daily, and it currently has no information on Iowa homes newer than July 18.
As a result, that database currently shows zero infections at the Montrose facility, along with one infection each at the Parkview Manor in Reinbeck and The Suites of Western Home Communities in Cedar Falls.
Advocate: Iowans most at risk have least access to data
Another problem is that extracting the two-week-old data from the CMS site can be a daunting task for many consumers, acknowledged Brent Willett of the Iowa Health Care Association, which represents many of Iowa’s for-profit nursing homes.
“It could be a lot more user-friendly,” he said. “The individual who deals with that data for us is fairly experienced in the complexities of all that.”
Olah says he’s concerned that the Iowans most at risk of dying from COVID-19 – those in nursing homes — are those least able to access information that could help.
“Older adults, especially those with compromised immunity systems and inflammatory diseases, are at great risk of exposure to COVID-19, in particular to the delta variant,” he said.
He noted that while other states continue to report facility-specific infection data to the public, Iowa does not. “If other states can provide up-to-date information on positivity rates and COVID-19 outbreaks, why can’t Iowa?” he asked.
Hale said if state or federal officials are collecting infection data from long-term care facilities, the information “should be reported to Iowans in a highly visible and readily understandable manner. The data will show if there’s a problem, where, and to what extent.”
He said there’s “a concerning absence of leadership in state government on COVID-related issues. COVID concerns amongst the public are rising dramatically, yet our leaders seem to be in a state of denial. We need leaders to step up, take responsibility, and lead.”
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