Greetings Member of the NYS Assembly & Senate,
As many of you are painfully aware, no group of residents in New York State has been more adversely affected by Covid-19 than our senior population. To say the least, this virus has occupied their everyday existence since March 23rd, when New York State went into the first pause/ lockdown.
Residents of assisted living, rehabilitation centers and nursing homes have had to bear the brunt of endless mandates controlling every aspect of their life from how and when they can eat, removal of furniture in common areas, the cancellation of all daily social activities and basic amenities such as haircuts. We should not be taking their willingness to quietly comply with order after order, for granted.
Speaking to that, the populace has been reminded, almost daily from Albany, to ‘follow the science’ and adhere to all mask and social distancing mandates. For the betterment of all, we do. Sometimes mandates and executive orders don’t ‘follow the science’ and through unintended consequences, create a disparate impact upon a specific populace.
This is where we are now.
With the guidance recently released by Governor Cuomo on November 24th addressing ‘Nursing Homes and Adult Care Facilities’ ,there is such an issue.
Under the section: “Residents who leave a facility must … Test negative immediately (within 24 hours) prior to return to the facility” is where there is a misstep ‘following the science.’
Please understand that a vast majority of care facilities (Assisted Living) have ‘residents’ that for the most part, can still take part in life’s daily activities, albeit truncated activities.
Under that specific guidance, all care facilities are required to deny entrance to any resident who fails to provide a negative Covid test when returning to their primary place of residence, from a day trip or short family outing.
Here is an example of correspondence given to families of relatives in a NYS care facility:
“Our best information at this time indicates this guidance applies to all December holidays and outings as well. Residents returning from any outing other than a medically necessary medical appointment—no matter how long the duration of the outing—must present a negative covid test result on return, or re-entry must be denied.”
Please note: These care facilities are not ‘just room and board.’ They monitor the health of residents and dispense needed medication as required by their doctor, cardiologist, gynecologist or psychologist. Denying entry is tantamount to denying primary care.
With the November 24th guidance notice, all care facilities in New York State will be quarantining a returning resident for no less than 14 days and administering at least 3 Covid tests during that same timeframe. We agree with this wholeheartedly.
That part of the protocol ‘follows the science’ and is confirmed by researchers at MIT:
“While early research on asymptomatic transmission has shown that some asymptomatic individuals will test positive two to three days before developing symptoms, we would definitely not expect a positive diagnostic test for COVID-19 one day after exposure.”
You can read their findings here: https://medical.mit.edu/covid-
Additionally, Harvard Medical published a similar opinion regarding the taking of a test on the same day one was theoretically ‘exposed.’
“Results may also be affected by the timing of the test. For example, if you are tested on the day you were infected, your test result is almost guaranteed to come back negative, because there are not yet enough viral particles in your nose or saliva to detect.”
You can read their findings here: https://www.health.harvard.
Knowing that taking a Covid test just a few hours after ‘possible’ exposure will return a negative result, our attention is directed solely at the exclusionary part of the mandate: Without a test result, entry is denied.
Denying medical care intentionally because of a flaw “following the science” is an unconscionable action and will cause harm to the same people we’re looking to protect: the senior resident. Separating them from access to their residence and professional caretakers is abhorrent and falls to an arbitrary and capricious action. Why did the Department of Health fail to consider important medical aspects of this problem, as they relate to the resident? Does the Department of Health retain information that is counter to the arguments made by medical professionals and presented above? Can the DOH articulate a satisfactory explanation that will connect their policy of withholding primary care, as a means of safeguarding the returning resident who will be quarantining for 14 days thereafter?
What have our seniors done to earn such a disservice from our state leaders?
Furthermore, the Governor's mandate on November 24th now raises a valid concern regarding all such movement in and out of a facility. If a resident is now required to provide rapid test negative results as a prerequisite to gaining access to their facility where they live, why wouldn’t we apply that same requirement to every care provider entering and exiting every day? Are we suggesting that residents leaving a facility for a few hours pose a greater threat of contracting Covid and spreading the virus than employees who leave for up to 16 hours between shifts or even two days through a weekend?
If it is required that a resident temporarily leaving their facility be mandated to procure a negative Rapid Covid Test as a prerequisite when returning to their residence, then every employee needing to gain access to that facility for employment must also be required to provide such a result. This makes sense if you are looking to mitigate exposure risk equally amongst all people that move in and out of a facility.
Our recommendation, based on opinions of medical professionals on the front line of this virus, is to strike the mandatory ‘same day negative result’ requirement for residents, thereby allowing them to gain access to both their professional care workers, and required medications.
Denial of either could result in catastrophic health complications for residents. This is obviously, not the intent of the mandate, but the unintended consequence.
We agree that the 14 day quarantine period along with three tests administered serve as the best method of insuring a safe environment for both resident and caretaker. This process also ‘follows the science’ regarding possible exposure to the virus within the first 24 hours.
Thank you in advance for your consideration of my comments.
We all want to make sure our seniors are treated fairly and equitably. They should not be denied access to their residence or kept at bay from the medications because of a flawed application of the law.
It is our hope that you will call both Governor Cuomo and Commissioner Zucker
to strike this ill-advised mandate and issue an updated notice to all care facilities operating in New York State immediately.
Respectfully,
William Nugent
On behalf of families with relatives in a New York State care facility.
