Sunday School Extra Credit 5/24/20

As I wrapped up this week's Sunday School entry, I forgot that Monday was a no-school day, so apologies for threatening you with an Extra Credit post I didn't deliver on the holiday.

Assuming you're all ready to dive back in after a day of contemplation  and remembrance, barbecues and beach parties, and ugly tweeting, here's your Extra Credit, with Dana Bash's unfortunately very short interview with Florida's Rep. Val Demings on CNN's State of the Union, and Chris Wallace talking with nursing home and long-term care executive Mark Parkinson on Fox News Sunday.

Bash's conversation with Demings,which was unfortunately shortened due to technical difficulties, started out with a question on theme parks, some of which are in the representative's district, and whether Demings was comfortable with the parks reopening. Demings talked about how "strategic, methodical, very thoughtful" the parks have been, how they've been collaborating with the public health folks and local leaders "to make sure that they are doing this right." And while she thinks "they're being smart about it,"

...let me say this. I am concerned, because we know that this virus is not yet under control, and it will not be until we have a vaccine. And we don't know when that will be, regardless of some of the reports that we hear coming out of the White House. But we just need to be vigilant and do what we need to do to keep people safe.

Moving quickly to the main 2020 campaign news, Bash asked about Papa Joe's "cavalier" comment about black voters who choose Trump over him. In a conversation with Charlamagne Tha God, Biden said 

You got more questions. But I tell anyone, if you have a problem figuring out whether you're for me or Trump, then you ain't black.

The collective cringe was felt around the country, even as Biden tried to explain away the comment in the interview by touting his record, and even after he apologized. Bash wondered what Deming thought of the comment, asking if it was "out of line."   

...look, the vice president went on the show. I'm so glad he did, because these are the conversations that we really need to be having. And one of the things I said in a statement on Friday was that, look, we know we have some serious issues that we're dealing with in this country. And if we're going to be able to address them effectively, then we have got to hold everybody accountable, even those that we do support.

Look, the vice president shouldn't have said it. He apologized for it. But I really think the gall and the nerve of President Trump to try to use this in his campaign, he who has, since day one, done everything within his power, of course supported by his enablers, to divide this country, particularly along racial lines?

Look, let's talk about race, because we definitely need to. We need -- we see it in housing. We see it in voting rights. We see it in health care. We see it in education. Mr. President, let's do have a serious conversation about race in America. And how about working for all people that you are supposed to represent, not just the privileged few?

But the vice president apologized for it. He engaged in the conversation. I'm glad he did. There will be more, as you heard, the invitation to come to New York. And so we look forward to sitting down together, working on some of America's toughest issues. And race is one of them.

And, before the ran out of time, Bash asked if Demings wanted to be vice president. 

What I want to do is continue to work hard to serve the American people. Look, I have chosen tough jobs in my lifetime, a social worker working with broken children, a law enforcement officer, 27 years, the chief of police, and now as a member of Congress, trying to do things right to support the American people. 

I want to do whatever job I can to continue to push this country in the right direction and make sure that America lives up to its promise for future generations.

She's on the short list, we hear, and there is a great deal of interest in seeing him choose a woman of color, although there's also apparently growing interest in Elizabeth Warren and Amy Klobuchar, according to other reports. I'll have more on all of that in an upcoming post.

Moving on to another hot topic - coronavirus and nursing homes - Chris Wallace dove right in with Parkinson, president and CEO of the ACHA and the NACL (he was previously governor of Kansas). Referencing a NY Times study that found more than a third of all US COVID-19 deaths have been in nursing homes and long-term care facilities (including patients and workers), he wondered what there was, other than the vulnerability of the population, that might explain this. 

Parkinson talked about the tragedy, calling it "almost unspeakable" for folks who have devoted their lives to taking care of the elderly. And, he pointed to "one very unique feature (of) this virus," that asymptomatic people have it, and spread it. Early on, when they didn't know about that,

we have visitors coming into our buildings, we had staff members in our buildings closely interacting with residents, as they need to, to take care of them, and we were unwittingly spreading the virus within the communities.Once the academic community and doctors figured out that you could be asymptomatic and carry it, it was too late for a lot of people.

And, he said, they didn't have the tests to know who had the virus. There was good news, though, he said; "we're now in recovery," and HHS had just allocated $5B which is "going to allow us to recover and really make this better."

Wallace noted a new report just out from the GAO, which found that 82% of nursing homes - over 13,000 of them - had been previously cited for infection control issues. And so, he asked, "didn't your facilities have a problem in this particular area long before the pandemic hit?"

Parkinson was quick to point out that "we have a real flawed survey system," including encouraging surveyors to find issues. He also noted that 99% of the deficiencies were not severe, or did not affect patient safety, and or were paperwork issues. And, he noted, this is not a normal infection issue; under normal circumstances, "infection control is symptom-related."

...we are adjusting our behavior, and that is why we're starting to see recovery and people actually getting better. Visitors are no longer allowed to come into building. Every interaction patients and staff now have masks on. Patients, residents are not eating together in the same room, they're eating privately in our own rooms so that now that we understand the very vicious nature of this virus, we're able to control it much better.

The topic shifted to what happened here in NY, where my Sonofa Gov Andrew Cuomo directed nursing homes to accept COVID-19 patients, in accordance with CDC guidelines, to alleviate anticipated hospital capacity issues. Wallace wondered if Cuomo had a choice, or if he had to follow the guidelines.Parkinson said that, at the time Cuomo made his initial decision, he was relying on data showing that NY hospitals were going to be overwhelmed with COVID patients, but there actually was plenty of capacity.

They didn't need to be discharged to nursing homes. In hindsight, it was an error. And to Governor Cuomo's credit, he has now reversed that policy. Fortunately, we were able to convince most of the other governors across the country to not institute that policy. And I think that's part of the reason that we're starting to see recovery.

Wallace pressed that Cuomo had a choice, saying "He didn't have to follow the CDC guidance anyway" and I'm sure that elevated him at least a little bit in the eyes of the president, who has ignored CDC guidance literally from Day One, and who has been complaining about Wallace and other Foxers not toeing the company line.

Parkinson suggested Cuomo would say, in hindsight, that it was an error, but one based on "incomplete and inaccurate information." Everyone was too concerned with hospitals being overrun, and nursing homes were left out of consideration.

Our residents were not a high priority for testing. We weren't given the equipment that we needed. You know, there needs to be some accountability for all of these people that were making these fantastic estimates that the entire hospital system across the country was going to be overrun. It wasn't, and there are consequences...unfortunately, nursing home residents were one of the consequences.

(Cuomo, of course, didn't say that - instead, he deflected to the facilities, saying any of them could have called the NYSDOH and said they couldn't take the patient; in fact, he said they had an obligation to do so.)

Echoing what Parkinson said about asymptomatic folk potentially infecting people, and the result "as you've locked down, is we've seen these terrible scenes where, for their own good, residents are kept away from their families at some of them get very sick, some of them pass away and their families can't be with them when that happens," Wallace wondered about reopening, and asked "under what restriction so that the families can be together but you're not endangering the lives of  - of all the patients inside these facilities?"

Parkinson talked about how they've offered FaceTime and "all sorts of other alternatives," but agreed there's "just no alternative to being together," and that keeping COVID down in the communities where the facilities are is "the most important thing."

If we spiked back up in COVID cases though, we're going to end up with more COVID in nursing homes. So issue one is, let's keep COVID down in the communities. Issue two is, let's get adequate testing so that we can get a test for every staff member, every resident. And then, ideally, if we could get on-site testing throughout the summer so that when people come and they get a test, we know that they're COVID-free, that would be the ideal. But we do recognize it's extremely important to get these folks back with their families.

Yes, it is. I can't really even imagine how painful, how heartbreaking it must be, to be outside looking in and finding out that you've lost a loved one, with no chance to say goodbye. 

That's your Extra Credit for this week. Stay safe, wash your hands, wear your mask and, I'd say, don't go in a pool with three hundred of your closest strangers. But maybe that last part is just me.