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Pennsylvania: Over 2/3 Covid-19 Deaths from Nursing Homes

Pennsylvania: Over 2/3 Covid-19 Deaths from Nursing Homes
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The elder care crisis in Pennsylvania was highlighted this week when data released by the Pennsylvania Department of Health showed the average age of those who have died of COVID-19 in the state is 80 years old and that more than two-thirds of the 4,505 who died of the virus as of Tuesday morning were residents of nursing homes and other long-term care facilities.

The Philadelphia Inquirer reported:

Deaths in nursing homes and assisted living facilities currently account for more than 68% of all the coronavirus-related fatalities in the state, with 3,086 long-term care residents dead as of Tuesday. Until Tuesday, the state had only released information by county, which showed the highest number of deaths occurring at unnamed homes in Philadelphia, Montgomery, Bucks, and Delaware Counties.

Additional evidence that COVID-19 is taking a devastating toll on the elderly in Pennsylvania is provided by an analysis of the age of death data released by the Pennsylvania Department of Health on Sunday, which shows, as seen in Table 1 below, that the average age of COVID-19 deaths in the state is 80 years old, five years older than the national average of 75.

Table 1

Pennsylvania COVID-19 Deaths

Age Group Ave Age Deaths Total Years
0-4 2 0 0
5-9 7 0 0
10-14 12 0 0
15-19 17 0 0
20-24 22 0 0
25-29 27 0 0
30-34 32 7 224
35-39 37 5 185
40-44 42 21 882
45-49 47 45 2,115
50-54 52 83 4,316
55-59 57 146 8,322
60-64 62 251 15,562
65-69 67 354 23,718
70-74 72 444 31,968
75-79 77 512 39,424
80-84 82 638 52,316
85-89 87 800 69,600
90-94 92 768 70,656
95-99 97 341 33,077
100-104 102 64 6,528
105-109 107 6 642
Total 4,485 359,535
(Age not classified for 8 of 4,493 deaths)
Average age of death calculation:
Total Years/Total Deaths = 80.16
 
Source:  Pennsylvania Department of Health
Weekly Report for Deaths Attributed to COVID-19: Issued May 17, 2020

Pennsylvania Gov. Tom Wolfe, a Democrat, and Pennsylvania Health Secretary Rachel Levine have both come under intense criticism for their handling of the COVID-19 nursing home crisis in the state.

Wolfe was one of several governors who established policies in March at the beginning of the coronavirus pandemic that required nursing homes to admit residents who tested positive for COVID-19, a move that many health experts say fanned the spread of the disease within those facilities.

Levine has come under criticism for removing her own 95-year-old mother from a nursing home in the state while supporting the decision to require nursing homes to admit those who tested positive for the disease.

The reliability of data reported by the Pennsylvania Department of Health (PDH) has also come under question, particularly a 22-page spreadsheet of COVID-19 deaths by every nursing home facility in the state, as The Philadelphia Inquirer reported on Wednesday:

Nursing home operators on Tuesday evening were puzzling over where the state obtained the numbers it made public, with some saying the figures did not match anything they had entered into any of the three or so databases they fill out for local, state, and federal authorities.

Pennsylvania Health Secretary Rachel Levine, using authority under Gov. Tom Wolf’s emergency order, ordered nursing homes late last week to start filling out a new daily survey with coronavirus and other information for their facilities by the end of Saturday. That was supposed to be the basis of public reporting starting this week.

But the state used a different system, its existing electronic disease reporting system, to compile the data published Tuesday. That’s because “many facilities did not report as they were directed,” Wardle said. Those facilities are not being considered noncompliant yet.

That reliability issue was highlighted by the unusual way in which the PDH reported COVID-19 data in its weekly report on Sunday.

While the Philadelphia Inquirer reported that as of Tuesday, nursing home residents accounted for 68 percent of COVID-19 deaths in the state and the Henry J. Kaiser Family Foundation reported that, as of last Thursday, nursing home residents accounted for 71 percent of the COVID-19 deaths in the state, the PDH chose an unusual method of reporting that data, “place of death.”

Based on national standards, the place of death is categorized as shown above. The place of death of the decedent is reported by the medical certifier, such as a physician, CRNP, or coroner, based on the physical location where the death occurred.

Using that measure, 43.4 percent of deaths (1,951) took place in long-term living facilities, 52.1 percent (2,341) took place in hospitals, 2.7 percent (121) took place in residences, and 1.8 percent (80) took place in hospices or “other.”

One possible explanation for the discrepancy between PDH’s Sunday report and the data reported on Tuesday by the Inquirer and the Henry J. Kaiser Family Foundation is that some nursing home residents who have died from COVID-19 died in the hospital, while others died in nursing homes and were not in the hospital at their time of death.

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