A group of U.S. senators asked top health officials to begin releasing detailed demographic data on coronavirus infections in nursing homes, pointing to mounting evidence that the disease disproportionately affects communities of color.
The federal government has required the nation’s more than 15,000 nursing homes to report COVID-19 counts from May onward, but the public information consists solely of confirmed and suspected cases, along with deaths.
The senators — Elizabeth Warren of Massachusetts, Bob Casey of Pennsylvania, Ron Wyden of Oregon, and Patty Murray of Washington — asked the Centers for Medicare & Medicaid Services (CMS) and Centers for Disease Control & Prevention (CDC) to go further.
“The COVID-19 pandemic has had a deadly impact on nursing homes and other long-term care facilities, and all evidence indicates that that impact has been disproportionately borne by people of color,” the lawmakers, all Democrats, wrote. “We urge you to fully inform the national response to this crisis by expanding this data collection to include race, ethnicity, sex, age, primary language and disability status.”
In general, non-white Americans have seen higher rates of COVID-19 infections and deaths, and emerging research has uncovered connections between the level of community spread and the intensity of outbreaks in facilities.
The group cited formal Congressional testimony from University of Chicago researcher R. Tamara Konetzka, whose early probes into COVID-19 infection patterns in nursing homes found a link between race and outbreak risk: Facilities with the lowest percentage of white residents were more than twice as likely to report infections and deaths than those with the greatest proportion of white residents.
That same analysis found no connection between a facility’s five-star quality rating or profit status and the likelihood of an outbreak, though later research has suggested that staffing levels and ratings may play a role in the severity of case spread in nursing facilities.
“Nursing homes are often a reflection of the neighborhoods in which they are located,” Konetzka said during a May Senate hearing. “Consistent with the pandemic generally, nursing homes with traditionally underserved, non-white populations are bearing the worst outcomes.”
In their letter, the Democratic senators asked CMS administrator Seema Verma and CDC director Robert Redfield to formulate a plan for releasing both current and retroactive demographic data, while also providing state and federal breakdowns of the information.
“This information is crucial to understanding disparities both within and between long-term care facilities,” they wrote. “Further, such data should be used to direct resources to the facilities at the highest risk and to provide appropriate guidance to providers, residents, and family members.”
CMS and CDC have reported more than 37,000 deaths from COVID-19 in nursing homes through July 5, the most recent date for which information is available; the senators, along with multiple independent voices, noted that the official number is almost certainly an undercount given testing delays and the lack of retroactive reporting prior to May.
The federal data currently shows more than 133,000 confirmed cases and about 83,000 suspected infections.