Six days a week, for up to 12 hours a day, Sherry Perry cares for elderly residents at a nursing home outside of Nashville, Tennessee. She supports 13 to 18 people per shift, changing their soiled clothes, brushing their teeth, giving them baths.
As nursing homes across the country have become ground zero for the coronavirus epidemic, Perry, 51, is worried.
Nursing aides at her facility, which Perry asked not be identified to protect her job, are provided a single cloth face mask for each shift, she said. They don't wear gowns or the more protective N95 face masks because her facility hasn't confirmed any coronavirus cases. But she knows that a single asymptomatic case of COVID-19, or one that's yet to be diagnosed, could quickly spread to workers and residents.
"We are so up close to the residents, in their faces doing their care,” she said. “They are touching us. How are we going to stop it?"
Across the country, nursing assistants — who are some of the country's lowest-paid health care workers — are asking the same questions. More than 55,000 nursing home residents and staff members have contracted COVID-19; more than 11,000 have died. In some states, more than half of coronavirus deaths have been in nursing homes.
Most of the public attention has been focused on the nation's 1.3 million nursing home residents, who are most vulnerable to the virus and who are thought to represent the vast majority of deaths. But hundreds of thousands of nursing assistants are also in mortal danger every day. It's unclear how many have gotten sick or died, but their facilities are running short of face masks, gowns and other personal protective equipment (PPE). And many nursing assistants complain that low wages, lack of benefits, high turnover and staffing shortages are making them and their facilities even more vulnerable to the coronavirus.
"Care staff are getting sick, but they can't afford to stay home,” said Richard Mollot, executive director of the Long Term Care Community Coalition, an advocacy group. “They take an aspirin and they go to work."
All of which makes nursing home residents more vulnerable, too.
A low priority for coronavirus response
One reason nursing homes are so vulnerable is that they were not the initial focus of the federal coronavirus response, which prioritized hospitals, said Elaine Ryan, vice president of government affairs for state advocacy at AARP. “In many ways, nursing homes were unfairly a second priority for receiving personal protective equipment,” she said. “Federal and state governments did not make them a priority, and that resulted in thousands of people losing their lives."