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To make ends meet, Martha Tapia works 64 hours every week at two completely different Orange County, Calif., nursing properties. She is considered one of hundreds of licensed nursing assistants who carry out the intimate and bodily work of bathing, dressing and feeding the nation’s fragile aged.
“We do all the things for them. All the pieces you do for your self, it’s a must to do for the residents,” Tapia says.
And she or he’s considered one of many in that low-paid area, predominantly women of color, who work at multiple facility.
In March, when the coronavirus started racing by way of nursing properties the federal government banned visitors. (That steerage has since been updated.) However, even with the ban, infections saved spreading. A crew of researchers from UCLA and Yale College determined to look at the individuals who continued to enter nursing properties in that point — the workers.
Keith Chen, a behavioral economist and UCLA professor, says the important thing query is that this: “The individuals who, we will infer, work on this nursing house — what different nursing properties do they work at?”
Using location data from 30 million smartphones when the visitor ban was in place helped the scientists “see” the actions of individuals going into and out of nursing properties. The info confirmed a number of nursing house employees are — like Tapia — working at multiple facility. Chen says the findings recommend that one supply of the unfold of infections is workers who work in a number of nursing properties.
“If you study that over 20 of your employees are additionally spending time in different nursing properties, that ought to be an actual crimson flag,” Chen says.
The toll on sufferers and past
Greater than 84,000 residents and workers of nursing properties and different long-term care amenities have died from COVID-19 throughout the U.S., representing 40% of all coronavirus fatalities within the nation, in response to Kaiser Family Foundation’s most recent analysis. (Kaiser Well being Information is an editorially impartial program of KFF.)
In California the analogous toll is greater than 5,700 deaths, making up 35% of all coronavirus fatalities within the state.
The UCLA crew created maps of motion and located that on common every nursing house is linked to seven others by way of workers motion. Limiting nursing house workers to 1 facility might imply fewer COVID-19 infections — however that might harm the workforce of people that say they work a number of jobs due to low wages.
After every of her shifts, Tapia worries she’ll convey the coronavirus house to her granddaughter. She tries to take precautions, together with shopping for N95 masks from nurses. She is aware of it is not simply sufferers who’re in danger. Nursing house employees like Tapia are additionally contracting COVID-19 — in California alone, 153 of them have died since the pandemic began.
On the nursing house she works at within the morning, she will get an N95 masks that she should solely use — and reuse — in that facility. At her different nursing house job, within the afternoons, she will get solely a blue surgical masks to put on.
“They are saying they can not give us N95 [masks],” she says, as a result of she works within the “normal space” the place residents have not examined optimistic for the coronavirus.
She does not wish to work at a number of nursing properties however her hire is $2,200 a month and her low pay and restricted hours at every nursing house make a number of jobs a necessity.
“I do not wish to get sick. However we have to work. We have to eat, we have to pay hire. That is simply how it’s,” Tapia says.
Employees connections equal infections
The UCLA research additionally discovered that some areas of the nation have a a lot larger overlap in nursing house staffing than others.
“There are some amenities in Florida, in New Jersey, the place they’re sharing upwards of fifty to 100 employees,” says UCLA affiliate professor Elisa Long, who, alongside together with her colleagues, examined information in the course of the federal customer ban from March to Might. “That is over an 11-week time interval, however that is an enormous variety of people which are transferring between these amenities, all of those are potential sources of COVID transmission.”
In addition they discovered the extra shared employees a nursing house has, the extra COVID-19 infections among the many residents.
“Not solely does it matter how linked your nursing house is, however what actually issues is how linked your connections are,” Lengthy says.
The researchers say they’ve informally dubbed these extremely linked nursing properties as every state’s “Kevin Bacon of nursing properties,” after the “Six Degrees of Kevin Bacon” parlor recreation.
“We discovered that if you are going to see a nursing house outbreak wherever it is more likely to unfold to the Kevin Bacon of nursing properties in every state,” Chen says.
The crew hopes that native well being departments might use related mobile phone information strategies as an early warning system. Utilizing the check outcomes from the “Kevin Bacon” of nursing properties as an indicator could be step one.
“As quickly as you detect an outbreak in a single nursing house, you’ll be able to instantly prioritize these different nursing properties that are elevated danger,” Chen says.
Prioritize masks and handwashing
The California Affiliation of Well being Services represents most nursing properties in California. In response to the research, the group says its members cannot forestall employees like Martha Tapia from taking jobs elsewhere, and so they cannot pay them extra, as a result of California does not pay them sufficient by way of Medicaid reimbursements.
Mike Dark, an lawyer with the California Advocates for Nursing House Reform, does not purchase that argument. He says the state already tried paying nursing homes more in 2006 — and that made them extra worthwhile, however no more protected and environment friendly. He’s skeptical that additional funding to pay workers would truly attain these employees.
“We all know from previous expertise that cash tends to enter the pockets of the executives and directors who run these locations,” Darkish says.
He agrees that health workers like Martha Tapia ought to be paid extra, however cautions towards one concept that’s being floated in some coverage circles: limiting employees to 1 nursing house.
“Then you’ll be able to wind up depriving a few of the essential well being care givers that we’ve in these amenities of their livelihoods, which might’t be a superb answer,” he says.
As an alternative, he says, regulators must deal with the fundamentals, particularly within the 100 California nursing properties with ongoing outbreaks, since it has been proven that an infection management measures work.
“Proper now there’s poor entry to [personal protective equipment]. There’s nonetheless erratic compliance with issues like hand-washing necessities,” he says. “If we spent extra time addressing these key points there could be a lot much less concern about unfold between amenities.”
Jackie Fortiér is well being reporter for KPCC and LAist.com. This story is a part of NPR’s reporting partnership with KPCC and Kaiser Health News, a nonprofit, editorially impartial program of the Kaiser Household Basis. KHN shouldn’t be affiliated with Kaiser Permanente.