On April 27, Gov. Charlie Baker and Health and Human Services Secretary Marylou Sudders announced a new package of aid for nursing homes struggling to contain the coronavirus. They said the state would make $130 million available for facilities that did two things: passed a health and safety audit, and tested at least 90% of all residents and staff.
The auditing process is ongoing — nursing homes will be monitored through June — and the testing deadline is Monday, May 25. But given the supply and personnel shortages that have hindered testing efforts nationwide, it’s unclear how many of the state’s 383 nursing homes will complete this “baseline” testing on time.
And beyond this baseline testing, senior care advocates generally agree that the best way to contain the spread of the virus long-term will be a targeted and ongoing “surveillance” testing program. This means long-term care facilities should test residents and workers not once, but often.
“Baseline testing allows us to take a snapshot in time of the virus in our facilities,” says Tara Gregorio, president of the Massachusetts Senior Care Association. “However, baseline testing in and of itself is not enough. What we need is regular surveillance testing so that we can monitor [residents who] test negative and ensure that they continue to test negative.”
Dr. Michael Mina, an epidemiologist at the Harvard T. H. Chan School of Public Health, put it more bluntly during a recent call with reporters.
One potential solution would be to retest everyone in a facility every week or every month, but experts say that’s a poor use of limited resources. There are about 38,000 older adults living in nursing homes in the state — plus thousands of employees — and securing that many tests on a regular basis is not realistic.
“The supplies for testing are still extraordinarily limited and very, very difficult to come by,” Mina says. “We can’t get the supplies we need here [and] we’re Harvard and M.I.T. and Boston — we’re the biotech hub of the world in some ways — and we can’t get these supplies.”
What’s more, regular baseline testing would be logistically challenging. The National Guard, which has been testing nursing home residents since early April, already can’t keep up with demand, and the state had to discontinue a program that asked nursing home staff to test residents after many tests came back contaminated.