America’s inability to—or, really, its decision not to—control the virus has meant a precipitous decline in quality of life for its oldest and most fragile, and a catastrophic number of deaths among them. People over the age of 85 are 630 times as likely to die of COVID-19 as people in their 20s, and 95 percent of coronavirus deaths have occurred among Americans older than 50. Data compiled by the Kaiser Family Foundation show that COVID-19 has claimed the lives of more than 100,000 people in long-term care facilities, meaning roughly 40 percent of coronavirus deaths have occurred in institutions housing fewer than 1 percent of Americans.
The kind of work done and the kind of care needed—the very architecture of life lived—in nursing homes and similar facilities pose a challenge when it comes to preventing the spread of the novel coronavirus. Such facilities congregate people, and have a rotating cast of caregivers, housekeepers, food-service workers, medical experts, and others tend to them. The work is often close, intimate—bed baths, blood draws, spoon-fed meals.
Yet the United States, by any measure, has not met this challenge. Nine months into the pandemic, long-term care facilities are still facing shortages of personal protective equipment. Many are floundering financially, even with help from the government. They are still having problems getting COVID-19 tests turned around quickly. PPE shortages worsened in the third quarter of the year, with 17 percent of nursing homes reporting being low on or out of N95 masks, 11 percent out or nearly out of gowns, 9 percent short of surgical masks, and 8 percent lacking eye protection.
Read: The vaccine is not coming soon enough for nursing homes
In this environment, care facilities have had little option but to close up. Following guidance from the CDC, many have barred in-person visits and kept residents in their rooms, among other measures. To compensate, facilities have set up Zoom and FaceTime calls, created outdoor areas for distanced visits, set up barriers that family members can talk through, helped residents play online social games, and arranged care-package drop-offs. Many of the care residents I spoke with for this article said that they had taken advantage of those options, and adapted.
Judy Friederici is a retired lawyer who proactively moved into a retirement facility a few years ago, as she is not married and does not have children. Isolation has been tough, she said, particularly given that she moved to her community in part to ensure she would not be isolated as she got older. But she has made a project of calling people in her complex who are likely to feel lonely.
Mary Anna Turner, who turns 100 next year, lives in a Virginia care facility. She indicated that her experience living through worse had given her some grit. “I remember flu epidemics!” she told me. “I remember I had a bad case, and I called a doctor and asked him to send me something for it. The nurse said no, and I asked, Why not? She said, Too many people are dying. We don’t have anything to send you.” Turner told me she misses her family, but is making do.