VALUING LIFE IN A PANDEMIC

The hantavirus and Ebola outbreaks serve as stark reminders that the regime’s devastating cuts to public health have left the United States unprepared for the next pandemic. “On virtually every front,” stated James Alwine, professor emeritus at the University of Pennsylvania’s Perelman School of Medicine, “this administration has crippled our abilities to track emerging disease outbreaks and respond quickly so that they don’t get out of hand. While these latest outbreaks likely don’t pose a risk to most Americans, we may not be so lucky next time, and there will be a next time.” These new viral outbreaks also compel us to revisit the first Trump administration’s decisions about whose lives were worth saving when Covid-19 struck.

Some of the nation’s most vulnerable groups reside in nursing homes. Nevertheless, Tom Friedan, former director of the Centers for Disease Control and Prevention, warned on March 8, 2020 that nursing homes were “ground zero for Covid-19.” Two weeks later the nation learned that thirty of the forty-six deaths in Washington had occurred at the Life Care Center in Kirkland. One fourth of the residents had died and dozens of others were in the hospital. It was soon clear that the Kirkland facility was not an aberration. By June 26, the virus had killed 54,000 nursing home residents and workers, representing 43 percent of all U.S. fatalities.

The tragedy unfolding in nursing homes was, as two researchers noted, a “perfect storm.” They housed an elderly population with multiple health problems in close quarters. Moreover, increasing control by profit-making entities left facilities unprepared and unable to resist the virus. Most had severely inadequate staffing levels and inadequate infection control procedures.

Some pundits blamed nursing home staff for the high death toll, arguing that they disregarded safety protocols, traveled on public transportation, brought the virus from their communities, and worked at multiple facilities, thus spreading disease from one to another. In response, many other commentators pointed out that many administrators refused to provide adequate personal protective equipment, low wages and part-time jobs forced staff to seek employment at different institutions, few staff members could afford to travel by car, the lack of paid sick days compelled them to work when ill, and they transferred disease not only to their workplaces but also to their own communities with overcrowded homes and high rates of morbidity and mortality.

State governments sent whatever protective gear and testing equipment they could garner first to hospitals, leaving nursing homes to scrounge for supplies. Soon after the pandemic began, New York Governor Andrew Cuomo ordered nursing homes to accept patients discharged from hospitals even if they had been treated for Covid-19; the facilities were not allowed to test the patients to determine if they were still contagious or had been newly infected. In June the Associated Press estimated that hospitals had sent as many as 4,500 infected patients to New York nursing homes. New Jersey and California instituted similar policies.

The Trump administration sent hundreds of millions of dollars of stimulus payments to nursing homes but did little to ensure that the money went to improving patient care rather than to corporate owners’ pocketbooks. Although Seema Verma, the administrator of the Center for Medicare and Medicaid (CMS), vowed to strengthen nursing home inspections, eighty percent of the facilities were cleared of infection-control violations. Few of the others received significant penalties.

The most widely publicized CMS action occurred early in the pandemic. On March 13 it restricted all visitation by family members except to deliver “compassionate care” for residents near death. Although the CMS has no jurisdiction over assisted living facilities, most voluntarily followed those guidelines. Suddenly everyone seemed to discover the critical role families play in long-term care institutions. A geriatrician who served as the medical director of a long-term care facility wrote in the Journal of the American Medical Directors Association, “Family is not synonymous with visitor. The daughter who feeds her bedbound mother lunch or husband who combs and braids his wife’s hair every morning, despite her anoxic injury that prevents her spoken word, are not visitors in our buildings…Maintaining connections between residents and their loved ones has safety, socio-emotional, and ethical components.”

Family members also protested. Mary Daniels, the wife of a man with early onset Alzheimer’s disease in a Florida nursing home, founded “Caregivers for Compromise—Because Isolation Kills Too.” The goal was to restore visitation rights in a “safe and reasonable a way” by providing rapid COVID-19 testing for staff members and visitors and designating as an “essential caregiver” a family member who was screened and tested and previously had regularly visited a resident. After Daniel’s husband Steven entered the nursing home, she had gone every evening, to feed him his dinner, help him change into pajamas, and lie next to him in bed watching television. When the facility shut its doors, she applied first for a volunteer position and then for a paid one. At the end of June, the nursing home finally hired her as a dishwasher two days a week. After each shift, she and Steven were able to resume their evening ritual. Her story soon captured the attention of the national media. Capitalizing on her new-found fame, she established “Caregivers for Compromise.” It had 6,000 members within two weeks and 13,549 on October 28.

Other carers recounted their experiences during the pandemic in online support groups. “Yesterday I received the dreaded message from DW’s care unit,” wrote Chris. “Four Coronavirus diagnoses on March 18 (I didn’t know until the 19^th). This is an award receiving facility. Absolutely top notch.” He wondered if his wife was strong enough to fight off the virus and if he ever would see her again. “You folks that Pray,” I could use some help…Just when I thought the tears were all gone. Sorry can’t type any longer.”

In the middle of April, Susan discovered her father’s institution had accepted a hospital patient with Covid: “I just learned that my Dad’s facility has their first COVID case and that the patient was recently admitted after being discharged from the hospital. In addition to the facility taking supposedly ‘Non-COVID’ hospital transfers, they also were not quarantining these new admission patients. The new admissions, including the asymptomatic positive case, was allowed to mingle amongst residents, and the staff was not using extra PPE when interacting with these patients. There’s nothing I can do about it now.”

Joseph had taken advantage of the exemption for compassionate carers. After spending three days in his wife’s facility while she was dying, he wrote, “I was able to observe the other residents and the current routine and it was not pretty. Changing the routine of dementia folks is not a good thing. No visits from family and loved ones, no outside entertainments and programs allowed in, no ordinary hustle and bustle of an active facility. Some residents appeared lost and confused, some residents who [usually] were active were just sitting around, some residents who ordinarily were fairly peaceful were acting up and being more agitated and aggressive. The staff and activity directors were trying hard but were overwhelmed at times with the needs of the residents. Never really thought about it but visits and time spent by the family members and friends takes a little pressure off the staff.”

On April 15, Joseph wrote again: “Since my Sally passed away three weeks ago, three others have passed away in the memory care facility. Although Covid 19 is not in the facility, I blame that cursed virus. The change in routine, no visitors and whatever normalcy they had has been uprooted and that can be the catalyst that sends many with dementia down into a vicious spiral. No one is coming out of this unscathed.”

A few carers brought relatives home. Nancy wrote that her husband’s facility had requested that she hire a sitter because he was falling and losing weight. Unable to afford a full-time companion, she asked if she could stay with him a few hours in the evening. “I am having a hard time understanding why the sitter, a complete stranger, is allowed to be with him—and why I, living a very quiet and careful life, CAN’T! He has been in [the nursing home] since mid January. I believe now I was very naïve to think they could care for him as his disease progressed and of course, no one counted on the effects that Covid would bring. At what cost are we keeping so many people from their loved ones? My heart is broken tonight.” Six days later she wrote again. Because the facility had denied her request, she had removed her husband. “Only God knows how many days he has left but I am so thankful those days are going to be spent at home,” she wrote. “He is unable to speak and is so incredibly thin and weak, but he has smiled so much.”

“Disasters have the power to reveal who we are, what we value, what we’re willing—and unwilling to protect,” wrote sociologist Eric Klinenberg. The Covid-19 pandemic represents a case in point. As we fight to rebuild the nation’s pandemic preparedness, we also must fight to ensure that no group, no matter how old and sick, is ever again considered disposable.

Sources:

“Viral Outbreaks Show Urgent Need to Rebuild Disease Monitoring, Pandemic Preparedness,” Defend Public Health News Release, Mary 21, 2026, https://www.defendpublichealth.org/press-release/viral-outbreaks-show-urgent-need-rebuild-disease-monitoring-pandemic-preparedness.

Emily K. Abel, Elder Care in Crisis: How the Social Safety Net Fails Families (New York University Press, 2022).