Editorial: Nursing home tests must be priority

The new plan for Pennsylvania nursing homes is to test everybody.

If that sounds familiar, it’s probably because it sounds like the old plan. At least in the shorthand.

The order issued Monday by Pennsylvania Secretary of Health Rachel Levine requires all nursing home residents and staff members be tested for covid-19 by July 24.

“Our goal with implementing this testing in nursing homes is to rapidly detect asymptomatic positive residents, manage their care and prevent further transmission of covid-19,” Levine said.

Sounds good. Let’s do that. But, wait, that was already the plan, right?

Well, yes, it was the plan. It was just never the order.

Instead it was a guideline. And a guideline is great. It’s the kind of thing everyone agrees is probably the right idea. It’s the kind of thing on a photocopied handout you get from your doctor about how to keep your cholesterol down. It’s also the kind of thing you wad up in a ball and pitch out before you ignore the advice and order a bacon cheeseburger.

Everything about a guideline tells you that you should do this but you aren’t required to do this.

Which probably explains why that guidance was issued in May and 10 days into June, 75 nursing homes have listened. That’s just over 10% of the more than 700 nursing homes in the state.

It is puzzling why testing in nursing homes has not been a priority from the beginning of the coronavirus pandemic. The first cluster of cases to appear in the United States was in a nursing home in Washington state. The first reported death was there, too, as well as the first health care worker reported to be infected.

To date, there have been 76,846 diagnosed cases of covid-19 in Pennsylvania and 6,062 deaths. Nursing and personal care homes account for 25% of the diagnoses and a staggering 69% of the deaths.

And this shouldn’t be a surprise to anyone. From the very beginning — even before the first cases were reported in the United States — there was one thing experts said about a disease everyone knew little about. It was going to hit the aged and ill population the hardest.

Well, nursing homes are where the aged and ill are. Why would a comprehensive plan for testing them not have been among the first priorities? Once it was identified as important, why would that testing be left up to the take-it-or-leave-it suggestion of a “guideline” over something with the resolution behind it of a directive or an out-and-out order?

We are now three months into the state’s pandemic response and just formulating a way to address our most at-risk population, and even now, the plan seems tepid.

“We will ensure that it happens by July 24,” Levine said. “We’re going to make every effort to make that happen.”

“Will ensure” and “make every effort” are as different from each other as “guideline” and “order.” The state needs to do better.