Minnesota’s long-term care homes are dangerous

This op ed appeared in the Star Tribune on May 27th, 2020

On Tuesday, the Minnesota Department of Health reported that another 18 of our fellow Minnesota residents died from COVID-19, bringing the total to 899. This is the dreadful human cost of the public health crisis facing Minnesota.

But it is a cost which has been largely borne by a very small portion of Minnesota’s population: the residents of its long-term care facilities.

Of the 18 people whose deaths were announced on Tuesday, 15 — 83% — were residents of long-term care or group homes. This was not a one-off. Overall, of the 899 fatalities so far, 732 — 81% — were residents of long-term care.

For context, residents in certified nursing facilities are about 0.4% of Minnesota’s population.

COVID-19 is a new disease, and one of the few things we know for certain is that it disproportionately produces severe illness among the elderly and those with underlying medical conditions. So, we might expect this section of Minnesota’s population to be hit particularly hard. But care home residents seem to be suffering more in Minnesota than in many other states.

Minnesota’s 81% of fatalities in long-term care settings ranks the state No. 1 in the U.S. for the share of its total COVID-19 deaths in those facilities, according to an analysis of state-by-state reports.

But that figure is just measuring deaths in long-term care facilities as a portion of total deaths. If the number of deaths in Minnesota outside such facilities were especially low, you would expect that ratio to be especially high. And the numbers do show exactly that.

On COVID-19 deaths outside long-term care facilities, per million of the population, Minnesota ranks 32nd out of the 45 states and District of Columbia for which such numbers can be calculated, according to another study. We have had 29 such deaths per million and the national median is 49.

But at the same time, looking solely at deaths inside these facilities, we are well above the average. For COVID-19 deaths in long-term care facilities per thousand residents of those facilities, Minnesota ranks 14th. We have seen 29 deaths per thousand residents compared with a median figure of 16.

Indeed, if our state’s long-term care facilities had suffered this lower, median death rate, 323 fewer residents of Minnesota’s care homes would have died.

The numbers are clear: Outside long-term care facilities, Minnesota is safer than average. Inside them, it is more dangerous.

On Thursday, it will be three weeks since Gov. Tim Walz announced a five point “battle plan” to tackle COVID-19 deaths in long-term care. Since then, another 302 long-term care residents have died, 83% of all coronavirus deaths in that period. Indeed, the overall proportion of deaths in long-term care facilities has edged up from 81% since the plan was unveiled. The battle is being lost.

Minnesotans are paying a high price in their war against COVID-19. Since March 16, 702,543 people in our state have filed for unemployment insurance. Last week, the Bureau of Labor Statistics announced that our state’s unemployment rate had leapt from 2.9% in March to 8.1% in April, the highest since January 1983.

This sacrifice will be for naught if the state government continues to fail to get to grips with the crisis in our care homes.

John Phelan is an economist with the Center of the American Experiment.