Minnesota’s care homes are a Covid-19 disaster area. How can we improve that?

At the latest count, 78% of Minnesota’s 1,504 Covid-19 deaths have come in our state’s care homes. This is the fourth highest share in the United States: indeed, Minnesota has had more deaths in its care homes – 1,172 – than 30 states have had in total. Minnesota’s Covid-19 crisis is first and foremost a crisis in its care homes.

I have often pointed this out and been asked ‘Well, what would you do?’, a not unreasonable question. New research offers an answer.

In a new paper titled ‘Nursing Home Staff Networks and COVID-19‘, researchers M. Keith ChenJudith A. Chevalier, and Elisa F. Long note that:

An early report issued by the Centers for Disease Control and Prevention identified staff members working in multiple nursing homes as a likely source of spread from the Life Care Center in Kirkland, Washington to other skilled nursing facilities.

However:

The full extent of staff connections between nursing homes—and the crucial role these connections serve in spreading a highly contagious respiratory infection—is currently unknown given the lack of centralized data on cross-facility nursing home employment.

Chen, Chevalier, and Long:

…perform the first large-scale analysis of nursing home connections via shared staff using device-level geolocation data from 30 million smartphones, and find that 7 percent of smartphones appearing in a nursing home also appeared in at least one other facility—even after visitor restrictions were imposed. 

They:

…estimate that nursing homes have, on average, connections with 15 other facilities.

These linkages, it appears, are an important avenue of Covid-19 transmission. Chen, Chevalier, and Long conclude that: 

Controlling for demographic and other factors, a home’s staff-network connections and its centrality within the greater network strongly predict COVID-19 cases. Traditional federal regulatory metrics of nursing home quality are unimportant in predicting outbreaks, consistent with recent research. Results suggest that eliminating staff linkages between nursing homes could reduce COVID-19 infections in nursing homes by 44 percent.

That is a huge number: 44% of 1,172 is 516 people. If Minnesota is to get on top of its Covid-19 crisis, reducing transmission between care homes by reducing shared staff seems to be an important part of the strategy.

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