March 31, 2021
This question was asked in the most recent issue of Scientific American1 which calculated the rates of death per 100,000 full-time employees (FTEs) in a variety of professions including ranchers, steel workers, truck drivers, roofers, pilots, loggers, fisherman, and nursing home workers. The statistics for nursing home staff were obtained from CMS and the US Bureau of Labor Statistics, however the CMS data did not include the beginning of the COVID-19 pandemic from February-May 2020.
Using the available data, employees of skilled nursing facilities were found to have 80 deaths per 100,000 FTEs, calculated by dividing the total number of deaths reported to CMS from May 17-December 27, 2020. In contrast, Scientific American reported the following death rates among what is generally considered high risk occupations:
Average Across all Occupations 3.5
Ground Maintenance Workers 19.8
Farmers, Ranchers, Agricultural Managers 23.2
Structural Iron and Steel Workers 26.3
Drivers/Sales Workers and Truck Drivers 26.8
Refuse and Recyclable Material Collectors 35.2
Helpers in Construction Trades 40.0
Aircraft Pilots and Flight Engineers 61.8
Logging Workers 68.9
Nursing Home Workers 80.0
Fishers and Related Fishing Workers 145.0
The authors identified that the death rate of 80/100,000 for nursing home employees is likely higher than reported due to the lack of data collection prior to May 17, 2020 when the first wave of COVID-19 infections was seen in long-term care.
There are numerous possible explanations for this high death rate including the lack of PPE available to nursing home staff, the lack of testing, variable infection control practices as well as staffing issues that have been pervasive issues long before the pandemic. The author suggests that COVID-19 will effectively bring society’s attention to the problems of reimbursement to nursing homes as well as the struggles of the CNA to perform care which is physically and emotionally draining. The limited amount of payment for these services in addition to underlying health issues, decreased access to health care and the likelihood that CNA live in multi-generational households with increased exposure to the virus. Of note, the majority of CNAs are women, people of color and immigrants, individuals who often have low visibility along with low wages, inadequate health care coverage and minimal sick-leave benefits.
In this era of COVID-19, providing care to nursing home residents has placed our staff in substantial jeopardy.
Lewis, T. Nursing home workers had one of the deadliest jobs of 2020. Scientific American. Published online February 18, 2021. https://www.scientificamerian.com/article/nursing-home-workers-had-one-of-the-deadliest-jobs-of-2020.