State health department must provide more data on COVID in Minnesota long-term care facilities

Why isn't the Minnesota Department of Health (MDH) releasing comprehensive COVID-19 data? The department's mission is to protect the public health, but how can that happen when stakeholders are not given detailed data with which to make informed decisions?

Over 70% of the state's COVID-19 deaths are happening in long-term care (LTC) facilities including nursing homes and assisted living. These are our mothers, fathers and loved ones suffering and dying from this horrific disease.

These data are critically important for COVID-19 researchers, to better understand and address the impact of COVID-19 on the population; for gerontologists, to understand and address the deterioration of quality care in LTC facilities; and for families, to know if their facility is impacted and how severely, so they can monitor and advise in the care of their loved ones.

Now, as national and state officials warn of new COVID-19 surges, MDH is still not being sufficiently transparent about COVID-19 cases and deaths in LTC settings.

That inadequate disclosure began in April, when MDH wouldn't identify which homes had COVID-19 infections, using the unfounded argument that it would violate federal health privacy law. After the Star Tribune and elder care advocates highlighted the missing information and contrasted it with public information in other states, MDH relented. It now lists care homes with 10 or more residents having one exposure in the last 28 days. But it does not include COVID-19 death data or how many are infected in each facility.

Currently, over 200 facilities are listed. However, the list is of little value without showing cumulative measures of exposures and deaths over time.

MDH asserts that robust data reporting would be burdensome, even though we are in a major public health emergency and they already collect the data. MDH also suggests that naming care homes would alarm long-term care providers, even though many of these providers are in a care crisis largely of their own making.

The Minnesota Coalition on Government Information (MNCOGI) has joined more than 130 organizations in signing a statement affirming the importance of government transparency during this pandemic. It states, "At all times, but most especially during times of national crisis, trust and credibility are the government's most precious assets."

Here's what is needed — a state health department that is forthcoming with timely public disclosure of COVID-19 infection cases and death numbers in specific nursing homes and assisted living residences. Instead of a meaningless list, we should be able to see cumulative and recent data (e.g. past week) on exposures and deaths by care setting. This would give Minnesotans comparable information on the prevalence of COVID-19 exposure and deaths in these care homes, the magnitude of outbreaks, recent trends of outbreaks, where stronger and targeted infection-control measures may be needed, where COVID-19 transfers occur, and where care homes have indefinitely suppressed critical information, leaving residents and families in the dark about safety.

Where is the MDH concern for the residents and their right to know?

Here's what is not needed — a state health department holding back public information about these care homes to "protect" the interests of the long-term care industry or the state agency.

The release of accurate, comprehensive public health data is more important than ever as COVID-19 cases are again rising. Its absence makes it impossible to distinguish between the relative health and safety risks associated with congregate care homes, it compromises the credibility of MDH and it jeopardizes otherwise laudable efforts by many of these care providers to protect their residents.

Making matters even worse is that most neglect and abuse complaints to MDH are not being investigated, leaving many residents at significant risk. With MDH redeploying 90% of their staff to address COVID-19, a significant but undisclosed backlog of cases has been created. Every day that passes, it becomes more likely that vital evidence will never be collected.

States such as Massachusetts and Connecticut have implemented adequate transparency measures. Why can't MDH? If MDH continues to conceal the data, then the Legislature needs to demand it.

As Abe Lincoln said, "Let the people know the facts, and the country will be safe."

Gregg Larson is operational lead, COVID-19 studies, Coordinating Centers for Biometric Research at the University of Minnesota School of Public Health. Eilon Caspi is assistant research professor, Institute for Collaboration on Health, Intervention and Policy at the University of Connecticut and an adjunct faculty member at the University of Minnesota School of Nursing. Kristine Sundberg is executive director of Elder Voice Family Advocates.