15 April 2020: Michigan Governor Gretchen Whitmer Issues a Potentially Deadly Directive

Michigan Gov. Whitmer signs EO to protect people working, living in long-term care facilities

Michigan Governor Gretchen Whitmer's Executive Order 2020-50 was issued on 15 April 2020. Here is how it was reported:

Michigan Gov. Gretchen Whitmer signed Executive Order 2020-50 to establish procedures in long-term care facilities to protect the health and safety of both their employees and residents.

At many of Michigan’s long-term care facilities residents and employees live and work in confined spaces. There is also a lack of personal protective equipment. A positive coronavirus (COVID-19) test can threaten the safety of the entire facility.

"The spread of COVID-19 has had a significant impact on residents and employees at Michigan's long-term care facilities," Whitmer said. “That's why I am taking action to implement policies that will protect the most people we can in those facilities. I know this is a hard time for Michigan's elderly residents, their families, and the hardworking staff who work with them every day. I will continue to do everything in my power to protect Michiganders everywhere from the spread of this virus. We will get through this together."

That sounds like noble intentions, but there are aspects of Executive Order 2020-50 that echo New York Governor Andrew Cuomo's deadly 25 March 2020 directive. Here's a directly relevant excerpt from Section III of the executive order:

5. Once a long-term care facility resident who has been hospitalized due to onset of one or more of the principal symptoms of COVID-19 becomes medically stable and eligible for discharge in the judgment of the resident’s medical providers, a hospital must discharge the resident in accordance with the following protocol:

1. If the long-term care facility where the resident resided prior to the onset of one or more of the principal symptoms of COVID-19 ("facility of residence") has a dedicated unit and provides appropriate PPE to the direct-care employees who staff the dedicated unit, the hospital must discharge the resident to their facility of residence for placement in the dedicated unit, provided there is available bed capacity.
2. If a discharge in accordance with section 5(a) of this part is not available, the hospital must discharge the resident to a regional hub, provided there is available bed capacity.
3. If a discharge in accordance with section 5(a) or 5(b) of this part is not available, the hospital must transfer the resident to any alternate care facility with available bed capacity in accordance with the following protocol:
1. Any alternate care facility within the state that has available bed capacity to receive the resident must accept a transfer authorized by this order.
2. An alternate care facility must discharge a long-term care facility resident to the facility of residence as soon as capacity allows. If the facility of residence lacks available capacity, the alternate care facility must transfer the resident to a regional hub. If a regional hub receives a resident under this part, it must transfer the resident to the facility of residence as soon as capacity allows.

6. For any transfer or discharge of a resident, the transferring or discharging entity must ensure that the resident’s advance directive accompanies the resident and must disclose the existence of any advance directive to medical control at the time medical control assistance is requested.

7. Any long-term care facility that has a dedicated unit and provides appropriate PPE to the direct-care employees who staff the dedicated unit must admit anyone that it would normally admit as a resident, regardless of whether the individual has recently been discharged from a hospital treating COVID-19 patients.

Note the repeated use of the word "must", which requires alternate care facilities and long-term care facilities like nursing homes to admit the patient transferred under this protocol. As a result, although the "medically stable" condition justifying the transfer a COVID patient could potentially mean they were still contagious, that would be a path for spreading COVID infections at the facilities receiving them.