14 July 2020: Backlash Against NY DOH Report

Blame game? Cuomo takes heat over NY nursing home study

This report covers the continuing backlash against the Cuomo administration's state Department of Health (DOH) report absolving both the DOH and the Cuomo administration from responsibility for their role in establishing the 25 March 2020 directive that forced nursing homes to admit patients known to have COVID-19 infections, and which also barred the facilities from testing them to determine if their infections were still active. Beyond that, this report also gets into scientific criticism of the DOH's report:

... some accused the state of using the veneer of a scientific study to absolve the Democratic governor by reaching the same conclusion he had been floating for weeks — that unknowingly infected nursing home employees were the main drivers of the outbreaks.

“I think they got a lot of political pushback and so their response was, ‘This isn’t a problem. Don’t worry about it,’” said Rupak Shivakoti, an epidemiologist at Columbia University’s Mailman School of Public Health.

“It seems like the Department of Health is trying to justify what was an untenable policy,” added Charlene Harrington, a professor emerita of nursing and sociology at the University of California at San Francisco.

In other words, the NY DOH report appears designed to reach a predetermined conclusion. Other epidemiologists who the AP requested review the DOH report raised additional criticisms of its methods and findings, which are detailed below in the following extended excerpt:

But several experts who reviewed the report at the request of The Associated Press said it has fatal flaws, including never actually addressing the effect of the order.

Among the questions not answered: If 80% of the 310 nursing homes that took coronavirus patients already had cases before the order, what was the effect of the released patients on the other 62 homes? If the median number of patients were released into nursing homes for nine days, that means that by the study’s own count more than 3,000 patients were released within nine days. Could they have been infectious?

Denis Nash, an epidemiologist at the City University of New York School of Public Health, also noted that New York’s nursing home death toll doesn’t include nursing home residents who died at a hospital, a “potentially huge problem” that undercounts the virus’ toll and could “introduce bias into the analysis.”

Among the holes in the study highlighted by University of Texas, Houston, epidemiologist Catherine Troisi was a lack of data on what happened at dozens of nursing homes that had no COVID-19 infections before those sick with the virus were sent to them.

“Would this get published in an academic journal? No,” Troisi said.

Shivakoti said he thinks the report may be correct in concluding that the major drivers of the outbreaks were nursing home workers who were sick without knowing it. But that’s not the same as saying the discharges played no role.

“If they didn’t infect other patients directly,” Shivakoti said, “they still could have infected a worker.”

Dr. Mark Dworkin, a former Illinois state epidemiologist, said the finding that people don’t transmit the virus after nine days of illness applies in the population at large, but it’s not clear whether that’s true of nursing home residents who may have weaker immune systems and shed the virus longer. He said the state’s report used “overreaching” language.

“They really need to own the fact that they made a mistake, that it was never right to send COVID patients into nursing homes and that people died because of it,” said Dr. Michael Wasserman, president of the California Association of Long Term Care Medicine.

The NY DOH report ticks several boxes on our checklist for how to detect junk science, specifically for Goals, Progress, and Inconsistencies.