Dr. Marc Siegel: Coronavirus and nursing homes — Florida sets example with these steps to protect elderly

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Ida Zelcer, age 91, is a Holocaust survivor who saw her dear brother Hershel burned alive in front of her by the Nazis when he was 5. Nevertheless, she managed to survive, to make it to America and to raise a family, including a son, Dr. Alan Zelcer, my father’s cardiologist, who has saved his life in the past month from COVID-19 and then from skyrocketing blood pressure.

Dr. Zelcer learned from his mother to value how precious and fragile life is, and how best to honor and protect it.

Ida Zelcer

Ida Zelcer

Ida lives in a skilled nursing facility in Palm Beach County, Florida, known as Lakeview Care Center. Dr. Zelcer chose this place for a reason. It is a well-lit, clean place with kind, highly skilled and caring staff.

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Lakeview is a great example of a nursing home that is taking seriously Gov. Ron Desantis’s edict that these facilities are “ground zero” for COVID-19. Gilda Anderson, Lakeview’s administrator told me in an interview that “we screen our staff daily prior to entering the building, including taking their temperatures. Our staff … are wearing the required PPE (Personal Protective Equipment) and we’re enforcing all infection control protocols.”

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Dr. Zelcer told me that he receives a phone call notifying him whenever a patient in his mother’s nursing home tests positive for COVID-19. The patient is then immediately isolated and the concerned staff is on the phone with an infectious disease specialist at Delray Medical Center, where the patient is frequently transferred.

The patient is not returned to Lakeview Care Center until they are completely symptom-free and have received negative tests for COVID-19. New York state had the opposite policy until Gov. Andrew Cuomo reversed course Sunday.

It was a complete disgrace and showed disregard for our most vulnerable treasure that New York was allowing COVID-19 positive patients into our nursing homes.

The Lakeview staff ready for another day.

The Lakeview staff ready for another day.

Consider that more than 5,000 people have died from COVID-19 in New York's nursing homes since March 1, which is three times the number of COVID-19 deaths (1,669) in the entire state of Florida, a state of comparable size and population, which also has major urban centers. Until Sunday, New York was not mandating testing of workers in their nursing homes the way Florida has. Florida also has a directive from the governor to aggressively test nursing home patients as well.

The solution to New York’s nursing home COVID-19 problem is to look to Florida as a role model. We need to separate out people who are sick and could have the virus. Be on the lookout not just for cough, shortness of breath and fever in our elderly, but bowel problems, loss of sense of taste and smell, discolorations on toes and fingers, swollen legs (blood clots), and above all changes in behavior and fatigue.

A family visit at Lakeview.

A family visit at Lakeview.

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Any suspected COVID-19 patient should be isolated and a nearby hospital (with an established protocol with the nursing facility) should be contacted. Deep disinfection in the nursing home should be a daily event, and all staff and residents should be tested frequently for COVID-19 (the test is only 60 to 70 percent accurate) as they are at Lakeview Care Center.

Diabetes, obesity, heart and lung disease and being immuno-compromised put people at additional risk (along with age) and residents with these conditions should be treated with extra care and caution.

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The Trump administration should issue a set of guidelines based on the way Lakeview Care Center conducts business, and these guidelines should be sent to every governor of every state for every skilled nursing facility in the country.

I would add one guideline that I haven’t seen anywhere. As the weather warms, it is time to bring our nursing home residents out of doors and allow them to see their families in the flesh while observing very careful rules of social distancing. It is those moments that make life most worth living, for Ida Zelcer and her wonderful son, and for us.

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