U.S. nursing homes have remained mostly locked down since COVID-19 swept through earlier this year, and it may be a while before that changes.
Nursing homes house a tiny share of the U.S. population, yet they have accounted for more than 20% of the country's COVID-19 deaths, according to an Associated Press estimate.
A combination of older, vulnerable residents and a virus that spreads through people who don't show symptoms has helped fuel this, especially in the pandemic's early stages.
Lack of testing and protective gear for staff has also been a problem, said Mark Parkinson, CEO of the American Health Care Association, which represents most nursing homes.
The former governor of Kansas spoke recently with The Associated Press about how his industry is dealing with the crisis. The conversation has been edited for clarity and length.
Q: Would you feel safe putting a family member in a nursing home now? What questions would you ask?
A: I would absolutely feel safe ... assuming that the nursing home had the equipment and access to testing that it needs. I would ask (about) the supply of equipment. What is your plan to keep people separate so that they don't get COVID? And if you suspect there is COVID, what is your testing protocol?
Q: How will your industry regain the confidence of the American people?
A: When the American people understand the true story of what happened in nursing homes. This is an unprecedented virus. Because it spreads through asymptomatic carriers, it was inevitable that it would show up in long-term care facilities. Once we became aware that asymptomatic people were carrying the virus, we were able to adapt. As long as we got the equipment and the testing that we needed, we've been able to perform well.
Q: Has the supply of personal protective equipment improved?
A: Slightly, but unfortunately, we've seen a major step back over the last few weeks. The demand for PPE in the general population has gone up. We're not just competing with hospitals. We're competing with the entire community.
Q: When people think of nursing homes, they think of residents living in close quarters and sharing dining and recreational areas. Will any of this change to avoid future outbreaks?
A: I hope so. One of the things that we have learned from this pandemic is the importance of private rooms. In most nursing homes, residents share rooms. We need to develop a financial structure and payment system so that residents can have their own rooms.
Q: When will most nursing homes allow family members and other visitors to return?
A: I don't think visitation like we had before the pandemic will return until there's a vaccine. But some controlled visitation will occur in any community that gets COVID under control.