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Why People in Nursing Homes are at Greater Risk of Death from Covid-19

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      Social autopsy aims at capturing the nonclinical factors that contribute to an adverse health outcome. It examines factors such as peer influence, family and community perceptions, and socio-cultural values. Social autopsy helps families and communities to conduct a kind of self-diagnosis, which facilitates behavior change as a consequence (Mahato et al. 2018). It has successfully generated desired changes in behavior and practices to reduce maternal mortality in low-income Southeast Asian countries (Mahato et al., 2018). There is earlier evidence in academic publications that nonclinical factors play an essential role in health outcomes. For example, a 2006 article stresses the need to address non-pharmaceutical initiatives to contain the spread of the infection in case of an influenza epidemic (Hatchett, Mecher & Lipsitch, 2006).

There is also evidence that addressing nonclinical socio-cultural factors can considerably heighten the preparedness of healthcare systems in dealing with sudden outbursts of illnesses such as during the extreme heat conditions in Chicago. The lack of conducting a social autopsy, on the other hand, results in poor preparedness and causes preventable deaths (Kilnenberg, 1999). A social autopsy is an incredibly important tool in the current Covid-19 pandemic because of the way the infection spreads through contact. Social distancing has so far been identified as the only strategy that works effectively in containing the spread. Therefore, it is critical to analyze the social behavior patterns that motivate or demotivate people from adopting this strategy. This is particularly critical for the nursing home population that is at the highest risk of the infection. 

Healthcare populations are at the highest risk of getting adversely impacted by the Covid-19 pandemic as they are often elderly people with existing medical conditions that compromise their overall immunity standard (CDC, 2020). Almost one among five Covid-19 deaths have been of a nursing home resident. Nursing staff working at nursing homes have been among the last to receive protective gear, which has allowed the infection to spread rapidly among residents and caused the death of those with existing comorbidities (Shapiro, 2020). Some of the nursing homes in New York that report the highest number of deaths are among the best, with five-star quality ratings (Shapiro, 2020). It indicates that the problem lies in nonclinical factors that a social autopsy can capture best.

The alarmingly high number of black deaths from Covid-19 reflects the possibility of long-standing obstacles to quality care access due to poverty and other nonclinical factors contributing to Covid-19 mortality of residents in nursing homes (Shapiro, 2020). The CDC guidelines (CDC, 2020) also highlight that some early preparedness could have suffered because the infection may well be asymptomatic in healthy people (CDC, 2020). This implies that infected nurses and other healthcare professionals who did not have protective gear might have been carriers who unknowingly spread the infection among residents. The government failed to respond to the pandemic on time, reports say (Corley, 2020). 

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