On Monday, Rep. Cindy Axne (IA-03) wrote to Iowa Governor Kim Reynolds to seek additional coronavirus (COVID-19) testing and data disclosure to better protect older Iowans and others living in skilled nursing, long-term care, and other assisted and congregate living facilities.
The letter requests the creation of a dedicated mobile TestIowa team that can work specifically to test seniors and other congregate living communities, increased testing for staff and residents at facilities to identify any potential outbreaks early, and expanded data on cases in long-term care facilities to include nursing homes and all other congregate settings.
“We are all aware that our seniors are at highest risk of serious illness from COVID-19. Moreover, seniors that have an underlying health issue are at yet an even higher risk for serious illness from COVID-19,” Rep. Axne wrote. “I am deeply concerned testing for Iowa’s seniors is not a priority, and current levels do not match the dire risk factors that this pandemic poses to them.”
The letter also highlights changes to the coronavirus.iowa.gov dashboard that removed details on positive cases in long-term care facilities, which on June 22nd showed 905 positive cases and 356 deaths – making the mortality rate in Iowa’s long-term care facilities 17 times higher than Iowa as a whole.
“Data that was previously available…and reported in statewide media showed that the state had confirmed at least 905 positive cases within long-term care facilities,” Rep. Axne wrote. “Data on the cumulative total of positive cases in long-term care facilities was moved or removed from the online dashboard.”
According to the Centers for Disease Control and Prevention (CDC), nursing home populations are at the highest risk for COVID-19 because of the older age of residents, insular group settings, and greater number of preexisting health conditions – and data provided by the Iowa Department of Public Health (IDPH) supports that finding.
IDPH data confirms that Iowans over the age of 61 account for 87% of Iowa’s COVID-19 related deaths, but Rep. Axne raises concerns in her letter that no public data is available to see how many tests have been conducted for those who are in that high-risk age group.
In May, Rep. Axne wrote to Governor Reynolds with Reps. Finkenauer and Loebsack to request additional TestIowa sites and seek additional information on the testing capacity of the program.
Rep. Axne’s full letter to the Governor can be found below:
Dear Governor Reynolds,
Iowans living in independent, assisted, nursing, skilled nursing, long-term, and other congregate living facilities across Iowa need improved access to COVID-19 tests. Unfortunately, the TestIowa locations are inaccessible for many of our seniors, and there has been a lack of tests provided directly to senior-living facilities.
I am writing to request that you: 1) create a mobile TestIowa option specifically for seniors and others living in congregate facilities; 2) work to increase the number of tests provided to these living facilities for residents and staff; and, 3) provide no less than weekly data reporting on all senior congregate living facilities, including reporting the number of tests for residents and staff, positive cases, and other relevant information. Additionally, data regarding testing, cases, and death rate, specifically for long term care facilities, has been moved or removed from Coronavirus.Iowa.Gov. I request that this data be restored and remain publicly accessible.
We are all aware that our seniors are at the highest risk of serious illness from COVID-19. Moreover, seniors that have an underlying health issue are at an even higher risk for serious illness from COVID-19. According to data from the Centers for Disease Control and Prevention (CDC), the majority of COVID-19 deaths have been in those over the age of 60. The CDC has also stated that, “nursing home populations are at the highest risk of being affected by COVID-19”. Those above the age of 65, living with a preexisting medical condition, and living in a group setting are the highest at-risk category for serious illness and death.
Iowa statistics bear similarities to these national numbers. The Iowa Department of Public Health (IDPH) states the “elderly and those with chronic health conditions remain the most vulnerable to serious illness from COVID-19.” Of the 752 COVID-19 deaths in Iowa, 87% have been among those aged 61 years or older. Data that was previously available on coronavirus.iowa.gov, and reported in statewide media, showed that the state had confirmed at least 905 positive cases within long-term care facilities, with 356 deaths reported on June 22nd. This means that for our Iowans in long-term care facilities, COVID-19 has a mortality rate of nearly 40% – 17 times higher than Iowa’s current mortality rate. Data on the cumulative total of positive cases in long-term care facilities was moved or removed from the online dashboard, and I was unable to find the most up-to-date number past July 7th.
Despite an abundance of evidence our seniors are most at risk, they have inadequate access to testing. As of July 9th, over 350,000 Iowans have been tested. However, no data was available on how many tests have been conducted on those who are over the age of 80 or between the ages of 61-80. I am deeply concerned testing for Iowa’s seniors is not a priority, and current levels do not match the dire risk factors that this pandemic poses to them.
That is why I am calling on you to create a mobile TestIowa strike team dedicated to our seniors and other congregate living communities struggling to access these resources. I’ve spoken to seniors from my district who have been exposed to COVID-19 through staff or other residents, but despite meeting the criteria for needing a test, the TestIowa sites are inaccessible or unavailable because of distance and travel time.
We must also be providing our senior living facilities with adequate tests for both residents and staff. Ensuring regular access to testing among our most vulnerable populations and those who care for them will help control the spread of the virus and provide peace of mind to residents, staff, and families.
Additionally, on April 19, 2020 the Centers for Medicare and Medicaid Services (CMS) released updated guidance that would require nursing homes to report cases directly to the CDC. Although Iowa reports daily data on COVID-19 cases in long-term care facilities, you have not required the daily reporting of cases in nursing homes or other congregate settings. I am requesting that you release nursing home COVID-19 data, as is already done for assisted living. This information will help better understand outbreaks of COVID-19 and the impact this pandemic is having on our most vulnerable, as well as provide seniors and their families with a better understanding of the risks of COVID-19.
While I did not receive a reply to my last letter to you regarding lack of testing sites in Iowa, I hope that future announcements to expand TestIowa to help Iowa’s seniors and other residents will be considered a top priority. Even with additional sites added over the past month, there are still 80 counties without a testing location – and I continue to hear from constituents with concerns about the distance and time required to receive the test they have been promised.
As one of Iowa’s Representatives in Congress, I am prepared to fight for any additional resources that our state and its public health officials need to prepare us for the next phase of this public health emergency. I encourage you and your team to keep us informed of what you may need from federal COVID-19 response efforts to best meet these testing and mitigation demands.
I respectfully request a reply to this letter by Friday, July 17th, as this is an urgent matter and older Iowans deserve to know what steps will be taken to protect them.
Member of Congress