Former New York Gov. Andrew Cuomo defends COVID-19 nursing home policies during congressional testimony

September 10, 2024

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(WASHINGTON) — Former New York Gov. Andrew Cuomo began his public testimony before Congress on Tuesday by defending his administration’s nursing home policies during the early days of the COVID-19 pandemic.

The hearing, before the Republican-led House Oversight and Accountability Select Subcommittee on the Coronavirus Pandemic, addressed Cuomo’s decision to allow COVID-19-positive patients back into nursing homes and long-term care facilities while the pandemic was underway.

Cuomo previously testified before the subcommittee during a closed-door hearing in June.

“The U.S. Centers for Disease Control and Prevention, the CDC on March 13, 2020, [Centers for Medicare & Medicaid Services] CMS issued guidance — let us trust the word ‘guidance’ — that specifically directed nursing homes to not accept COVID-19-positive patients if they were unable to do so safely and to only accept individuals if the nursing home could follow CDC transmission based guidance,” subcommittee Chairman Rep. Brad Wenstrup, R-Ohio, said in his opening statement on Tuesday.

In March 2020, as COVID-19 cases were surging, Cuomo issued an order requiring nursing homes to readmit all residents who were “medically stable” and returning after being hospitalized for the virus.

“No resident shall be denied re-admission or admission to the [nursing home] solely based on a confirmed or suspected diagnosis of COVID-19,” the order read. It further stated that nursing homes were “prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission.”

However, Cuomo responded that the CMS and CDC, under the administration under former President Donald Trump, advised that “that COVID-positive people could go from hospitals to nursing homes, even if they were still infectious. That was your ruling.”

“‘The March 25 guidance was consistent with the CMS guidance. The March 25 guidance was consistent with the CMS guidance if nursing homes have the ability to adhere to infection prevention and control recommendations.’ That’s the attorney general’s position opinion,” Cuomo said, referring to New York Attorney General Letitia James.

At the time of the directive, Cuomo explained that the order would help expand hospital capacity to meet the demands of caring for the sickest COVID-19 patients. After facing criticism from nursing home advocates, however, the governor amended the order in May 2020, prohibiting hospitals from discharging patients to nursing homes unless they first tested negative for COVID-19.

“The March 25 directive was dubbed a ‘must admit order’ by the public and press, and rightfully so,” Wenstrup said, addressing the former New York governor. “Your directive was not consistent with federal guidance, nor consistent with medical doctrine. You do not put highly contagious patients in with vulnerable patients. subject to infection, and in this case death.”

Cuomo fought back against criticism of his policies and, in July 2020, a report from the New York State Department of Health (NYSDOH) stated that COVID-19 was introduced into nursing homes by infected staff, and that peak staff infections correlated with peak nursing home resident deaths. The report also found that “admissions policies were not a significant factor in nursing home fatalities.”

However, in January 2021, New York Attorney General Letitia James released a report that found the NYSDOH had undercounted the number of nursing home residents who died of COVID-19 by as much as 50%, and failed to count in its official death tally nursing home residents who died of COVID-19 after being admitted to hospitals.

In total, more than 15,000 nursing home residents in New York died of COVID-19.

In 2022, Cuomo’s representative said the Manhattan District Attorney’s office would not file criminal charges in connection with the former governor’s handling of nursing home deaths during the pandemic.

Earlier this year, an independent investigation, commissioned by current New York Gov. Kathy Hochul, found that although Cuomo’s nursing home response policy was based on “the best available data at the time,” communication to the public was poor and caused anxiety for family members of nursing home residents.

“Even the most well-intentioned policy had unforeseen consequences in [New York state] nursing homes,” the report read.

Flu deaths in children hit new record as vaccination rates decrease: CDC

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(NEW YORK) — The number of kids dying from influenza in the 2023-2024 season has set a new record for a regular flu season, after one new death was reported last week, according to the Centers for Disease Control and Prevention (CDC).

There were 200 pediatric flu-related deaths in the 2023-2024 season, compared to the previous high of 199 during the 2019-2022 season.

About 80% of the kids that died from flu this season were not fully vaccinated against influenza, CDC data shows. Nearly half of the children had at least one pre-existing medical condition.

Everyone over the age of six months is recommended to get their annual flu vaccine before the end of October, according to the CDC.

Children up to 8 years old receiving their first flu shot should receive two doses if they previously have not, the CDC notes.

Older adults over the age of 65, who are at higher risk of severe illness including hospitalization and death, may opt for a higher dose flu shot for further protection.

“Vaccination remains our most effective tool to prevent illness and reduce the risk of serious complications in children,” said Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor.

Vaccination rates among children for flu have been declining in recent years. About 53.9% of children were vaccinated against influenza this season, about 2.2% points lower than last season and 8.5% points lower than pre-pandemic.

“The decline in flu vaccination rates among children is deeply concerning and is at least partly linked to the rise in pediatric cases we’re witnessing,” Brownstein said.

Estimates show that flu vaccination reduced the risk of flu medical visits by about two-thirds and halved the risk of hospitalization among kids, according to the CDC.

“We must address this drop in vaccinations to prevent further unnecessary and preventable loss of young lives,” Brownstein added.

The influenza virus spreads year-round, but flu activity typically picks up in the fall and winter, peaking between the months of December and February.

While the impact of flu varies from season to season, estimates from the CDC show the virus has resulted in up to 41 million illnesses, 710,000 hospitalizations and 51,000 deaths annually in the past decade, according to the CDC.

“The record number of pediatric flu deaths this season is a stark indicator of how severe influenza can be,” Brownstein said.

Overdose deaths have continued to drop, now at their lowest level in three years, data shows

In this Jan. 25, 2024, file photo, a used Narcan brand Naloxone nasal spray rests on the street after paramedics and police responded to a suspected fentanyl drug overdose in Portland, Oregon. — Patrick T. Fallon/AFP via Getty Images, FILE

(ATLANTA) — The estimated number of drug overdose deaths in the U.S. have been dropping for months and are now at their lowest levels in three years, according to data from the Centers for Disease Control and Prevention (CDC).

Deaths from overdoses dropped for the first time in five years in 2023, following a steady rise during the pandemic. However, the current number of overdose deaths still remains higher than pre-pandemic levels.

In April 2024, the latest month with data, the estimated number of deaths in the past 12 months was 101,168, according to the CDC. The last month with figures that low was in May of 2021, with 100,997 deaths.

Data from other sources, such as emergency department visits and calls to EMS, support the downward trend, according to an analysis led by Dr. Nabarun Dasgupta, a senior scientist at the Injury Prevention Research Center at the University of North Carolina at Chapel Hill. He tells ABC News that the data may point to 20,000 fewer deaths annually, or more.

While experts continue to explore possible reasons driving the decline, there are a few public health initiatives to curb drug overdoses that may be showing signs of success.

“Enhanced access to naloxone, expanded treatment programs for opioid use disorder, and increased public awareness about the dangers of synthetic opioids like fentanyl are likely playing significant roles in saving lives,” said Dr. John Brownstein, chief innovation officer at Boston Children’s Hospital and an ABC News medical contributor.

Another potential explanation for the downturn, Dasgupta says, may be related to changes in the drug supply, such as more people using xylazine, a dangerous, non-opioid animal sedative that’s often mixed with other illicit drugs, including fentanyl.

“Xylazine makes people use less fentanyl, is the bottom line,” Dasgupta told ABC News, while citing research that showed that those who overdosed and tested positive for xylazine had less severe health outcomes than those who did not have xylazine in their system. This could be due to the fact that those who used illicit substances, like fentanyl, mixed with xylazine may be using those substances less often, Dasgupta said.

“We’re seeing this pattern kind of happening that looks a lot like a change in the drug supply, more so than just explained by all the interventions in the public health space,” Dasgupta added. “It’s probably a mix of all these things at the end of the day, but something really changed in the third quarter of last year.”

Within each state, however, the decline in overdose deaths is not uniform among all people. Maryland, for example, experienced a decline in deaths among white populations, yet an increase among Black populations, Dasgupta points out.

Changes in drug overdose deaths also vary greatly by state, with some still experiencing increases in the past 12 months, CDC data shows. States with the greatest dips in overdose deaths over the past year, according to the same data, were Nebraska, North Carolina, Vermont, Ohio, and Pennsylvania, in that descending order.

While the national downward trend may continue, experts told ABC News it may not be permanent.

“We’ve seen dips that have been erased a year later. So, I’m cautious. I feel like things really haven’t cooled down yet,” Dasgupta said. “It feels like we’ve put the lid on the pot, but we’re still at a rolling boil. There’s still a lot of people dying of overdose.”

“It’s crucial that we continue to intensify our efforts to address the root causes of the opioid epidemic,” Brownstein said. “We need to continue investing in comprehensive strategies that address the complex factors driving the opioid crisis.”

Jake Goodman, MD, MBA is a psychiatry resident physician and a member of the ABC News Medical Unit.

CDC updates recommendations for bird flu testing, treatment after more infections found among dairy workers

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(WASHINGTON) — The Centers for Disease Control and Prevention (CDC) is updating its recommendations for testing, treatment and protection for workers who may be exposed to animals infected with bird flu.

The update comes after the agency found evidence of dairy workers with positive antibodies, suggesting more bird flu infections that previously reported, according to a new report released Thursday afternoon.

Serologic testing, which looks at antibodies in the blood, found that eight out of 115 workers, or 7%, who were exposed to bird flu during outbreaks among cows at dairy farms in Michigan and Colorado had evidence of recent infection.

All eight workers said their jobs included either milking cows or cleaning a milking parlor. Four workers recalled experiencing symptoms, mainly conjunctivitis, also known as pink eye. The remaining four patients said they did not experience symptoms when the cows were ill.

As a result, the CDC said it is updating its guidance addressing who should be tested for bird flu to include workers who were exposed to bird flu and do not have symptoms.

“There may be individuals infected but who do not recall having symptoms,” Dr. Nirav Shah, the CDC’s principal deputy director, told reporters during a media call Thursday morning. “That means we need to cast a wider net in terms of who is offered a test.”

Secondly, the CDC is now recommending offering oseltamivir – a prescription medication to treat influenza that’s often marketed under the name Tamiflu – to asymptomatic workers who have experienced high-risk exposure to animals infected with bird flu and who did not wear adequate personal protective equipment (PPE).

Shah said a high-risk exposure event could include a splash in the face with raw cow milk, or a culling event without PPE being worn.

He added that the Tamiflu treatment recommendation both reduces asymptomatic cases from becoming symptomatic because they are being treated, and reduces the risk of infected individuals spreading the virus to close contacts.

Lastly, the Shah said the CDC was changing its PPE guidance for workers.

Although the risk of bird flu transmission from dairy cows to humans Is low, the CDC said there have been few reports addressing how PPE is used during work activities on dairy farms.

The new CDC report said the Colorado Department of Public Health and Environment (CDPHE) and the Colorado Department of Agriculture (CDA) offered PPE to all Colorado farms before or during the bird flu outbreak in cows in 2024.

When asked if they had access to PPE before a bird flu outbreak, 88% of workers reported access to gloves, 76% reported access to eye protection such as safety glasses or goggles, 71% reported access to rubber boots or boot covers, and 69% reported access to head covers, according to the report.

“Reported use of many individual PPE items was higher among dairy workers who reported exposure to ill cows in the week before or week after the detection of [bird flu] on the farm compared with those who did not report exposure to ill cows,” according to the CDC report.

Shah said that CDC recommendations will now prioritize what PPE a farm worker should wear based on which farm tasks present the highest risk for bird flu.

“Simply put, the higher-risk activities will call for more PPE use,” Shah said. “The purpose of these actions is to keep workers safe, to limit the transmission of H5 [bird flu] to humans and reduce the possibility of the virus changing,” Shah said.

As of Thursday, there have been 46 human cases of bird flu reported in the U.S. this year, Dr. Demetre Daskalakis, the CDC’s director of the National Center for Immunization and Respiratory Diseases, said during the media call.

Of those cases, 26 were due to the outbreak in dairy cows and 20 were due to people coming into contact with infected poultry. There is one case in Missouri that had no known animal exposure.

All of the patients experienced mild conjunctivitis or mild respiratory symptoms and all have recovered, according to the CDC.