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Nursing homes have been caught in the crosshairs of the coronavirus pandemic. As of early May 2020, Covid-19 had claimed the lives of more than 28,000 nursing home residents and staff in the United States. But U.S. nursing homes were unstable even before Covid-19 hit. They were like tinderboxes, ready to go up in flames with just a spark. The tragedy unfolding in nursing homes is the result of decades of neglect of long-term care policy. Since the U.S. coronavirus outbreak began in a nursing home in Kirkland, Washington, more than 153,000 residents and employees of 7700 U.S. nursing homes have contracted Covid-19, accounting for 35% of the country’s deaths. Here, as in many other countries, nursing homes have been ill equipped to stop the spread of the virus. They lacked the resources necessary to contain the outbreak, including tests and personal protective equipment, and their staff are routinely underpaid and undertrained. Furthermore, nursing homes were sitting ducks for Covid-19, housing people who are particularly vulnerable to poor outcomes of the virus, often in shared living quarters and communal spaces, making social distancing or isolation difficult, if not impossible. (Rachel M. Werner, Allison K. Hoffman, and Norma B. Coe, 5/27)

An assistant director at a Chicago nursing home and long-term care facility alleges in a whistleblower lawsuit that she was fired in retaliation for "objecting to, reporting and refusing directives to participate in unsafe and unlawful conduct in violation of her professional nursing obligations" in relation to COVID-19 care and precautions. The complaint comes at a time when nursing homes and long-term care facilities nationwide are seeing outbreaks of COVID-19 cases and climbing death tolls. In Illinois, 47% of the state's 5,083 COVID-19-related deaths have been in long-term care facilities, according to the Illinois Department of Public Health. (Ginger Christ, 5/27)

From testing to PPEs to data disclosure, Arizona’s response to the COVID-19 impact on long-term care residents has been frustratingly underwhelming. At what point will it turn around?Two weeks ago, Gov. Doug Ducey and his administration pledged, finally, to test all residents and staff in the state’s 147 nursing homes for the novel coronavirus and to secure personal protective equipment for the facilities. (Abe Kwok, 5/27)

Autumn Road Family Practice is a small, six-doctor primary care practice that’s been caring for people in Little Rock, Ark., for more than half a century. On a Thursday in mid-March, the entire staff met to update the practice’s response to the coronavirus outbreak, since the first case had just been identified in Little Rock. The floor dropped out quickly... Covid-19 is pushing our entire health care system to the brink, from large hospitals in big cities with overwhelmed ICUs to small primary care practices in rural communities. (Andy Slavitt and Farzad Mostashari, 5/28)

Every nurse encounters mental illness in the course of a working day, even those who don't work in psychiatric or mental wellness settings. In the coronavirus pandemic, mental health issues are even more prevalent, both in medical staff, the patient pool, and the general public. (Rose Kennedy, 5/26)

Even before the COVID-19 pandemic, the prior authorization process had become the bane of doctors and patients. Physicians say that health insurers' authorization requirements, which can delay the use of drugs and treatments by days or weeks, are not just a small irritant. They can subject patients to serious harm. They can even be life-threatening. (Vincent J. Rogusky, 5/27)

I wrote a draft of my father's obituary on the evening of March 30th. He had been on a ventilator for 11 days. The attending physician at the intensive care unit had called that morning and asked whether they should include a Do Not Resuscitate order in my dad's chart. They had asked before. I had been indecisive. A successful resuscitation would extend his life. But it might also lead to brain damage. Now multiple organ systems were failing. They needed an answer. (Louis Foglia, 5/27)

My brother, sister and I wouldn’t even answer the phone when our parents would call us. Years of damage from our father’s violence, years of disappointment at our mother’s acquiescence, years of their tag-team invalidation of our hurt had left us estranged from them but inseparable as siblings. But when my brother texted me and our sister that Mom was going to start coronavirus duty at the hospital where she works, the two fragments of our family snapped together in the face of this threat. (Caroline Shin, 5/28)

The emergence of COVID-19 suggests that global warming may present an even graver threat to human welfare than many recognize. As indicated in the scientific literature, not only could the current warming of our planet increase the likelihood of an air-borne pandemic such as COVID-19; it could also damage our health and welfare. (Richard Richels, Henry Jacoby, Gary Yohe and Ben Santer, 5/27)