Karl Marx once said that history repeats itself, “first as tragedy then as farce.”
Marx was wrong about many things, but he understood the dark irony of history. One need only look to Connecticut to see what he meant, where lawmakers are reviving one of the most controversial policies of the pandemic (sort of).
“Nursing homes are being asked to accept COVID-positive admissions from hospitals, according to a new guidance from the Department of Public Health, even as positivity rates within nursing homes are increasing sharply,” the Hartford Courant reported Thursday. “The latest guidance from the DPH is an indication that the state is trying to alleviate the growing crush of COVID-19 cases in hospitals as they near record numbers of patients.”
The guidance, the Courant noted, places even more pressure on eldercare homes, already struggling because of staffing shortages and testing limitations. But this seemed of little concern to public health officials.
In a two-page memo, Public Health Commissioner Dr. Manisha Juthani wrote that “hospitalized patients should be discharged from acute care whenever clinically indicated” and nursing homes should admit them regardless of their COVID-19 status.
“Discharge should not be held due to a pending SARS-CoV-2 test, as receiving PAC (post-acute care) providers should now have quarantine policies in place based on COVID-19 vaccination status,” Juthani wrote. “PAC providers should be equipped to safely care for individuals with active COVID-19 who are ready for discharge from acute care.”
If Connecticut’s policy sounds familiar, it should. It bears striking resemblance to former New York Gov. Andrew Cuomo’s policy that forced nursing homes to admit recently discharged COVID-19 patients even if they were still COVID positive.
Cuomo’s policy at the time raised eyebrows from medical experts, who warned it could put elderly populations at risk.
“Nursing homes are working so hard to keep the virus out, and now we’re going to be introducing new COVID-positive patients?” David Grabowski, a professor of health policy at Harvard Medical School, told NBC at the time.
Cuomo, however, brushed off these concerns.
“They don’t have the right to object,” Cuomo told a reporter in the spring of 2020, who asked about nursing home administrators concerned about the policy. “That is the rule, and that is the regulation, and they have to comply with it.”
Cuomo eventually reversed his policy, but it still ended up costing hundreds or even thousands of lives. Cuomo’s attempt to conceal these deaths, along with accusations of sexual misconduct, eventually led to his political downfall.
A Crucial Difference in Connecticut’s Policy?
Even with the presence of vaccines, why anyone would want to copy Cuomo’s disastrous policy is anyone’s guess. But there seems to be a small but crucial difference with the policy in Connecticut.
Health care administrators say they interpret the order to mean they are being asked—not forced—to admit patients released from hospitals with COVID.
“Our initial reading based on the memo released today is that nothing in the memo undermines the nursing home’s appropriate authority to refuse an admission due to their ability to meet the care needs of the resident because of staffing shortages, and COVID status may be a factor in that assessment,” Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, told the Courier.
Max Reiss, a spokesman for Connecticut Gov. Ned Lamont, told the newspaper that if a nursing facility chooses to refuse a COVID-positive person, it would be incumbent on the hospital to find another place for that person.
Asking nursing homes to do something and forcing them to do something is different for obvious reasons. Yet some medical experts say the policy of placing COVID-positive people in nursing homes is dangerous nevertheless.
“For two years, calls for better focused protection of the old have been ignored,” Harvard Medical School professor Martin Kulldorff tweeted. “That's why governors, like @GovNedLamont , can still get away with policies that lead to unnecessary deaths among the old.”
For two years, calls for better focused protection of the old have been ignored. That's why governors, like @GovNedLamont, can still get away with policies that lead to unnecessary deaths among the old. https://t.co/LKtzID6kGx— Martin Kulldorff (@MartinKulldorff) January 9, 2022
The Fatal Conceit
There’s a tendency for humans to believe that if we only put the wisest people in charge, they will solve the world’s problems. Climate change. World hunger. Global pandemics.
COVID-19 has served as a tragic but vital reminder of how false this idea is. Throughout the pandemic, decision-making was removed from individuals and placed in the hands of politicians and bureaucrats, who decided for Americans—oftentimes on penalty of jail— what their actions should be.
The result has been mass confusion, panic, economic ruin, and unintended consequences that have resulted in an untold number of lives lost. Meanwhile, despite unprecedented coercion, the virus continues to spread at record levels.
The results of this mad experiment likely would not have surprised the Nobel Prize-winning economist F.A. Hayek, who understood modern man’s fixation on perfecting society through control. In his Nobel Prize-winning speech, Hayek said this “fatal striving to control society” stood to make man “a tyrant over his fellows” and “the destroyer of a civilization” if it was not tempered by humility.
Humans are in the process of receiving this lesson in humility. It’s bitter medicine, but it has the power to heal. If we take it, we might be lucky enough to avoid repeating history as a farce.