Gov. Andrew Cuomo is pictured Monday morning in New York City. The governor’s mandate that nursing homes in New York state test employees twice a week is drawing concern from local health officials over supply availability and cost. AP photo

Chautauqua County health officials have expressed concern over a state mandate requiring nursing home facilities to test staff twice a week during the coronavirus pandemic.

At the heart of the issue is testing capabilities, specifically having enough supplies and resources for the 2,500 employees of local nursing and assisted living facilities. The topic was discussed during a recent meeting of the Chautauqua County Board of Health.

Christine Schuyler, county public health director, told the board that about three weeks ago, members of the state Health Department approached the county about assisting state officials with starting an initiative that would test all residents and staff in nursing facilities.

“About a week into that, before we could even get it rolling, the governor came out with his mandate of twice-weekly testing of all staff,” said Schuyler, noting that the state changed its initiative focus from staff and residents to just residents.

As of last week, no resident at a nursing home in the county had tested positive for COVID-19. An employee at a Westfield nursing home did come down with the virus; however, tests to remaining staff and employees have come back negative.

A patient is pictured being wheeled into a Brooklyn hospital in April.

Schuyler said one local facility has committed to testing residents on two of its three units.

“That will be our first resident testing as far as really going into a facility and doing some mass testing,” Schuyler said.

“The nursing homes and facilities in our county have done a really good job with infection control and maintaining protecting the staff within their facilities,” she continued. “The residents have been locked down for so long now that really the way in for the virus is through the staff. So it is important to monitor the staff.”

Gov. Andrew Cuomo issued an executive order in early May requiring all nursing homes in New York state to test staff twice a week for COVID-19. Cuomo said the mandate is to curb the spread of the virus in facilities where residents are most vulnerable.

The governor has come under fire for his handling of nursing homes and its residents during the pandemic.

Members of the county Board of Health discussed the difficulties of helping area nursing home administrators meet the mandate. That includes having the facilities secure enough tests, having those tests come back in a timely manner and what impact there might be of twice-a-week testing on employees.

“I think most everyone in health care, including public health, are very concerned with the governor’s requirement for twice-weekly testing,” Schuyler said. “We don’t have the testing supplies available for twice-a-week testing. There’s about 2,500 employees of long-term care facilities in our county, so that would 5,000 testing supplies for them alone. Not to mention the preferred way to get a specimen is the nasopharyngeal swab, which is not very pleasant, and I just can’t help but think that that could not cause some damage twice a week over a long period of time.”

Schuyler said one nursing home has been performing oral swab testing on staff. The state Health Department has said oral testing is acceptable, though not recommended.

“But right now it is acceptable, so we will see how that goes,” Schuyler said. “It’s been a real challenger.”

The public health director was asked if she expected any changes to Cuomo’s executive order in response to possible concerns outlined by health departments across the state. Schuyler said the particular executive order expires June 9.

“So at that time he could have the option to change the executive order to something that’s a little more rational,” she said. “We will see where that goes.”

The board was asked what impact the mandate might have on getting test results in a timely manner. Dr. Robert Berke, county physician, said the twice-weekly testing will “overrun the system. They can’t even manage the number of tests that are coming in down stream now with the pre-ops. It’s really been, along with everything else with this process at every level, this one at our level is not exactly being well thought out.”

“I feel that if this were to continue, the governor is on track to collapse the long-term care system in New York state,” Schuyler added. “I am very hopeful that he is consulting with public heath and health care experts.”