“The emotional toll on the workforce has been immense,” said Pagano. “Every day, they face the full weight of working and caring for residents in an epidemic that doesn’t seem to have an end.” 

“Some express their grief at having lost many residents – who they had long cared for – in a short period of time,” Pagano continued. “They also experience heightened stress and fear of bringing the virus home and infecting their family members.” 

In Michigan, African Americans make up 14 per cent of the population, yet represent one-third of positive cases and 40 per cent of deaths, according to Michigan state health department.  Racial health disparities in access to healthcare and health outcomes have been exacerbated by COVID-19, which is disproportionately affecting African-Americans. 

“As the state begins reopening, in order to prevent new and severe infections, hospitalisations, and preventable deaths, decision makers need to remain vigilant,” said Pagano. “They need to commit to developing and adhering to a comprehensive COVID-19 response plan that addresses racial health disparities and supports facilities to address the problems of understaffing and increased workload, especially when personnel fall sick or have to self-isolate.”