Nursing home cases said to soar
Researchers find virus surging despite federal efforts
WASHINGTON — Despite the Trump administration’s efforts to erect a protective shield around nursing homes, coronavirus cases are surging within facilities in states hit hard by the latest wave of covid-19 cases.
An analysis of federal data from 20 states for The Associated Press found that new weekly cases among residents rose nearly fourfold from the end of May to late October, from 1,083 to 4,274. Deaths among residents more than doubled, from 318 a week to 699, according to the study by University of Chicago health researchers Rebecca Gorges and Tamara Konetzka.
The findings came as confirmed cases worldwide surpassed 50 million on Sunday, with the U.S. accounting for the biggest number — 9.9 million — followed by India, Brazil, Russia and France,
according to data compiled by Johns Hopkins University. More than 1.2 million people have died of causes related to covid-19.
Analysis also found that weekly cases among nursing home staff members more than quadrupled in states where the virus is surging, from 855 the week ending May 31 to 4,050 in the week ending Oct. 25. That rings alarms because infected staffers not yet showing symptoms are seen as the most likely way the virus gets into facilities. When those staffers test positive, they are also sidelined from caring for residents, raising pressure on the remaining staff.
The administration has allocated $5 billion to nursing homes, shipped nearly 14,000 fast-test machines with a goal of supplying every facility, and tried to shore up stocks of protective equipment. But researchers said the data calls into question the broader White House game plan, one that pushes states to reopen while maintaining that vulnerable people can be cocooned, even if the virus rebounds around them.
“Trying to protect nursing home residents without controlling community spread is a losing battle,” said Konetzka, a nationally recognized expert on long-term care. “Someone has to care for vulnerable nursing home residents, and those caregivers move in and out of the nursing home daily, providing an easy pathway for the virus to enter.”
The nation is setting records for coronavirus cases heading into the cold weather season, when many experts expect the virus will be harder to contain. The seven-day rolling average for daily new cases stood at nearly 104,000 on Saturday, according to data from Johns Hopkins.
Nursing homes and other long-term care facilities account for about 1% of the U.S. population but represent 40% of covid-19 deaths, according to the COVID Tracking Project.
In Fort Dodge, a manufacturing and transportation center in north-central Iowa, Julie Thorson said she knew she was in for a bad week when several employees at the Friendship Haven nursing home tested positive last Monday. As president of the senior living community, Thorson contacted the county health department. “They were basically not surprised because they’re seeing it all over the county,” she said.
Residents also started testing positive. The facility had 11 new cases among residents as of Friday.
“I was thinking all night what’s worse, to have it hit and not know what you are getting into, or to prepare, prepare, and prepare, and then have it hit,” she said.
FEDERAL RESPONSE
Responding to the study findings, the federal Centers for Medicare and Medicaid Services issued a statement saying that “the bottom line is that the covid-19 pandemic’s effect on nursing homes is complex and multifactorial.”
The agency noted different ways the administration has worked to help nursing homes and said its focus now is on ensuring that residents and staffs would “immediately” have access to a vaccine once approved. But it also added that facilities “bear the primary responsibility for keeping their residents safe.”
“Many times, the likely causes of nursing home outbreaks are simply nursing homes failing to comply with basic infection control rules,” the statement said.
But Konetzka said her research has shown that nursing home quality has no significant effect on cases and deaths once community spread is factored in. “It’s not like the high-quality facilities have figured out how to do things better,” she said. Other academic experts have reached similar conclusions.
Highly rated by Medicare, St. Paul Elder Services in Kaukauna, Wis., has had 72 covid-19 cases among residents and 74 among staffers, according to its Facebook page. The first case among residents was Aug. 19, and 15 people have died, said the facility’s president, Sondra Norder.
“The outcomes are really not much different here than they were in New York back earlier in the pandemic,” Norder said. “It’s been called the perfect killing machine of the elderly, especially those who live in congregate settings.” Kaukauna is a small city about 100 miles north of Milwaukee.
The study, based on data reported by nursing homes to the government, also raised other concerns:
■ For the week ending Oct. 25, about 1 in 6 nursing homes in states where the virus is surging did not report having tested staffers the prior week. Government requirements call for staff testing at least weekly in areas where the virus is spreading.
■ During the same period, nearly 1 in 5 nursing homes reported shortages of basic protective supplies such as masks and gowns.
■ Nearly 1 in 4 facilities reported a nurse staffing shortage.
The 20 states analyzed in the study were Alaska, Arkansas, Iowa, Idaho, Indiana, Kansas, Kentucky, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Dakota, Utah, Wisconsin, West Virginia and Wyoming. They were selected because they’re now seeing their highest hospitalization rates for covid-19.
N.Y. CASES
New York reported 3,428 cases Sunday, the third consecutive day with more than 3,000 infections and the highest levels since early May. Cases in New York, the early epicenter of the U.S. outbreak, have been rising steadily since late September, as the state identified hot spots in Brooklyn and Queens in New York City and in counties upstate.
New York Gov. Andrew Cuomo said in a statement that the positive test rate in the current hot spots is 3.7% compared with 2.2% for the rest of the state.
“We’re coming up to the worst two months, I think, that we may have seen visa-vis covid,” Cuomo said on ABC’s “This Week.” “You see the numbers going crazy all across this country, all across the globe … and you’re seeing it in the fall with the cold coming back, and we’re going to have a long two months.”
U.S. deaths remained at more than 1,000 for a fifth day, a streak last seen in August, according to data compiled by Johns Hopkins.
GERMAN PROTEST
German officials on Sunday condemned the actions of 20,000 people who demonstrated against coronavirus restrictions by jamming together in a Leipzig city square largely without wearing masks. The officials called for an investigation into how the protest was able to get out of control.
The eastern city had tried to move Saturday’s demonstration to a larger location after calculating only 5,000 people could gather in the Augustusplatz area and maintain a safe distance from one another. A court at the last minute overturned the city’s order, however, and the demonstration went ahead.
After it ballooned to more than 20,000 people and authorities determined that coronavirus regulations mandating mask-wearing and social-distancing weren’t being followed, the crowd was told to disperse. But thousands lingered, some scuffling with reporters and throwing projectiles and fireworks at police.
“What we saw yesterday in Leipzig cannot be justified,” said Justice Minister Christine Lambrecht. “The freedom to demonstrate is not a freedom to use violence or put others at massive risk.”
She “strongly condemned” the attacks on police and the press.
“The mockery of science and right-wing hate speech that we have seen are abhorrent,” she said.
She called for an investigation into how the situation was able to escalate, a sentiment echoed by many, including opposition parties.
In other virus news:
■ Iowa reported 2,964 infections Sunday as cases have escalated in recent weeks, reaching a total of 152,802. After taking seven months to reach 100,000 cases, the state has added more than 50,000 in the past four weeks and broke two records for infections last week. More than 900 people are hospitalized for covid-19, the most of the outbreak by far.
■ Florida’s infections continued a second ascent, as the state reported 6,820 cases Sunday. That is the most since August, when the Sun Belt was recovering from a deadly surge. But it’s far lower than July’s peak of roughly 15,000 daily cases.
■ Oklahoma added 4,507 new cases on Saturday, more than double the previous daily record, even after a downward revision for duplicate reports, Health Commissioner Lance Frye said in a statement Sunday. The previous record, set Thursday, was 2,101.
■ India reported 45,674 new coronavirus infections over the previous 24 hours, as the capital copes with a sharp surge of nearly 7,000 cases a day last week. India’s tally of confirmed cases — currently the second-largest in the world behind the United States — has exceeded 8.5 million. The Health Ministry on Sunday reported 559 deaths in the previous 24 hours, taking total fatalities to 126,121.