Nursing homes see steep decline in covid-19 cases
Doctors credit vaccinations for significant turnaround
Nursing homes have been hit hard throughout the pandemic. The coronavirus has raced through some 31,000 long-term-care facilities in the United States, killing more than 163,000 residents and employees and accounting for more than one-third of all virus deaths since the late spring.
But for the first time since the U.S. outbreak began roughly a year ago — at a nursing care center in Kirkland, Wash. — the threat inside nursing homes may have finally reached a turning point.
Since the arrival of vaccines, which were prioritized to long-term-care facilities starting in late December, new cases and deaths in nursing homes, a large subset of long-term-care facilities, have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data. The turnaround is an encouraging sign for vaccine effectiveness and offers an early glimpse at what may be in store for the rest of the country as more and more people get vaccinated.
From late December to early February, new cases among nursing home residents fell by more than 80%, nearly double the rate of improvement in the general population. The trend-line for deaths was even more striking: Even as fatalities spiked overall this winter, deaths inside the facilities have fallen, decreasing by more than 65%.
“I’m almost at a loss for words at how amazing it is and how exciting,” said Dr. David Gifford, chief medical officer for the American Health Care Association, which represents thousands of long-term-care facilities across the country.
“If we are seeing a robust response with this vaccine with the elderly with a highly contagious disease,” he said, “I think that’s a great sign for the rest of the population.”
Experts attribute the improvements in large part to the distribution of vaccines. About 4.5 million residents and employees in long-termcare facilities have received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention, including about 2.1 million who have been fully vaccinated.
Other factors, including the steep drop in new infections nationwide in recent weeks, may have contributed as well.
Today, new cases in U.S. nursing homes are at their lowest point since May, when the federal government began tracking such data.
“What is certainly surprising to me is how quickly we’re seeing this,” said Dr. Sunil Parikh, an associate professor of public health research and medicine at Yale School of Public Health in Connecticut, where weekly cases in nursing homes had dropped from several hundred around the holidays to as little as 30 statewide during one recent week.
“It’s a dramatic decline,” he said, adding that more research was needed to determine what role community transmission played and whether the first dose of vaccine may offer more protection than previously thought.
In one promising sign, the American Health Care Association, the industry group, looked at nearly 800 nursing homes that received early doses of the vaccine in December and compared caseloads with facilities in the same counties that had not yet held vaccination clinics.
“If we are seeing a robust response with this vaccine with the elderly with a highly contagious disease, I think that’s a great sign for the rest of the population.”
— Dr. David Gifford, chief medical officer for the American Health Care Association
The nursing homes that got the earlier vaccine saw a 48% decline in cases among residents, compared with 21% among nearby nursing homes.
In some nursing homes, 4 out of 5 residents or more have now been vaccinated. Some states, such as Connecticut and West Virginia, have reported finishing vaccinations at all nursing homes, but many employees and a smaller share of residents nationally have declined to get the shots.
At Valley Senior Living in Grand Forks, N.D., more than 90% of residents agreed to be vaccinated. The high rate of uptake, combined with low levels of community transmission, has meant that life is slowly inching back to normal for the 400 or so people who live in the facility’s nursing and assisted living centers.
Residents are now allowed to visit with loved ones again, one or two people at a time. They are singing in choirs, albeit masked and spaced apart. There was even a recent Mardi Gras parade, complete with beads and music. It is a marked change from much of the past year, when outbreaks there led to months of shutdown and at least 12 deaths.
“Things are better,” said Garth Rydland, chief executive at Valley Senior Living. “You kind of knock on wood every time you say something like that, but now I feel a lot more confident.”