The Atlanta Journal-Constitution
Cases, deaths plunge at senior care homes
Facility leaders credit vaccination: ‘You can’t deny the connection.’
After the coronavirus swept through A.G. Rhodes’ three nursing homes in metro Atlanta last year, residents were largely confined to their rooms. Deke Cateau, CEO of A.G. Rhodes, watched the crushing toll of isolation and loneliness.
The measures were meant to be temporary, designed to prevent the spread of a virus especially dangerous for older adults. But there appeared to be no end in sight, as the virus raged. In December, 109 residents of the three homes became infected and four died; in January, 32 residents were infected and seven died.
Then in February, a dramatic change: Among the three homes there was only one new case and no COVID-19 deaths.
New infections are plummeting at many other Georgia longterm care facilities, as hundreds of nursing homes, assisted living communities and personal care
homes reported no new cases in February. And while January was the deadliest month of the pandemic, in February deaths of long-term care residents plunged 68%. That is giving hope that the worst may be over and some of Georgia’s most vulnerable population may be able to inch back to normalcy.
Many experts point to vaccinations as the major driver of the improvements. That’s the view at A.G. Rhodes nursing homes, which in late December were among the first in the state to start receiving the vaccine.
“We are extremely optimistic the vaccination efforts are working,” said Cateau. “You can’t deny the connection.”
But other factors are also helping reduce infections. Among them, as the post-holiday surge of cases tapered out, the state as a whole saw fewer cases. That makes it less likely for workers to unknowingly bring the virus into the facilities. Case counts declined more rapidly, though, at long-term care homes than in the state overall. They’re down about 74% among Georgia long-term care residents, compared with about 59% statewide, according to state data.
Another factor is that the virus ran so rampant at senior care facilities since the start of the pandemic, that survivors of the disease likely remain protected by infection-acquired antibodies, said Ben Lopman, an epidemiology professor at Emory University.
How care facilities manage the pandemic is also vastly improved since the first major U.S. outbreak at a nursing home in Washington in February 2020 resulted in dozens of deaths, said Dr. Ted Johnson, the chair of family and preventive medicine at Emory University.
State and federal governments supplemented supplies of personal protective equipment, he said. What’s more, virtual training, like Zoom classes Johnson teaches in partnership with Georgia State University for staff at 180 care homes across the state, helped facilities improve screening, infection control and treatment plans.
Vaccine priority
Still, there were Georgia senior care facilities reporting an uptick in infections in February, state data show. Some were facilities that admit COVID-19 positive residents from hospitals, said a representative for PruittHealth, one of Georgia’s largest nursing home providers.
By and large, though, the number of new cases appears tied to when vaccinations rolled out. Data nationally show the nursing homes that received their shots first saw their cases decline first, Johnson said.
Nursing homes were the first priority for vaccine, and by Jan. 25, the first round of vaccinations was completed at the homes for
anyone who wanted to be inoculated. Vaccines rolled out later to assisted living and personal care homes, with some still awaiting first shots in February.
Over time, as more residents get the booster shot and have more time to build up immunity, many expect the trend line will only get better.
“We are seeing vaccinations pay off huge and doing exactly what we had hoped,” said Ginny Helms, president and CEO of LeadingAge Georgia, which represents nonprofit and mission-driven senior care organizations. “This will give residents their lives back.”
Concerns still loom
The sudden drop in cases in Georgia is mirroring a national trend of sharp declines in cases. The American Health Care Association and National Center for Assisted Living, representing more than 14,000 nursing homes and long term care facilities across the country, just released a report showing new COVID-19 cases at nursing homes declined by 82 percent since late December.
Yet challenges remain to make sure the COVID-19 picture continues improving.
Lopman said a concerted effort is needed to persuade workers at long-term care facilities to get the shots.
While an estimated 80% of residents at long-term care homes in Georgia have gotten the COVID-19 vaccine, only around 40% of staff have been vaccinated, according to Tony Marshall, president and CEO of The Georgia Health Care Association and Georgia Center for Assisted Living.
At some facilities, the staff rate is even lower, he said.
Industry leaders have set an ambitious goal of getting 75% of staff vaccinated by June 30, Marshall said. Providers are holding more informational sessions about the vaccine, and offering other perks like more PTO days for those getting vaccinated.
Even if that effort is successful, long-term care facilities will have to remain vigilant because of how vulnerable their residents are. The populations inside them also are transient. New residents move in often, and staff turnover can be frequent.
Now that the national pharmacy vaccination clinics are winding down, it will be up to care homes to either have their staff administer the vaccine or to find providers who can return often to vaccinate new residents, much as they do now with flu vaccines.
“That’s going to be a tricky thing to do,” said Amber Schmidtke, a public health researcher and former Mercer University professor who tracks Georgia’s epidemic on her widely read blog.
Another concern is that the number of new cases overall in Georgia has leveled off since mid-February, with the seven-day rolling average of new confirmed and suspected cases remaining at about 3,000 per day.
Nationwide, cases have started to increase in some states and the rolling average has flattened nationally, amid warnings from The Centers for Disease Control and Prevention that new, more infectious strains of the coronavirus are taking over.
It’s likely new booster shots will have to be developed to adjust as the virus replicates and alters its own defenses, experts say.
Haunted by the harsh toll of the pandemic, Georgia long-term care facilities acknowledge that it’s too soon for anyone to let down their guard. But administrators say that in light of the significant declines in cases and deaths, they will move ever so cautiously to ease restrictions, to allow some visitation and more communal activities, such as group exercise programs and cooking classes.
“I wouldn’t go as far as saying the nightmare is over, but I feel a lot better and I feel a lot of relief,” said Cateau, of A.G. Rhodes. “But we cannot take our foot off the pedal when it comes to vaccination and safety measures — social distancing, mask-wearing, and infection-control measures. We want this trend to continue and not only for a short period.”
Gwen Hardy, chief operating officer of Presbyterian Homes of Georgia, which includes six senior living communities including independent apartment living, said isolation has been as much of a challenge for senior facilities as the virus.
“As it relates to visitation, our cognitively impaired residents do not understand why their family is not visiting them, and this brings further confusion. And for those who are alert and oriented, they have a sadness about them, and even though the staff does everything they can to fill the gaps, there is still a void when family cannot be present . ... It has been heartbreaking for our staff and heartbreaking for our residents during this time of isolation.”
‘Weight has been lifted’
Meanwhile, Albert Maslia, a resident of The William Breman Jewish Home, said, for him, getting the COVID-19 vaccine, “means freedom.” The 90-year-old hasn’t left the building since moving in last
August. His wife, Isabelle, lives in the same campus at an independent living community, separated by a breezeway. It’s been a long, difficult eight months.
He frequently connects with his wife and children by phone or by tablet, especially for Friday night Shabbat meals, which include challah, a traditional Jewish bread, and wine, both blessed before the meal begins.
“We do conference calls, but it’s not the same. I can’t smell anything. I can’t see the lines in their faces. Let’s just say it’s not as warm. It’s about to drive me crazy.”
But on a recent phone call, Maslia said he is hopeful about soon seeing his family — face-to-face.
“It’s what keeps me going,” he said.
Harley Tabak, president and CEO of Jewish HomeLife, which includes The William Breman Jewish Home, shares Maslia’s optimism.
“We feel like we are in a new day,” said Tabak. “As far as having the vaccine, a real weight has been lifted, and we haven’t felt this way in more than a year.”
The current number of active COVID-19 cases at The William Breman Jewish Home: zero.
Bernard Lafayette Jr. was a young activist emerging from the 1961 sit-ins and Freedom Rides that fought for Black civil rights and an end to racial segregation when he received his next assignment.
It was one that would help change the course of American history.
“I looked on the blackboard and they had an ‘X’ through Selma,” Lafayette, now 80, recalled in an interview with The Associated Press, referring to the Alabama city that would become emblematic of the fight to secure Black voting rights and the 1965 marches that were a turning point in that struggle.
The Student Nonviolent Coordinating Committee, the youth civil rights arm, had sent two teams to scout out the city.
“Both teams came back and said, ‘No, we’re not going to Selma,’” Lafayette said. “And they gave the same reason: ‘The white folks were too mean and the Black folks were too scared.’”
“But I was determined,” said Lafayette, who at 22 was painfully aware of the risk after being badly beaten by a white mob in Montgomery, Alabama, while taking part in Freedom Ride protests there against segregated bus terminals.
“I’ll go to Selma,” he recalled saying — words that would place him in the middle of the movement to register Black voters and eventually the 1965 Selma marches.
Today marks the 56th anniversary of those marches and “Bloody Sunday,” when more than 500 demonstrators gathered on March 7, 1965, to demand the right to vote and cross Selma’s Edmund Pettus Bridge. They were met by dozens of state troopers and many were severely beaten.
The attack, broadcast on
national television, captured the attention of millions and became a symbol of the brutal racism Black Americans endured across the South. Two weeks later, the Rev. Martin Luther King Jr. and thousands of civil rights protesters marched the 49 miles from Selma to the state capital, Montgomery — an event that prompted Congress to eventually pass the Voting Rights Act of 1965.
Changes to jubilee this year
This year’s Selma Bridge Crossing Jubilee will be the first without the towering presence of four civil rights icons — U.S. Rep. John Lewis, the Rev. Joseph Lowery, the Rev. C.T. Vivian and attorney Bruce Boynton — who all died in 2020.
It also will be largely virtual because of the coronavirus pandemic, and comes at a time when the nation is still reckoning with
the convergence of three crises that have disparately impacted Black Americans: the pandemic, its ensuing economic fallout and the racial injustice movement.
Organizers, activists and civil rights leaders say this year’s event will honor the memory of civil rights legends and marchers and serve as a rallying cry and reminder that the fight for racial equity must continue.
This year’s theme, “Beyond the Bridge: People Power, Political Power, Economic Power,” also will provide live workshops and training to help the next generation of organizers, said Drew Glover, the jubilee’s principal coordinator.
It will feature performances and events honoring civil rights legends and also the “foot soldiers,” whose names are lesser known. It will culminate in a virtual bridge crossing featuring local and national leaders.
“The issues that we’re dealing with today, with voter suppression, white supremacy, intimidation, the Capitol insurrection — these are all issues that our ancestors have been organizing for, for generations,” Glover said.
John Lewis Voting Rights Advancement Act
House Majority Whip Jim Clyburn, a member of the jubilee’s honorary committee, believes one way to honor that struggle is to enact the John Lewis Voting Rights Advancement Act, to strengthen protections granted under the Voting Rights Act of 1965 and protect against racial discrimination and voter suppression.
Separately, the House of Representatives is poised to vote on sweeping voting and ethics legislation, House Resolution 1, that if enacted would usher in the biggest overhaul of U.S. elections law in a generation.
It would touch virtually every aspect of the electoral process — striking down hurdles to voting erected in the name of election security, curbing partisan gerrymandering and curtailing the influence of big money in politics.
Acting on former President Donald Trump’s repeated false claims of a stolen election, dozens of Republican-controlled state legislatures are pushing bills that would make it more difficult to vote.
Democrats and activists argue this would disproportionately impact voters of color and low-income voters.
“If we do believe in what John Lewis stood for, of what Joe Lowery or C.T. Vivian fought for, then if that’s what we believe, then we will restore the efficacy of their efforts,” Clyburn said.
‘Symbolic moment in time’
The Selma commemoration is also a way for other people of color and allies to support the civil rights movement. Dolores Huerta, a co-founder of the United Farm Workers with Cesar Chavez, is a slated speaker.
“This is not a once-in-a-while type of work that we have to do; our commitment to social and racial justice has to be one of a lifetime,” the 90-year-old Huerta said.
“The Pettus Bridge is a very symbolic moment in time and history and shows us that we have to continue to march and not give up — even when we’re beaten or knocked down.”