A shot in the arm for nursing homes
COVID cases fall 89% as residents get vaccinated
New federal data offers a glimmer of hope in what has been the darkest and deadliest corner of the pandemic.
The number of COVID-19 cases and deaths at America’s nursing homes have dropped significantly since December as millions of vaccine doses have been shot into the arms of residents and staff.
The weekly rate of COVID-19 cases at nursing homes plummeted 89% from early December through the second week of February. By comparison, the nationwide case rate dropped 58% and remains higher than figures reported before late October.
Nursing home cases are at the lowest level since the Centers for Medicare and Medicaid Services in May began requiring the nation’s more than 15,500 facilities to report cases each week. In fact, the 3,505 new cases reported the second week of February is nearly half as many recorded the week before and just one-tenth as many counted in one December week, the highest of the pandemic.
More than 170,000 Americans have died at nursing homes and other longterm care and assisted living facilities, according to state data compiled by The COVID Tracking Project.
The dramatic drop in cases at nursing homes, where nearly 130,000 residents and staff have died since the virus emerged in the United States, raises optimism for brighter days ahead at nursing homes and in communities overall as more Americans are vaccinated, experts say.
A USA TODAY analysis of federal data shows new cases are decreasing within homes at a much faster pace than communities where the homes are located.
Even as the virus slows nationwide, nursing home cases have dropped at a faster pace than COVID-19 infections overall in about 1,700 of the roughly 2,100 counties with available data.
In 36 counties with more than 150,000 residents, an even more dramatic trend developed: Nursing home
cases plummeted even as infection rates increased in the broader community. In Harris County, Texas, COVID-19 cases were 38% higher in the last three weeks than during three weeks of the December peak. Nursing home cases, meanwhile, fell by 31%.
Along with nurses, doctors and other frontline health workers, residents and staff of nursing homes were the first Americans to get vaccinated. As of Thursday, 4.5 million residents and staff received at least one dose and 2.2 million received both doses, according to the Centers for Disease Control and Prevention.
Early data from the federal government provides compelling evidence the vaccine has likely helped keep residents and staff safe, said Dr. June Mckoy, a Northwestern University associate professor of medicine, preventive medicine and medical education.
“Only one thing has been introduced that could have caused this dramatic shift in the number of cases per day,” Mckoy said. “It’s the vaccine.”
An analysis of preliminary data collected by the American Health Care Association found new cases dropped at a
faster rate when nursing homes vaccinated residents and staff. The analysis compared 797 homes that had vaccinated residents and staff in late December to more than 1,700 homes in the same county that had not yet vaccinated.
Three weeks after the first vaccine clinic, vaccinated nursing homes had a 48% drop in new cases among residents, compared to a 21% drop among nonvaccinated nursing homes. Case rates among staff, who have been hesitant to accept the vaccine, also dropped at homes with vaccine clinics, albeit at a slower rate than among residents.
David Gifford, chief medical officer of the American Health Care Association, said the new data shows the vaccine is protecting nursing home residents and staff, and perhaps represents the “light at the end of the tunnel.”
But he cautioned more research is needed to determine how much the drop in cases is attributable to vaccine.
“It’s a little tricky because the cases and deaths are going down everywhere,” Gifford said. “The question is, are they going down because of the vaccine, or are they going down because we’re on the backside of the outbreak . ...
It’s a combination of both.”
Another factor: Residents and staff who’ve been previously infected have developed some natural immunity to the virus. When combined with a high percentage of patients getting vaccinated and workers less likely to get the virus in their communities, nursing homes are likely benefiting from “localized, institutional herd immunity,” said Dr. William Schaffner, a Vanderbilt University School of Medicine professor of preventive medicine.
States that aggressively rolled out vaccines to nursing homes have reported large drops in new cases.
Connecticut, hit hard with outbreaks last spring and again in December, was among the first states to vaccinate residents. The state has completed three rounds of vaccination clinics at nursing homes and assisted living centers since the winter holidays.
Statewide, nursing home resident cases have dropped 91% since early December almost twice as fast as the state at large. In New Haven County, nursing home cases dropped 94% and community cases fell 58% over the past two months.
David Hunter is president and CEO of the Mary Wade Home in New Haven, which includes 94 nursing home and 54 assisted living units. Only one resident has refused to be vaccinated.
Like other homes last spring, Mary Wade was overwhelmed when COVID hit with dozens of cases and 17 deaths. But since the summer, it had only five resident cases in its nursing home units and nine cases among staff, according to federal data. All the cases occurred in December or January.
Still, Hunter said the vaccine “has to be a factor” in reducing COVID, along with efforts such as distancing, separating residents from those who are exposed to the virus and adequate supplies of personal protective equipment.
Mag Morelli, president of Leadingage Connecticut, which represents 40 nonprofit nursing homes, said the aggressive vaccine rollout, fewer community cases and nursing homes’ infection-control efforts have resulted in a “significant drop” in cases.
“We are really pleased with the results,” Morelli said. “We are hopeful that it will keep moving forward.”
National calls abound for unity and reconciliation after the country’s political divisions of recent years. But this requires some basic ground rules about what shouldn’t be tolerated.
Case in point: the nasty, often-violent protests around pipelines and energy infrastructure projects. Too often, extremists have trespassed, sabotaged facilities, bullied innocent bystanders and placed the public and the environment at risk in the name of an immediate shift to renewables.
In Ohio, take the protesters who recklessly entered a fenced-off construction area and began shoveling dirt back into a trench that had been dug for a pipeline, or the group that locked themselves in a van in Columbus and stopped in an intersection to protest the Dakota Access Pipeline.
Pipeline project delays and cancellations have huge impacts on local and state economies, jobs and energy supplies; create higher energy costs for families and businesses; and harm the environment.
How about we stop treating the permitting process like a zero-sum game — pitting our energy needs against our desire for a clean environment, and start treating those on the opposite side with respect by protesting peacefully and without threats?
Now more than ever, we need the civility that people voted for in November.
Chris Ventura, Midwest Regional Director for Consumer Energy Alliance