Increase in Covid-19 cases in nursing homes

The outbreak of Covid-19 fueled by the Omicron variant is hitting nursing homes hard, with the highest number of cases ever documented among staff members and a near-record number of residents also testing positive, according to new federal data.

Rising staff numbers pose an operational challenge for facilities that have struggled with labor shortages for months, while an increase in patient cases threatens the return of serious illnesses and deaths among residents.

In the week ending Jan. 9, there were 32,061 new confirmed cases of Covid-19 among nursing home residents, up from 18,186 a week earlier and 6,406 the week before, according to the news. data from the Centers for Disease Control and Prevention.

Last week’s total was near the highest documented weekly level, which topped 34,000 in December 2020. CDC data only goes back to the end of May 2020.

Cases among staff members are increasing even more sharply. In the most recent week of CDC data, there were 57,243 cases of Covid-19 among nursing home staff, 36% more than the previous week’s total and nearly double the peak documented by CDC in December 2020.

The staff situation “is truly dire,” said Vincent Mor, a professor at Brown University specializing in long-term care.

Some of the largest nursing home operators, including Genesis Healthcare Inc.,

ProMedica Senior Care and the Evangelical Lutheran Society of the Good Samaritan recently had to suspend admissions to some facilities due to staff issues.

Residents and a staff member of the Good Samaritan Society nursing home in Denton, Texas.

A staff member delivering meals to residents of the Good Samaritan Society nursing home in Denton, Texas.

“It’s hard to find staff right now,” said Nathan Schema, managing director of Good Samaritan, part of Sanford Health, a non-profit organization that operates 155 nursing homes. “We don’t have these people waiting behind the scenes to recoup those overtime hours.”

Cases of Covid-19 nonprofit staff are around five times more numerous than before the holidays, he said, although the number of residents has increased much less.

Redstone Presbyterian SeniorCare, a Greensburg, Pa. Based nonprofit that includes a nursing home and two assisted living facilities, saw just two cases of Covid-19 among staff in November, then two more the week after Christmas, before an increase of 23 cases in the first week of 2022, said Vicki Loucks, chief operating officer.

As a result, Redstone has had to suspend admissions twice in recent weeks. He had positions open even before the virus sidelined staff in recent days, she said, and tried to fill in the gaps with managers taking on frontline shifts.

“It has been incredibly difficult,” she said.

When nursing homes stop taking new patients, the safeguards spread to hospitals which are often already overwhelmed.

Northern Light Health, which operates 10 hospitals in Maine, has an average of about 100 patients a day who are ready to leave the hospital but unable to find an opening in long-term care facilities, said Suzanne Spruce, spokesperson. word.

These patients stay in hospital beds. Emergency rooms then have to hold patients until a bed opens, often for days, she said. The backlog includes critical patients who need intensive care units.

“Unfortunately, people are dying while on the waiting list for the next available intensive care bed,” she said.

A resident in her room at the Good Samaritan Society nursing home in Denton, Texas.

The growing number of Covid-19 cases in nursing homes is also fueling concerns that facilities could see another wave of serious illness and mortality among their fragile occupants, which regularly accounted for a third or more of Covid deaths. -19 in the United States during the early periods. of the pandemic.

Resident deaths reached 645 for the week ended Jan. 9 in CDC data, but are far behind weekly totals which topped 6,000 at the end of 2020. In the past, the increase in mortality has fell a few weeks behind the number of cases.

Experts and nursing home operators say widespread vaccination and the availability of treatments for Covid-19, along with the potentially somewhat milder course of the disease, could help mitigate the impact of the current outbreak .

“We have better treatments now,” said Morgan Katz, an assistant professor at Johns Hopkins University, who specializes in infectious diseases. “We have a much better understanding of the virus. “

Nursing homes have benefited from an aggressive, early nationwide vaccination campaign that helped quell the worst effects of the viral disease for much of 2021.

About 87% of nursing home residents are vaccinated and about 62% of those people have received a booster dose, according to recent data from the CDC. The rate of Covid-19 cases is much lower among those who have received a third vaccine, a CDC spokeswoman said.

“We should be much higher in terms of boosters,” said David Grabowski, a professor of health policy at Harvard Medical School who studies long-term care. “It’s a huge gap right now. “

A staff member at the Good Samaritan Society nursing home in Denton, Texas, working near the so-called red zone, where HIV-positive residents are being relocated.

The Good Samaritan Society Nursing Home in Denton, Texas currently has around 10 staff and 15 residents who have tested positive for Covid-19.

The Biden administration has made vaccination mandatory for nursing home staff and other healthcare workers, but some states are challenging those requirements in a case recently debated in the Supreme Court.

Data from the CDC shows that 82% of nursing home staff completed the vaccination, but only 28% of them received an extra dose. “The CDC is actively working to further assist nursing homes and protect residents and staff, while continuing to ensure access to COVID-19 vaccines in long-term care facilities,” the spokesperson said. of the CDC.

The Centers for Medicare and Medicaid Services, which regulate nursing homes, have not commented.

Webster in Rye, New Hampshire had no cases of Covid-19 among residents until an outbreak in November 2021, when 32 were infected with the virus and six died. Residents were all vaccinated and were due to receive their booster shots when the outbreak occurred, administrator Todd Fernald said. Now, he said, all residents are vaccinated and 78% have booster shots, the rest being mostly new admissions.

He remains concerned, however, that new cases could be seeded by epidemics in the community, he said, in part because regulations limit his ability to restrict visitors. “As more and more people enter a building, it becomes more difficult to control,” he said.

Write to Anna Wilde Mathews at [email protected] and Jon Kamp at [email protected]

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