Nursing home

The federal government shipped vaccines to nursing homes a week or more before most other groups. The statistics now show that even giving the first dose of the two-shot vaccine in nursing homes almost immediately caused new cases and deaths to plunge.

The vaccine works!

The abrupt decline in new cases and deaths in nursing homes has provided as dramatic, national proof that the Moderna and Pfizer vaccines can tame the pandemic.

The federal government shipped vaccines to nursing homes a week or more before most other groups. The statistics now show that even giving the first dose of the two-shot vaccine in nursing homes almost immediately caused new cases and deaths to plunge.

Nursing home residents and staff have accounted for 163,000 deaths nationally — a stunning one third of all deaths. Although nursing homes account for 34% of the deaths nationally, they account for just 5% of cases.

From late December to early February, new cases in nursing homes fell by 80% - twice the rate of the general population. Deaths inside facilities decreased by 65%, a much sharper rate of decrease than in the general population.

The stunning success of the vaccine in the most vulnerable population offers solid hope the massive vaccination campaign can tame the pandemic more quickly than doctors had hoped – providing enough people get the shot.

Statewide, about 22% of the population has gotten at least one dose of the vaccine.

That’s good news for the White Mountains, where clusters of cases in nursing homes have driven the death rate for the whole region.

So far in nursing homes, the virus has infected 1.3 million people in 31,0000 facilities. Arizona doesn’t report its data on nursing homes to the national database maintained by the federal Centers for Disease Control, so it’s unclear how we rank. Among states that do report their data, nursing homes accounted for the highest share of deaths in New Hampshire – a dismaying 73%. Alabama reported the lowest share of nursing home deaths — 16%.

The Arizona Department of Health Services website indicates that the number of confirmed cases in the state’s nursing homes has dropped from a weekly high of about 94 in early December to about 20 the week of Feb. 14.

On average, the virus kills 10% of the people it infects in nursing homes — 10 or 15 times the death rate in the overall population. Even well run facilities have struggled to keep the virus at bay. In part, that reflects the shortage of nursing home staff and the large number of staff members who work in multiple nursing homes and the widespread presence of the virus in the community.

The federal government funded a separate vaccine rollout program for nursing homes, generally relying on contracts with pharmacies to deliver the doses. The system initially allocated an excess of doses to nursing homes, contributing to an apparently slow rollout. In addition, initial reports suggested only about half of nursing home staff members were getting the shot. The progress of the vaccination program in nursing homes has been much less transparent than the tracking system overall. Even local county health officials don’t get updates on the percentage of people vaccinated in local nursing homes.

However, the latest figures show the vaccination program has been a heartening success, with both infections and deaths plummeting even after residents got the first shot – and despite a lag in the inoculation rate among staff.

Nationally, sampling has demonstrated that the Moderna and Pfizer vaccines have both maintained the extremely high 95% protection rate they showed in the more carefully controlled circumstances of the clinical trials. Early evidence has also suggested that the first shot confers strong protection, even during the three- to four-week wait for the second dose.

The American Health Care Association this week set a goal of getting 75% of the 1.5 million nursing home staff vaccinated by June 30.

“With COVID-19 vaccinations being distributed across long-term care facilities over the past two months, we have already seen a decline in cases in nursing homes, indicating that the vaccines are working,” said Mark Parkinson, president and CEO of AHCA. “Many of our staff continue to be excited about the vaccines and the hope they represent, but some caregivers still have questions. We are continuing to inform our staff about the credibility and safety of the vaccines.”

The lag in vaccinations of nursing home staff underscores the difficulty health departments will face once they move through the group of people eager for a vaccine. Statewide polls in Arizona found that some 25% of residents say won’t get vaccinated — which means the state will have trouble getting to the protection of “herd immunity.” This comes when 80 or 90 % of the population has gotten the shot or recovered from an infection. At that level, the virus can’t find enough unprotected people to infect and the pandemic will fade away.

“Achieving a high rate of staff vaccinations will be a game changer for nursing homes. Real progress has been made in vaccinating nursing home residents. Now we must also achieve high rates of staff vaccinations,” said Katie Smith Sloan, president and CEO of LeadingAge. “It’s critical to acknowledge the reasons for vaccine hesitancy are real and varied, and staff concerns must be understood and thoughtfully addressed as we work toward this goal.”

Many nursing home staffers are low paid and many are members of minority groups. Studies suggest those characteristics go hand in hand with a reluctance to get vaccinated.

“We look forward to working with President Biden’s Administration and the CDC to make this goal happen,” added Parkinson. “We cannot chance slowing the positive progress we have already made. The sooner we can get more of our staff vaccinated, the sooner we will be able to defeat this deadly virus.”

Peter Aleshire covers county government and other topics for the Independent. He is the former editor of the Payson Roundup. Reach him at paleshire@payson.com

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