Thursday, August 5

Covid Cases Fall Over 80% Among US Nursing Home Residents and Staff | US News


JOan Phillips, a certified nursing assistant at a Florida nursing home, loved her job but feared the danger of going to work during the pandemic. When the vaccines became available in December, he jumped at the opportunity to get one.

Months later, it seems that the danger has faded. After the launch of Covid vaccines, the number of new Covid cases among nursing home staff fell 83%, from 28,802 for the week ending December 20 to 4,764 for the week ending February 14. , as shown by data from the Centers for Medicare & Medicaid Services.

New Covid-19 infections among nursing home residents fell even more sharply, by 89%, in that period, compared with 58% in the general public, data from CMS and Johns University show. Hopkins.

These numbers suggest that “the vaccine appears to have a dramatic effect on reducing cases, which is extremely encouraging,” said Beth Martino, spokeswoman for the American Health Care Association and the National Center for Assisted Living, an industry group. .

“It’s a huge relief to me,” said Phillips, who works at the North Beach Rehabilitation Center outside of Miami. Now, he said, he is urging undecided coworkers and anyone else who can to “go out and get vaccinated.”

After a brutal year in which the pandemic killed half a million Americans, despite unprecedented measures to slow its spread, including the use of masks, physical distancing, school closings and economic closures, vaccines they give hope that an end is near.

National figures on infections of health workers in other settings are difficult to come by.

Research in other countries suggests that vaccines have caused large drops in infection. TO study of publicly funded hospitals in England indicated that a first dose was 72% effective in preventing Covid-19 among workers after 21 days and 86% effective seven days after the second injection.

Lost on the Frontline, a year-long data and reporting project by KHN and The Guardian, is investigating more than 3,500 Covid deaths of US healthcare workers.The monthly number has been declining since December, but deaths are often weeks or months behind infections.

Along with other healthcare workers, nursing home staff and residents were first in line for vaccinations in December because seniors in congregated settings are among the most vulnerable to infection – more than 125,000 residents. have died from Covid, CMS data shows, while more than 550,000 nursing home staff members tested positive and more than 1,600 died.

However, the vaccination rate among staff is much lower than that of residents. When the first clinics were open from mid-December to mid-January, a median of 78% of nursing home residents took a dose, while the median for staff was just 38%, according to the Centers for Control and Disease Prevention. Now, several nursing home associations said the vaccination rate of staff has increased, according to informal surveys.

Vaccine adoption by nursing home residents has been “very promising,” said Dr. Morgan Katz, an infectious disease specialist at Johns Hopkins University who advises on Covid responses in nursing homes. . “I think this is a huge contributing factor” to the decrease in personnel cases, he said.

Having even one or two vaccinated people in a building can slow down transmission.

Another factor, Katz said, is that “many nursing homes have already experienced large outbreaks, so there is probably a significant proportion of residents and staff who are already immune.” Additionally, Covid rates have fallen nationally after an increase in vacation travel and gatherings in November and December, so staff members have less exposure in their communities.

But “even though we are seeing a really wonderful change in the number of cases,” he said, “we have to remember that as long as staff are 50 or 30% vaccinated, they are still vulnerable and they are also making long-term care residents incredibly vulnerable. at risk “.

Vaccination efforts are running out of time as new variants of Covid circulate and some states drastically relax Covid restrictions, which facilitates the spread of the virus.

Mistrust fuels doubts about vaccines

The question looms as to why some workers reject the vaccine. The New Jersey Veterans Memorial Home in Menlo Park suffered a major outbreak last year in which more than 100 workers hired Covid and more than 60 residents and a certified nursing assistant, Monemise Romelus, were killed. Shirley Lewis, president of the union representing CNAs and other workers, said it was traumatizing. Still, only about half of the workers there have been vaccinated, Lewis said, and one is sick with Covid.

“A lot of my members are not very excited about taking this vaccine because they are scared,” Lewis said.

Some workers want to wait a little longer to see how safe the vaccine is, he said. Others tell him they don’t trust vaccines because they developed so quickly, he said.

Other staff members “feel like it’s an experimental drug,” Lewis said, “because as you know, blacks, Latinos and other groups have been used for experiments” like the Tuskegee syphilis study, he said.

Vaccination hesitancy is highest among 30-49-year-olds, rural residents, and black and Hispanic adults, according to KFF.

Certified nursing assistants, who make up the majority of long-term care workers, have historically been least likely to get the flu vaccine than other healthcare workers, said Jasmine Travers, an assistant professor of nursing at New York University who studies vaccine vacillation. Nursing homes generally do not have nurse educators, who address worker concerns about vaccines in hospitals, he said, and CNAs also face structural barriers such as limited internet access.

Nursing homes tend to be hierarchies commonly run by white staff, while about 50% of CNAs, at the bottom of the power structure, are black or Hispanic, he added.

With the Covid vaccine, some fear taking sick time off work and don’t want to burden their already understaffed coworkers, Travers said.

Deliberate misinformation

Low vaccine use among long-term care workers has been a national concern, so much so that LeadingAge, a national group representing nonprofit long-term care facilities, held a virtual town hall on vaccine safety on March 4 with the Black Coalition against Covid-19.

The event, which drew more than 45,000 spectators, was aimed at African-American long-term care workers.

Dr. Reed Tuckson, co-founder of the Black Coalition Against Covid-19, said viewers raised concerns about fertility, pregnancy, and contraindications. He said the event also had “many provocateurs” who insisted, “everything is a myth, everything is a lie.”

His group plans to hold more public information sessions aimed at black audiences.

“There is no question that the three vaccines that we now have available are extraordinarily safe and tremendously effective,” said Tuckson, a former public health commissioner in Washington.

The nursing home industry has Set a goal have 75% of staff members vaccinated nationwide by the end of June.

Hesitation does not mean rejection

Most nursing homes do not have mandatory vaccinations, industry officials say, due to fear of losing staff. Because vaccines were authorized in emergencies, liability is also a concern.

Juniper Communities, which runs 22 long-term care facilities in four states and employs nearly 1,300 people, caused 30 workers to leave work after it demanded vaccines, according to Dr. Lynne Katzmann, president and CEO.

Even when staff are initially reluctant to get vaccinated, “it doesn’t mean this is a permanent refusal,” Travers said.

In southwestern Ohio, Kenn Daily runs two nursing homes run by Ayden Healthcare. About half of his staff and 85% of residents were vaccinated in mid-February, he said, and they have not had a case of Covid since. Still, he said, vaccine resistance persists among younger employees who read misinformation online.

“Facebook is the nightmare of my existence,” said Daily. The workers tell him that they are concerned “they are going to microchip me” or that the vaccine will change his DNA.

Now that that time has passed since the initial launch, Daily said: “I hope to put some pressure on my staff to step up and get vaccinated.”

His message: “It’s working, guys. It is working very well. “

Elizabeth Lucas, KHN Data Editor, contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the top three operational programs in KFF (Kaiser Family Foundation). KFF is a nonprofit organization that provides health information to the nation.


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