WASHINGTON (AP) – Lagging vaccination rates among nursing home staff are linked to a nationwide rise in COVID-19 infections and deaths in elderly facilities, and are at the center of federal investigations in a hard-hit Colorado neighborhood where detectives were found. many workers were not vaccinated.
An investigation by the Centers for Disease Control and Prevention at facilities in Grand Junction, Colorado raises concerns among public health doctors that successes in protecting vulnerable older people with vaccines could be jeopardized as the more aggressive delta variant spreads across the country.
According to Medicare, nationally, about 59% of nursing home staff have been vaccinated, roughly equal to the total percentage of adults fully vaccinated, but significantly lower than about 80% of residents vaccinated. And in some states, the vaccination rate is much lower – about 40%.
Some policy experts are urging the government to close this gap by demanding vaccinations for nursing home employees, a mandate that the Biden administration has been reluctant to issue. Nursing home operators fear such a move could backfire, prompting many employees with vaccine concerns to quit their jobs.
Of course, the vast majority of fully vaccinated people infected with the delta variant have only mild symptoms.
But “older adults may not fully respond to the vaccine, and there is a huge risk of contracting the virus,” said Dr. Joshua Scharfstein, associate dean of public health at Bloomberg Johns Hopkins School of Public Health.
“Vaccinating workers in nursing homes is a national emergency because the delta option poses a danger even to those who are already vaccinated,” he said.
The CDC investigated delta variant outbreaks in elderly care facilities in Mesa County, Colorado in May and June. This area is a coronavirus hotspot. The agency said it is helping states and counties across the country as part of the White House “task forces” on COVID-19.
Nationally, data compiled by the CDC show that the number of deaths and confirmed infections among nursing home staff has dropped significantly since vaccinations began in January. But the number of deaths among employees has started to rise again, which raises new concerns.
At one memory care facility in the Grand Junction area, 16 fully vaccinated residents were infected and four died, according to a CDC slide provided by the Associated Press. The deceased residents were described as being in the care of a hospice, with an average age of 93, indicating that they were particularly weak.
The CDC did not release the results of its investigation, but said it plans to publish the results in an upcoming weekly morbidity and mortality report. The slide was provided to AP by an internal contributor who requested anonymity as he did not have permission to publish the data.
Of 16 fully vaccinated patients infected at a memory care facility, the CDC found that 13 developed symptoms, most of which are described as mild.
The CDC investigated several nursing homes in Mesa County where new outbreaks have occurred. At one location, described as “Facility A,” 42% of staff were still not fully vaccinated, as opposed to only about 8% of residents who failed to get vaccinated.
The CDC found that the rate of COVID-19 infection among vaccinated residents and facility staff is 30%, with the vast majority of cases occurring in residents.
Throughout the pandemic, people in long-term care facilities have carried a disproportionately heavy burden of suffering and death, not to mention increased isolation due to quarantines. It is estimated that nursing home residents make up about 1% of the US population, but account for about 22% of deaths from COVID-19 – more than 133,400 people whose lives have been lost.
Experts generally agree that staff are a major trigger for outbreaks in nursing homes, because workers can unwittingly bring the virus from the surrounding community before they develop symptoms.
With the advent of vaccines and active efforts to vaccinate residents, the number of cases has dropped dramatically, and nursing homes have emerged from isolation. But COVID-19 has not been eradicated. As of the week ending July 4, 410 residents were sick and 146 died nationwide.
Colorado is not alone in experiencing outbreaks of disease in nursing homes, as a significant proportion of staff remain unvaccinated.
In Indiana, seven residents have died from COVID-19 at a facility where less than half of the staff – 44% – were fully vaccinated, said Dr. Emily Baker, a Howard County health care provider. Eleven other residents tested positive during the outbreak, which authorities say began in mid-June.
One of the people who died was fully vaccinated, and five fully vaccinated residents were among those who tested positive, Baker added. She did not name the object.
Backer admitted that 44% of the facility’s vaccination rate was “lower than we would like.”
“But at this point,” she added, “they can’t force them.”
Baker said she was worried about the continued resistance to vaccinations, fueled by exaggerated claims of side effects. Some experts fear that hard-won progress in combating disease outbreaks in nursing homes may be missed, at least in some communities.
Laura Gelezunas knew firsthand about the turning point in the nursing home.
After numerous calls and emails to a Missouri nursing home and the company’s headquarters in Tennessee, Gelezunas finally received confirmation that her mom’s nasal congestion, headache and sore throat were symptoms of COVID-19.
However, Gelezunas said the institution was not transparent about how her vaccinated mother, Joanne, got sick. While the house was pointing out strangers, Gelezunas said her mother’s only visitors were her brother and his wife, who were both vaccinated. Gelezunas believes it was an unvaccinated employee, but the house has not yet given her answers.
Gelezunas asked her mother to communicate only with vaccinated workers, but directors said they could not make promises due to confidentiality concerns and their inability to schedule vaccinations for workers.
“My mom is bedridden. I have people who take care of her, and you tell me that you cannot tell me that for $ 7,500 a month my mother cannot force someone who is vaccinated to take care of her, ”Gelezunas said. who lives in Mexico.
Joanne told her daughter that 12 to 15 residents have recently been infected with the virus, as she learned from one of her assistants.
When it comes to vaccinations, one hurdle is that COVID-19 vaccines are not yet fully FDA approved and are being introduced in emergencies.
“What we need to do is move away from emergency use so that (vaccination) becomes the standard of care,” said Terry Fulmer, president of the John A. Hartford Foundation, a non-profit organization working to improve care for the elderly.
Highlighting potential vulnerabilities, government data show a large interstate gap in nursing home vaccinations. In Vermont, 95% of nursing home residents are fully vaccinated, and in Nevada, 61%. Hawaii is the leader in staff vaccination, with 84% fully vaccinated. But in Louisiana, that’s half that, 42%.
Harvard health policy professor David Grabowski said he believes trust is a key issue for many unvaccinated nursing home workers. Low-wage workers may be distrustful of vaccine messages from management in their factories.
“I think it partly reflects what we see in the general population, but it is really confusing for healthcare professionals,” Grabowski said.
Indiana County health official Baker accused of spreading misinformation.
“There is a lot of really bad information that is completely untrue,” she said. “It’s really sad because I think we can end this with vaccinations. Nobody else needs to die from this. “