The number of COVID-19 cases across the country is
rising at an alarming rate, and the long term care industry is concerned that it may cause a correlating spike of new cases in nursing homes and assisted living communities. Even though the vaccine was prioritized for long term care residents and staff and yielded a sharp decline in nursing home cases and deaths, the pandemic persists, and we are not yet out of the woods, industry officials warn.
Increasing cases in the community can have a devastating impact on long term care residents and staff.
Independent research from our nation’s top academic institutions and the federal government indicate that the rate of spread within a surrounding community is a primary factor in the likelihood of an outbreak in a nursing home.
The latest
data from the Centers for Medicare and Medicaid Services (CMS) indicates that as of March 30, 177 counties in the U.S. have a community positivity rate of higher than 10 percent, a 43 percent increase in three weeks. More than 1,100 nursing homes are in those 177 counties. This is nearly double the amount of nursing homes in red counties from the previous week, which was 620.
“This is not the time to let our guard down,” said Mark Parkinson, president and CEO of the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL). “We call on members of the public to respect our elders by doing their part: wear a mask, avoid large groups of people, practice social distancing, and get vaccinated as soon as you are able. We understand that everyone is tired of this pandemic, but it is our most vulnerable who pay the ultimate price by our complacency. We must remain vigilant, and together, we can protect our nation’s seniors and end this nightmare.”
Local reports have already begun to
trickle in and industry officials are concerned more will soon arise. Specific causes for new cases and deaths in nursing homes and other long term care facilities can be determined by state public health officials, but some of the reasons may include:
- The time it takes for vaccinated individuals to develop protective antibodies, which usually takes 10-14 days. Residents could be become infected with COVID during this window of time.
- The vaccines do not always prevent infection from happening, but they are extremely effective at preventing symptomatic disease. Therefore, some residents may test positive during regular, surveillance testing, but never develop symptoms.
- The vaccines are incredibly effective at preventing severe illness (90-95 percent), but they are still not 100 percent. Given that millions have been vaccinated and the ongoing spread of the virus, it is possible that vaccinated individuals may contract COVID.
- Long term care residents were not included in the vaccine clinical trials, so we must continue to monitor their efficacy among this population. AHCA/NCAL wrote to the CDC in February urging that vaccine research on the long term care population be prioritized.
- While there is promising data about the vaccines’ ability to prevent transmission—not just severe illness—of the virus, this is still being determined by scientists and experts.
- The rise of new variants of the vaccine continue to remain a threat, especially if community spread remains rampant, more variants will continue to emerge.
- According to CMS guidance for nursing homes, indoor visitation is allowed, no matter the vaccination status of residents or visitors.
- While a vast majority of residents were vaccinated during the on-site clinics that took place between December and March, not every resident was vaccinated and new, unvaccinated residents are being admitted on a regular basis.
Industry officials are particularly
concerned about the lack of steady, rapid access to additional vaccines, especially with federal officials pausing the use of the Johnson & Johnson vaccine yesterday, which was primarily being allocated to long term care through partnering pharmacies. Nursing homes frequently accept new patients from the hospital, and assisted living communities welcome new residents from the community, and many of these individuals may not yet be vaccinated.
“There is this notion among some that vaccines were administered in long term care, so we’re done, and that would be a perilous mistake,” said Dr. David Gifford, chief medical officer of AHCA/NCAL. “We need federal and state public health officials to continue to prioritize long term care for vaccine allocations and other support for the foreseeable future and until this virus is eradicated.”
The long term care industry also recognizes the addressing vaccine hesitancy is critical. With support from the Centers for Disease Control and Prevention (CDC), AHCA/NCAL launched the
#GetVaccinated campaign to help educate residents, staff and families about the vaccines and help reach their nationwide goal of getting
75 percent of all staff vaccinated by June 30, 2021. Education is proving to be an effective approach, and vaccine uptake and confidence is increasing. A recent
survey from OnShift shows that staff willingness to get the vaccine has increased by 94 percent since December.
While the vaccines are the best hope we have to ending the pandemic as quickly as possible, we also need members of the public to help flatten the curve. Public health officials must also continue to keep long term care its top priority for resources and support, so we can protect our most vulnerable citizens and heroic caregivers.
ABOUT AHCA/NCAL
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit
www.ahcancal.org.