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Nursing-home coronavirus cases up nearly 80% in worrisome rebound, report says

Residents at the Southern Pines nursing home in Warner Robins, Ga.
Residents at the Southern Pines nursing home are separated and wear face coverings during their daily bingo game in Warner Robins, Ga., in June.
(John Bazemore / Associated Press)

COVID-19 cases in U.S. nursing homes jumped nearly 80% earlier this summer, driven by the disease’s rampant spread across the South and much of the West, according to a new industry report.

“The case numbers suggest the problem is far from solved,” said Tamara Konetzka, a research professor at the University of Chicago, who specializes in long-term care. She was not involved with the study, which was released Monday.

Residents in long-term care facilities account for less than 1% of the U.S. population but more than 40% of COVID-19 deaths, according to the COVID Tracking Project.

The situation is a politically sensitive issue for President Trump, who is scrambling to hold onto support from older voters as polls show disapproval of his administration’s response to the pandemic.

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The White House announced in late July the release of $5 billion for nursing homes, while launching a program to equip each of some 15,000 facilities with a fast-test machine to screen residents and staff for the coronavirus.

Monday’s study from the American Health Care Assn. found 9,715 coronavirus cases in nursing homes the week of July 26, a 77% increase from the low point logged the week of June 21. The association is the industry’s main trade body.

New York’s coronavirus death toll in nursing homes, already among the highest in the nation, could actually be a significant undercount

Weekly deaths rose to 1,706 the week of July 26, an increase of nearly 25% from a low point the week starting July 5.

Nursing homes in Sunbelt states had more time to prepare than facilities in the Northeast that were hit in late winter and early spring, with grim results. But Konetzka and other researchers have been warning that once a community anywhere experiences an outbreak, it’s only a matter of time before the coronavirus enters its nursing homes.

A leading theory is that staffers who don’t yet know they’re infected unwittingly bring the virus into the homes. Inside, the coronavirus encounters an ideal environment in which to spread among frail older people living in close quarters.

“As the virus surges in Sunbelt states, there’s no reason to think it won’t affect nursing homes in the same way it did in states that surged earlier,” said Konetzka. “We have learned some things about how to minimize the effect in nursing homes, but providers need the tools to implement those best practices. This is the critical role of federal policy that has not been fulfilled: securing supply chains for [personal protective equipment] and rapid testing.”

State inspectors worry they could be unwittingly spreading coronavirus from nursing home to nursing home while doing their jobs.

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The industry analysis illustrates the march of the coronavirus across the U.S.

As of the week of May 31, fewer than one-third of the weekly cases were from nursing homes in Sunbelt states. But by the week starting July 26, that share was 78%.

Deaths followed a similar pattern. Nursing homes in states across the South and parts of the West accounted for 28% of deaths the week of May 31. That share was 69% by the week starting July 26.

The Trump administration says it’s executing its plan to provide fast-test machines to nursing homes and to make sure that all facilities have the protective equipment they need. But Seema Verma, head of the Centers for Medicare and Medicaid Services, said states and nursing homes also have responsibility to safeguard residents. She called on nursing homes to step up their game.

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Mark Parkinson, head of the nursing home trade group that produced the study, said the problem is bigger.

“The data indicate that this virus is spread by asymptomatic carriers and that even perfect infection-control wouldn’t have stopped it,” he said. “The challenge with this virus is that because it is spread by asymptomatic carriers, the prior infection-control procedures didn’t work.”

Parkinson said that about 10% of facilities still report lacking an adequate supply of N95 masks, considered standard for hospital personnel.

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The nursing home association is urging states struggling with the latest coronavirus surge to enact mandates for people to wear masks, saying it would indirectly benefit residents living in such facilities. “There’s a direct link between COVID in the community and COVID in the building,” Parkinson said.


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