Long term care facilities have been at the forefront of the fight against the COVID-19 pandemic. Heroic caregivers have been working around the clock to protect residents and staff, but because of the vulnerability of residents and the pre-symptomatic and asymptomatic spread of the virus, long term care residents account for nearly 40 percent of COVID-related deaths in the United States, while comprising only six percent of total cases.
But there is good news. With cases declining among the general population and widespread vaccine distribution underway, COVID-19 cases in long term care facilities are also declining.
The most recent week of complete data from the federal government shows that among nursing home residents, new weekly cases have declined by 22 percent over three weeks between December 20 and January 10. Nursing homes were experiencing record-breaking cases and deaths in November and December due to high community spread leading into the fall and through the holidays. While this decline is encouraging, long term care facilities are still experiencing higher weekly cases and deaths than the Sun Belt surge last summer, signaling the need for ongoing vigilance and vaccinations.
Fortunately, every state has activated its vaccination program for long term care facilities, and more than half of nursing homes have completed their second clinics.
The Vaccine Is Working, May Prevent Spread
While the vaccines’ are 95 percent effective in preventing serve illness due to COVID-19, their ability to reduce spread and infections is currently unknown. However, a new analysis by the Center for Health Policy Evaluation in Long Term Care (CHPE), the research division of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), found that COVID-19 cases decreased at a faster rate among both residents and staff at nursing homes that had completed their first vaccine clinic, compared to nursing homes that had not yet administered the vaccine.
CHPE examined data from 797 nursing homes that conducted their first vaccination clinic between December 18, 2020 and December 27, 2020 and compared it to nursing homes in the same county that had not yet conducted a clinic (1,709 facilities). The analysis found:
Vaccinated nursing homes experienced a 48 percent decline in new resident cases three weeks after the first clinic, compared to a 21 percent decline among non-vaccinated nursing homes located in the same county.
Similarly, new staff cases declined by 33 percent in vaccinated nursing homes compared to 18 percent in non-vaccinated facilities.
“The decline in new cases three weeks after the first dose, compared to facilities having vaccine clinics later, is encouraging and signals that the vaccine may decrease the spread of COVID, a finding not shown in the trials. If verified with additional data, this could expedite the reopening of long term care facilities to visitors, which is vital to residents’ health and wellbeing. Given the disproportionate impact COVID-19 has on long term care residents, we must continue to prioritize vaccinating the elderly in these settings,” said Dr. David Gifford, Chief Medical Officer for AHCA/NCAL.
“We are excited to see this trend and hope to see it confirmed as we look at facilities whose clinics started later. We are also hoping to learn more about whether the decline in deaths is associated with vaccination,” said Marsida Domi, Senior Research Analyst, AHCA/NCAL.
The CHPE analysis is the first to look at the relationship between the COVID-19 vaccines and spread in long term care.
This preliminary data underscores the need for the Centers of Disease Control and Prevention (CDC) and other researchers to further evaluate the effectiveness of this vaccine on preventing spread and illness among long term care residents and staff. The sooner we can gather conclusive results of the vaccines’ efficacy, the sooner providers can reopen their facilities and reunite families.
Slowing Community Spread Is Helping
Decline in community spread is also contributing to the decline in cases in long term care facilities. Throughout the pandemic, AHCA/NCAL has repeatedly pointed to independent research that shows the correlation between community spread and the likelihood of outbreaks in long term care facilities.
A report released by the CDC last month confirmed that trends in community infections from COVID-19 align with cases throughout nursing homes. The report examined the CDC’s National Healthcare Safety Network (NHSN) data from May 25 through November 22, 2020. The CDC found that COVID-19 rates increased in nursing homes in June and July and again in November, similar to trends found within the surrounding communities. The CDC report aligns with similar research conducted by experts at some of our nation’s top academic institutions, including Harvard University, Brown University and The University of Chicago.
The downward trend in cases is encouraging, but underscores the importance of remaining vigilant. The general public must keep doing their part to keep community spread down. Wearing a mask, maintaining social distancing, avoiding large gatherings and practicing proper hygiene will help minimize potential outbreaks in our communities.
In addition, long term care residents and staff must continue to be prioritized. As the vaccines become available to more Americans, ensuring high vaccination rates is equally important, especially as new strains emerge. AHCA/NCAL is also asking Congress for $100 billion to the Provider Relief Fund and dedicate a substantial portion of this fund to long term care so providers have the supplies, testing and staffing they need.
The fight against the pandemic is not over. We must continue to do all that we can to protect our most vulnerable citizens and frontline workers.
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.