Unvaccinated employees noticed in rising nursing residence instances and deaths |
WASHINGTON – Delayed vaccination rates among nursing home workers have been linked to a national surge in COVID-19 infections and deaths in senior facilities and are the focus of a state investigation into a hard-hit Colorado location where disease detectives found many workers not vaccinated.
Investigation of the Centers for Disease Control and Prevention facilities in the Grand Junction, Colorado area raises concerns among public health doctors that success in protecting vulnerable elders with vaccines could be jeopardized as the more aggressive Delta variant spreads across the country spreads.
Nationwide, about 59 percent of nursing home workers have had their vaccinations, about as much as the total percentage of fully vaccinated adults – but significantly lower than the 80 percent or so of residents who are vaccinated, according to Medicare. And some states have significantly lower vaccination rates of around 40 percent.
Some policy experts are calling on the government to fill the void by mandating nursing home staff, a mandate the von Biden government was reluctant to give. Nursing home operators fear that such a move could backfire, leading many employees with vaccination problems to simply quit their jobs.
It is true that the vast majority of fully vaccinated people who become infected with the Delta variant only suffer from mild symptoms.
But “older adults may not respond fully to the vaccine and there is an enormous risk of someone getting infected with the virus,” said Dr. Joshua Sharfstein, Vice Dean of Public Health Practice at the Johns Hopkins Bloomberg School of Public Health.
“Vaccinating nursing home workers is a national emergency because the Delta variant poses a threat to those who have already been vaccinated,” he said.
The CDC conducted its investigation into Delta variant outbreaks in elderly care facilities in Mesa County, Colorado in May and June. The area is a corona hotspot. The agency said it was supporting states and counties across the country as part of the White House’s COVID-19 “surge teams”.
At the national level, data collected by CDC shows deaths and confirmed infections among nursing home workers have decreased significantly since vaccinations began in January. But the number of deaths reported among employees has risen again, raising new concerns.
At a memory care facility in the Grand Junction area, 16 fully vaccinated residents were infected and four died, according to a CDC slide provided to The Associated Press. The deceased residents were described as being in hospice with an average age of 93, suggesting that they were particularly frail.
The CDC has not made the results of its investigation public, but has announced that it will publish the results in an upcoming weekly Morbidity and Mortality Report. The slide was made available to the AP by a person involved in internal consultations who requested anonymity as they did not have permission to publish the data.
Of the 16 fully vaccinated residents infected in the memory care facility, CDC found that 13 developed symptoms, which in most cases were described as mild.
The CDC investigated several Mesa County nursing homes that had new outbreaks. At one location – referred to as “Facility A” – 42 percent of employees were not yet fully vaccinated, compared to only about 8 percent of residents who had not completed their vaccinations.
The CDC found a 30 percent COVID-19 infection rate among vaccinated residents and staff at the facility, with residents accounting for the vast majority of cases.
Throughout the pandemic, people in long-term care facilities have carried a disproportionate burden of suffering and death, not to mention the increasing isolation from lockdowns. Nursing home residents are estimated to make up about 1 percent of the US population, but they are responsible for about 22 percent of COVID-19 deaths – more than 133,400 people whose lives have been lost.
Experts generally agree that staff is one of the main triggers of nursing home outbreaks, as workers can unwittingly bring in the virus from the surrounding community before they develop symptoms.
With the arrival of vaccines and aggressive efforts to immunize residents, cases and deaths plummeted and nursing homes came out of lockdown. But COVID-19 was not wiped out. In the week that ended July 4, 410 residents across the country were infected and 146 died.
Colorado is not alone with outbreaks in nursing homes as large sections of the staff remain unvaccinated.
In Indiana, seven residents died of COVID-19 in a facility where fewer than half of the staff – 44 percent – were fully vaccinated, said Dr. Emily Backer, Howard County Health Officer. Eleven other residents tested positive in the outbreak, which officials believe began in mid-June.
One of the deceased was fully vaccinated, and five fully vaccinated residents were among those who tested positive, Backer added. She wouldn’t name the facility.
Backer admitted that the facility’s staff vaccination rate of 44 percent was “lower than we’d like”.
“But at this point,” she added, “you can’t force it.”
Backer said she was concerned about persistent vaccination resistance fueled by exaggerated claims about side effects. Some experts fear that hard-won advances in fighting outbreaks in nursing homes could be lost in at least some communities.
Laura Gelezunas has firsthand experience with a groundbreaking case in a nursing home.
After numerous calls and emails to her mother’s nursing home in Missouri and the company’s headquarters in Tennessee, Gelezunas finally received confirmation that her mother’s congestion, headaches, and sore throats were symptoms of COVID-19.
However, Gelezunas said the facility is not transparent about how their vaccinated mother Joann got sick. While the house has drawn attention to outside visitors, Gelezunas said her mother’s only visitors were her brother and wife, who were both vaccinated. Gelezunas believes this is an unvaccinated worker, but the home has not yet given her any answers.
Gelezunas asked her mother to only interact with vaccinated workers, but directors said they couldn’t make promises due to privacy concerns and their inability to mandate vaccinations for workers.
“My mother is bedridden. I have people who take care of them and you tell me you can’t tell me that for $ 7,500 a month my mom can’t take care of them from someone who is vaccinated, ”said Gelezunas, who is in Mexico lives.
Joann told her daughter that between 12 and 15 residents had recently been infected with the virus, which she learned from one of her helpers.
One obstacle when it comes to vaccination requirements is that COVID-19 vaccines are not yet fully approved by the Food and Drug Administration and are being administered under an emergency permit.
“What we need to do is overcome the emergency base in order for (vaccination) to be a standard of care,” said Terry Fulmer, president of the John A. Hartford Foundation, a nonprofit committed to improving care for older adults begins.
The government figures highlight the potential vulnerability and show wide variations between states in vaccination rates in nursing homes. Vermont has 95 percent of its nursing home residents fully vaccinated, but Nevada has 61 percent. Hawaii leads the way in personal vaccination, with 84 percent fully vaccinated. But in Louisiana it’s half, 42 percent.
Harvard Health Policy Professor David Grabowski said he believes trust is the core issue for many nursing home workers who remain unvaccinated. Low wage workers may not have a lot of confidence in the vaccine news from management in their facilities.
“I think some of this reflects what we’re seeing in the general population, but it’s really worrying among healthcare workers,” Grabowski said.
Indiana County Health Officer Backer blames the whirling misinformation.
“There is a lot of really bad information that is completely untrue,” she said. “It’s really sad because I think we have the power to end this with a vaccination. Nobody else has to die from it. “
Dearen reported from New York City. Associated Press Writer Kathleen Foody in Chicago and Patty Nieberg in Denver contributed.