New coronavirus cases have surged to an all-time high at nursing homes across the country despite federal efforts to shield residents through aggressive testing and visitor restrictions, a new report shows.
Federal data shows 10,279 COVID-19 cases during the week of Nov. 1, the most recent data available. The figures surpassed the previous high of 9,903 cases in late July, according to a report by the American Health Care Association and National Center for Assisted Living.
The surge in cases among the nation’s most vulnerable residents comes as cases, hospitalizations and deaths surge nationwide. Industry representatives say that when cases spread in a community, it’s difficult to shield nursing home residents despite rules that restrict visitors.
“We have been begging people the last eight months to wear a mask, socially distance and to be careful,” said Mark Parkinson, president and CEO of AHCA/NCAL. “Unfortunately, the public has not listened or complied.”
The number of deaths began increasing in October, and reached 1,431 during the first week of November. While the deaths remain below levels reached during the summer surge that mainly affected Sun Belt states, Parkinson said death rates lag new infections so, “there will be an increase in deaths over the next two or three weeks.”
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The COVID Tracking Project said that although fewer than 1% of U.S. residents live in nursing homes, these facilities account for 40% of the nation’s COVID-19 deaths. As of Tuesday, more than 94,000 Americans have died at long-term care facilities.
The U.S. Department of Health and Human Services has provided billions in emergency funds to nursing homes and long-term care facilities to test, staff and purchase personal protective equipment to prevent infections among staff and residents. Among the initiatives: HHS has purchased point-of-care machines and kits that can deliver test results within minutes.
Nurses and other employees who live in communities where the virus is circulating are most likely the source of these infections. Despite testing staff members twice a week in communities where cases are widespread, the virus might not be detected.
Parkinson said testing has vastly improved since the spring, when public health labs were overwhelmed and private labs initially gained federal authorization to test for the virus.
In particular, HHS this week shipped 2 million rapid testing kits made by Abbott Laboratories to skilled nursing facilities and another 400,000 to assisted-living facilities.
Tamara Konetzka, a University of Chicago professor and nursing home expert, said nursing homes are vulnerable when the virus circulates in the community.
“This virus is a really difficult one and when you are in a virus hotspot, and you have staff going in and out of the facility every day, the virus is going to get in,” Konetzka said. “It’s really hard to keep it out completely.”
But there are other challenges homes face to ensure both residents and staff are safe. Some homes continue to report shortages of personal protective equipment. Nursing homes also have struggled to maintain adequate staffing, as nursing assistants and others are exposed to or sickened by the virus.
Konetzka’s research found 30% of homes in Wisconsin recently reported staffing shortages. Homes often pay extra to hire contract workers who temporarily fill shifts, but they often must complete with hospitals and other health facilities.
“Staffing shortages in nursing homes have been around for a long time, but it really got exacerbated by the pandemic,” she said. “Even if they want to pay more and get staff in, they just can’t find people to do it.”