Nursing home COVID-19 cases rise four-fold in surge states

The Associated Press finds that new weekly cases among residents rose nearly four-fold from the end of May to late October, from about 1,100 to nearly 4,300.

Posted: Nov 8, 2020 9:13 AM

WASHINGTON (AP) — Despite Trump administration efforts to erect a protective shield around nursing homes, coronavirus cases are surging within facilities in states hard hit by the latest onslaught of COVID-19.

An analysis of federal data from 20 states for The Associated Press finds that new weekly cases among residents rose nearly four-fold from the end of May to late October, from 1,083 to 4,274. Resident deaths more than doubled, from 318 a week to 699, according to the study by University of Chicago health researchers Rebecca Gorges and Tamara Konetzka.

Equally concerning, weekly cases among nursing home staff in surge states more than quadrupled, from 855 the week ending May 31, to 4,050 the week ending Oct. 25. That rings alarms because infected staffers not yet showing symptoms are seen as the most likely way the virus gets into facilities. When those unwitting staffers test positive, they are sidelined from caring for residents, raising pressures on remaining staff.

The administration has allocated $5 billion to nursing homes, shipped nearly 14,000 fast-test machines with a goal of supplying every facility and tried to shore up stocks of protective equipment. But the data call into question the broader White House game plan, one that pushes states to reopen while maintaining that vulnerable people can be cocooned, even if the virus rebounds around them.

“Trying to protect nursing home residents without controlling community spread is a losing battle,” said Konetzka, a nationally recognized expert on long-term care. “Someone has to care for vulnerable nursing home residents, and those caregivers move in and out of the nursing home daily, providing an easy pathway for the virus to enter.”

Nursing homes and other long-term care facilities account for about 1% of the U.S. population, but represent 40% of COVID-19 deaths, according to the COVID Tracking Project.

In Fort Dodge, a manufacturing and transportation center in north-central Iowa, Julie Thorson said she knew she was in for a bad week when several employees at the Friendship Haven nursing home tested positive last Monday. As president of the senior living community, Thorson contacted the county health department. “They were basically not surprised because they’re seeing it all over the county,” she said.

Residents also started testing positive. The facility had 11 new cases among residents, as of Friday.

“I was thinking all night what’s worse, to have it hit and not know what you are getting into, or to prepare, prepare, and prepare, and then have it hit,” she said.

Responding to the study findings, the federal Centers for Medicare and Medicaid Services issued a statement saying that “the bottom line is that the COVID-19 pandemic’s effect on nursing homes is complex and multifactorial.”

The agency noted different ways the administration has worked to help nursing homes and said its focus now was on ensuring that residents and staff would “immediately” have access to a vaccine once approved. But it also added that facilities “bear the primary responsibility for keeping their residents safe.”

“Many times, the likely causes of nursing home outbreaks are simply nursing homes failing to comply with basic infection control rules,” the statement said.

But Konetzka said her research has shown that nursing home quality has no significant effect on cases and deaths once community spread is factored in. “It’s not like the high-quality facilities have figured out how to do things better,” she said. Other academic experts have reached similar conclusions.

Highly rated by Medicare, St. Paul Elder Services in Kaukauna, Wisconsin, has had 72 COVID-19 cases among residents and 74 among staff, according to its Facebook page. The first case among residents was Aug. 19, and 15 have died, said the facility's president, Sondra Norder.

“The outcomes are really not much different here than they were in New York back earlier in the pandemic,” Norder said. “It's been called the perfect killing machine of the elderly, especially those who live in congregate settings.” Kaukauna is a small city about 100 miles north of Milwaukee.

The study, based on data reported by nursing homes to the government, also raised other concerns:

— For the week ending Oct. 25, about 1 in 6 nursing homes in surge states did not report having tested staff the prior week. Government requirements call for staff testing at least weekly in areas where the virus is spreading.

— During the same period, nearly 1 in 5 nursing homes reported shortages of basic protective supplies such as masks and gowns.

— Nearly 1 in 4 facilities reported a nurse staffing shortage.

Most of the states in the study are in the middle and northern tiers of the country.

The Commons, a senior living community in Enid, Oklahoma, that includes a nursing home, is in a coronavirus hotspot. The oil and gas hub has a positive rate approaching 18%. A local mask mandate has twice been shot down, said Steven Walkingstick, CEO of The Commons.

“From my standpoint, a mandate unfortunately is needed,” said Walkingstick. “I don’t want the government involved, but evidence has shown we are not going to do this voluntarily.”

Walkingstick said he believes the U.S. has gotten better at saving the lives of COVID-19 patients, but not at keeping the virus out of nursing homes.

Thorson, head of the Fort Dodge facility, said it takes a lot of effort to try to keep the virus out, and it's demoralizing to see it break through.

“Don’t forget about us, because we are still here, doing the best we can in rural areas,” she said.

The 20 states analyzed in the study were Alaska, Arkansas, Iowa, Idaho, Indiana, Kansas, Kentucky, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Dakota, Utah, Wisconsin, West Virginia, and Wyoming. They were selected because they're now seeing their highest hospitalization rates for COVID-19.

Minnesota Coronavirus Cases

Data is updated nightly.

Cases: 582576

Reported Deaths: 7284
CountyCasesDeaths
Hennepin1208311715
Ramsey50357867
Dakota45046442
Anoka40774432
Washington26338278
Stearns21901220
St. Louis17502302
Scott16980124
Wright15722135
Olmsted1309797
Sherburne1139484
Carver1031645
Clay807492
Rice7952106
Blue Earth739241
Crow Wing651888
Kandiyohi647282
Chisago581051
Otter Tail567578
Benton560197
Goodhue470872
Mower460332
Douglas459574
Winona448450
Itasca417953
McLeod417258
Morrison413660
Isanti408262
Nobles406748
Beltrami387358
Steele381015
Polk379567
Becker375449
Lyon357650
Carlton340353
Freeborn339529
Pine323521
Nicollet320943
Brown303040
Mille Lacs297152
Le Sueur285322
Todd277431
Cass265528
Meeker250140
Waseca235721
Martin227731
Roseau205019
Wabasha20313
Hubbard183341
Dodge18133
Renville178043
Redwood170836
Houston169215
Cottonwood162721
Fillmore153810
Pennington153319
Wadena152321
Chippewa151338
Faribault149919
Kanabec142424
Sibley140910
Aitkin133136
Watonwan13009
Rock127219
Jackson121211
Pipestone113826
Yellow Medicine113520
Pope10806
Murray10559
Swift103918
Stevens88511
Marshall87417
Clearwater85716
Koochiching81314
Lake80619
Wilkin79812
Lac qui Parle74922
Big Stone5934
Lincoln5733
Grant5648
Mahnomen5408
Norman5379
Unassigned48893
Kittson48122
Red Lake3957
Traverse3685
Lake of the Woods3183
Cook1560

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 364579

Reported Deaths: 5902
CountyCasesDeaths
Polk57228619
Linn20701333
Scott19754239
Black Hawk15746307
Woodbury15087228
Johnson1439083
Dubuque13322209
Dallas1109597
Pottawattamie11036166
Story1054248
Warren572988
Clinton551692
Cerro Gordo535689
Sioux512474
Webster510892
Marshall480875
Muscatine473899
Des Moines451466
Wapello4283122
Buena Vista424140
Jasper413070
Plymouth400179
Lee372355
Marion360075
Jones296857
Henry290437
Carroll284752
Bremer282460
Crawford264340
Boone262334
Benton254955
Washington253050
Dickinson247343
Mahaska229250
Jackson220742
Clay214725
Kossuth214764
Tama208871
Delaware208040
Winneshiek196433
Page192121
Buchanan190431
Cedar188823
Fayette184441
Hardin184443
Wright183336
Hamilton179249
Harrison179173
Clayton168756
Butler163834
Mills161321
Madison160319
Floyd159542
Cherokee158338
Lyon157541
Poweshiek154633
Allamakee150351
Iowa147924
Hancock146434
Winnebago140831
Cass137654
Grundy135932
Calhoun135813
Emmet133740
Jefferson132135
Shelby130537
Sac130019
Appanoose128047
Louisa127849
Union127632
Mitchell125642
Chickasaw123615
Guthrie120729
Humboldt118726
Franklin116421
Palo Alto112123
Howard104122
Montgomery102737
Unassigned10070
Clarke99624
Keokuk95331
Monroe95028
Ida90334
Adair86232
Pocahontas85422
Monona82830
Davis81324
Osceola77916
Greene77610
Lucas76823
Worth7348
Taylor65612
Fremont6219
Decatur6059
Van Buren55618
Ringgold54524
Wayne53223
Audubon5069
Adams3374
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