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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: 276500

Reported Deaths: 3321
CountyCasesDeaths
Hennepin590031089
Ramsey24988472
Anoka19724213
Dakota19215176
Washington12538106
Stearns1226689
Scott753854
St. Louis740897
Wright663436
Olmsted610130
Sherburne512539
Clay445155
Carver409712
Blue Earth373511
Rice361431
Kandiyohi348215
Crow Wing316130
Nobles296028
Chisago28398
Otter Tail266615
Benton261940
Winona246128
Mower236722
Polk228621
Douglas219829
Morrison211621
Lyon193711
McLeod18879
Beltrami184615
Goodhue177626
Becker17559
Itasca168924
Steele16756
Todd165312
Isanti165015
Carlton153610
Nicollet146523
Freeborn13935
Mille Lacs132830
Le Sueur13219
Waseca129710
Cass12018
Pine11926
Brown117510
Meeker10797
Roseau9923
Martin98220
Hubbard97022
Wabasha9121
Dodge7850
Redwood78018
Watonwan7754
Chippewa7697
Sibley7094
Renville70818
Cottonwood7060
Wadena7006
Aitkin68923
Pipestone67018
Rock6439
Houston6152
Fillmore6050
Yellow Medicine56611
Pennington5356
Kanabec52911
Murray5283
Swift4976
Pope4820
Faribault4750
Stevens4442
Clearwater4356
Marshall4277
Jackson4091
Lake3584
Unassigned34356
Koochiching3325
Wilkin3275
Lac qui Parle3203
Lincoln3141
Norman3096
Big Stone2771
Mahnomen2494
Grant2346
Red Lake1903
Kittson1856
Traverse1330
Lake of the Woods871
Cook580

Iowa Coronavirus Cases

Data is updated nightly.

Cases: 213603

Reported Deaths: 2193
CountyCasesDeaths
Polk31707324
Linn13442161
Scott1040375
Black Hawk10393127
Woodbury9932114
Johnson911635
Dubuque879290
Story647619
Dallas602856
Pottawattamie585166
Sioux351925
Webster335930
Marshall332942
Cerro Gordo326541
Clinton307737
Buena Vista291114
Muscatine270366
Des Moines270116
Plymouth259537
Warren258510
Wapello242871
Jones222212
Jasper206639
Marion194418
Carroll190920
Lee190315
Bremer182612
Henry17087
Crawford170615
Benton160315
Tama146340
Jackson13758
Delaware136221
Washington131313
Boone128811
Dickinson127510
Mahaska121327
Wright11625
Buchanan11009
Page10834
Hardin107510
Clay10624
Clayton10234
Harrison102328
Hamilton10157
Cedar101413
Calhoun10047
Mills9886
Fayette9768
Floyd96914
Lyon9668
Kossuth9464
Poweshiek93712
Butler9134
Winneshiek90310
Iowa88011
Winnebago87523
Louisa81316
Hancock8067
Grundy79710
Chickasaw7893
Sac7817
Cherokee7624
Cass75419
Appanoose7426
Shelby7265
Allamakee72411
Mitchell7184
Union7096
Guthrie70815
Emmet70623
Franklin68419
Humboldt6645
Madison6474
Jefferson6351
Palo Alto6064
Unassigned5950
Keokuk5397
Pocahontas5192
Howard5069
Greene4980
Osceola4941
Clarke4614
Davis4405
Ida43910
Montgomery43210
Taylor4312
Monroe42912
Adair4157
Monona3932
Fremont3463
Van Buren3364
Worth3360
Lucas3076
Decatur3000
Wayne2876
Audubon2831
Ringgold1892
Adams1551
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