Covid-19 cases plunge 83% of US nursing staff, despite vaccine vaccination

Months later, the danger seems to have faded. Following the deployment of covid vaccines, the number of new covid cases among people in the nursing home fell by 83% – from 28,802 for the week ending December 20 to 4,764 for the week ending February 14, data from the Centers for Medicare & Medicaid Services screenings.

New covid-19 infections among nursing home residents declined even more sharply during that period, by 89%, compared with 58% in the general public, according to data from the CMS and Johns Hopkins University.

These numbers suggest that “the vaccine appears to have a dramatic effect on reducing cases, which is extremely encouraging,” said Beth Martino, spokeswoman for the American Health Care Association and the National Center for Assisted Living, an industry group. .

“It’s a big relief for me,” says Phillips, who works at the North Beach Rehabilitation Center outside Miami. Now, she said, she is appealing to reluctant co-workers and anyone else who ‘can take vaccination’.

After a brutal year in which the pandemic killed half a million Americans, despite unprecedented measures to combat its spread – including wearing a mask, physical distance, closing the school and economic closures – the vaccines give hope that a end is in sight.

CMS noted that more than 3 million doses of vaccine have been distributed in nursing homes, and CMS on Wednesday issued new guidelines that allow for indoor visits to the facilities in most circumstances, even among non-vaccinated residents.

National figures on health care workers in other areas are hard to come by, but some trends across the country look promising. In California and Arkansas, cases of health care workers have declined faster than for the general public since December, and in Virginia, the number of hospitals unemployed for co – operative reasons has dropped dramatically.

Research in other countries suggests that vaccines have led to large declines in infections. A study of publicly funded hospitals in England indicated that a first dose was 72% effective in preventing covida among workers after 21 days and 86% effective seven days after the second shot. At the Sheba Medical Center – the largest hospital in Israel, with more than 9,600 employees – 170 staff members tested positive from December 19, the first day the vaccine was offered, until January 24. Of those who tested positive, only three received both doses of the vaccine, according to The Lancet.
Lost on the Frontline, a year-long data and reporting project by KHN and The Guardian, investigates more than 3,500 deaths of U.S. health workers. The monthly number has decreased since December, but deaths often stay weeks or months behind infections.

Along with other health care workers, nursing home staff and residents were the first to receive vaccinations in December because elderly people in congregations are among the most vulnerable to infections: more than 125,000 residents died from covid, CMS data show, while more than 550 000 staff members of the old age home tested positive and more than 1 600 died.

Yet the vaccination rate among staff is much lower than that of residents. When the first clinics took place from mid-December to mid-January, a median of 78% of nursing home residents took a dose, while the median was only 38% for staff, according to the Centers for Disease Control & Prevention. Now, several nursing home associations are saying that the vaccination of staff has increased, based on informal surveys.

While vaccines “contribute to the observed decline in COVID-19 cases in nursing homes, other factors, such as effective infection prevention and control programs / practices, are also at stake,” said CDC spokeswoman Jade Fulce.

The uptake of vaccines by nursing home residents was ‘very promising’, says Dr. Morgan Katz, a specialist in infectious diseases at Johns Hopkins University, who advises on reactions in nursing homes. “I think it’s a big contributing factor” to the decline in staffing.

“If the immune system is activated faster” due to vaccination, “the virus cannot multiply in your body and your respiratory tract,” Katz said. If you even have one or two vaccines in a building, it can slow down the spread.

Another factor, Katz said, is that “many nursing homes have already experienced major outbreaks – so there is likely to be a significant portion of residents and staff who are already immune.” Rates have also fallen nationally following a rise in holiday travel and gatherings in November and December, leaving staff with less exposure in their communities.

But “although we see a wonderful turnaround in the number of cases,” she must remember, as long as the staff is vaccinated 50 or 30%, they remain defenseless. incredibly vulnerable long-term caregivers who are at risk. ‘

Vaccination efforts are being rushed by the time new covid variants circulate and some states dramatically relax covid restrictions, making it easier for the virus to spread.

During the second week in February, 2,850 nursing homes still reported at least one new positive test result for a staff member, the CMS data show.

When that happens, residents suffer, says Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care. She said she hears of cases where one positive test result causes a facility to be locked up, preventing families from visiting their loved ones.

“They are scared”

The New Jersey Veterans Memorial Home in Menlo Park last year had a major outbreak in which more than 100 workers collectively contracted and more than 60 residents and a certified nursing assistant, Monemise Romelus, died. Shirley Lewis, a union president representing CNAs and other workers, said it was traumatic. Only half of the workers there have taken the vaccine, Lewis said, and one is sick with covid.

“A lot of my members are not excited about taking this vaccine because they are scared,” Lewis said.

Some workers want to wait a little longer to see how safe the vaccine is, she said. Others tell her they do not trust the vaccines because they were developed so quickly, she said.

Other staff members “feel like it’s an experimental tool,” Lewis said, “because as you know, blacks, Latinos, other groups have been used for experiments,” like the Tuskegee syphilis study, she said. She said her members are mostly black or Hispanic.

Certified nursing assistants, who make up the majority of long-term care workers, have historically been less likely to get flu vaccines than other health care workers, studied Jasmine Travers, an assistant professor of nursing at New York University. Nursing homes usually do not have nursing educators, which addresses workers’ concerns about vaccinations in hospitals, and CNAs also face structural barriers, such as limited internet access. Nursing homes are usually hierarchies usually led by white staff members, while about 50% of the CNAs at the bottom of the power structure are black or Hispanic, and have mistrust and different attitudes toward vaccination, she added.

Some people are afraid with the vaccine for enthusiasm that they will have to take sick time to miss work and do not want to tax their co-workers, who already have short staff, Travers said.

According to KFF, vaccine hesitation is higher among 30- to 49-year-olds, rural residents and black and Hispanic adults. Spanish adults are less likely than white adults to say they will “definitely” get the vaccine, as well as black adults working in a healthcare setting. Black adults were excessively burdened by the pandemic and left behind in the vaccination due to barriers due to structural racism.

Deliberate misinformation

A low intake of vaccines among long-term care workers is a concern across the country – so much so that LeadingAge, a national group representing long-term non-profit long-term care facilities, held a virtual town hall this month on vaccine safety with the Black Coalition. Teen COVID-19.

The event, which attracted more than 45,000 viewers, was aimed at black long-term care workers.

Dr. Reed Tuckson, co-founder of the Black Coalition Against COVID-19, said viewers were concerned about fertility, pregnancy and contraindications. He said the event also had ‘many challengers’ who insisted:’ It’s all a myth. It’s all a lie. ‘

His group plans to hold more public information sessions for black audiences.

“There is no doubt that the three vaccines we now have available are extremely safe and extremely effective,” said Tuckson, a former public health commissioner in Washington, DC.

The nursing home industry aimed to have 75% of staff nationwide vaccinated by the end of June.

A vaccine mandate?

Most nursing homes did not require vaccination, industry officials say, for fear of losing staff. Since the vaccines were granted in an emergency, liability is also a concern.

Juniper Communities, which operates 22 long-term care facilities in four states and employs nearly 1,300 people, laid off 30 workers after being vaccinated by vaccines, according to Drs. Lynne Katzmann, President and CEO.

“If you can make a choice at the end of the day to promote well-being and prevent disease, that’s the choice we want to make,” she said.

Greenbrier Nursing and Rehabilitation Center in Arkansas made the vaccine mandatory, but due to medical exemptions, it did not result in 100% vaccination.

However, Greenbrier has seen a significant decrease in coviate infections since vaccination began. In late November and early December, more than 60% of staff members tested positive, according to Regina Jones, Greenbrier’s director of nursing. After staff began receiving the vaccine at the end of December, four workers who had already received a dose tested positive but asymptomatic.

Hesitation does not mean refusal

Tuckson said he sees a “dramatic decline” in vaccination of vaccines, based on recordings of black audiences. He heard “a hunger for scientifically valid information provided by trusted sources,” he said. “It’s not like their opinions are locked in stone.”

Staff participation increases with each round of vaccinations, says Martino, spokesperson for the nursing home industry.

In the Jewish home in Los Angeles, dr. Medical Officer Noah Marco said his staff “did everything in our power to dispel the nonsense on social media that contributed to the hesitation of vaccines”, including producing videos and a weekly newsletter.

“The vaccine may have some unknown side effects,” he told workers, “but we know the virus kills.”

About 80% of its 1,600 staff – which includes workers in nursing homes and other institutions – are vaccinated, he said, along with 99% of residents. No residents of nursing homes have contracted covid since 13 January.

In southwest Ohio, Kenn Daily owns two nursing homes at Ayden Healthcare. About half of its staff and 85% of the residents had been vaccinated by mid-February, and they have not had a case of covid since. Still, he said, there is vaccine resistance among younger staff members who read misinformation online.

“Facebook is the object of my existence,” Daily said. Workers tell him that they are worried that ‘they are going to microchip me’, or that the vaccine will change their DNA.

Now that time has passed since its initial implementation, Daily said: “I hope to put some pressure on my staff to act and vaccinate.” His message: “It works, guys. It works very well.”

Elizabeth Lucas, data editor of KHN, contributed to this report.

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