En español | COVID-19 deaths in America's nursing homes continued to surge unabated through the weeks around Thanksgiving, to a rate of about 1 in 65 residents dying per month from the virus, a new AARP analysis of federal data shows. The infection rate among residents jumped by nearly two-thirds over the same period, the analysis found, to a rate of nearly 10 percent of all nursing home residents testing positive for the virus per month.
Less than two weeks ago, an AARP analysis revealed that over a four-week period from mid-October to mid-November nursing homes reported their highest death rate on record since they began submitting data to the government in late spring. More than 8,000 residents died from the virus during that time, a national death rate of 0.78 deaths per 100 residents.
But in the following three weeks, from Nov. 16 to Dec. 6, deaths continued to skyrocket, AARP's new analysis shows. In just 21 days, 12,454 residents died — compared to 8,436 deaths in the previous 28 days — catapulting the national death rate to 1.53 deaths per 100 residents for the period surrounding Thanksgiving.
It's another devastating blow for the long-term care community, which has lost more than 113,000 residents and staff to COVID-19 over the course of the pandemic. Long-term care deaths account for almost 40 percent of all U.S. coronavirus fatalities.
Infection rates in nursing homes also continue to soar. Resident cases surged from 5.7 per four weeks per 100 residents during the Oct. 19 to Nov. 15 period to 9.4 per 100 residents during the Thanksgiving period. Staff infections followed a similar pattern, surging from 5.4 per four weeks per 100 residents to 8.4 per 100 residents.
Alarmingly, the final week of the reporting period, from Nov. 30 to Dec. 6, saw the highest rates in all three categories measured in the new report — resident death rate, resident infection rate and staff infection rate — suggesting that the worst may still be yet to come. The new national infection and death rates eclipse the rates for any individual state at the time AARP began analyzing the federal nursing home data in mid-October.
"Back then, we'd look at states that were really struggling, like Arkansas, North Dakota and South Carolina, and say, ‘Wow, these rates are so high',” says AARP's Ari Houser, a senior methods advisor and coauthor of the new analysis. “But today, the national averages are topping every single one of those states. That shows the whole nation is struggling with this right now.”
The analysis highlights that the recent COVID-19 trends occurring in nursing homes track closely with the COVID-19 trends occurring in the general population. Total reported U.S. COVID-19 deaths nearly doubled from about 8,000 in the week ending Nov. 15 to more than 15,000 in the week ending Dec. 6, while new cases increased from 1 million to 1.4 million over the same time period, the analysis says.
"The virus gets introduced into these facilities through community networks of transmission,” said Justin Lessler, an associate professor of epidemiology at the John Hopkins Bloomberg School of Public Health, in an earlier interview with AARP. “So, if the virus is transmitting more efficiently in the community, no matter what measures we take to protect these facilities, the chance of the virus getting in is going to increase because the people who work there, and visitors — they're all more likely to become infected."
With Christmas just around the corner and with COVID-19 infections still raging in the general population across the entire nation, advocates for residents are pleading to families to reconsider visiting loved ones in nursing homes over the holiday period, or to exercise extreme caution if they do.
"We really need to quadruple down on the CDC guidance,” says John Sauer, president and CEO of the Wisconsin branch of LeadingAge, an advocacy group representing nonprofit long-term care facilities. “Everyone knows what [the rules] are, but for God's sake, we have to follow them for society."
The AARP special report, conducted by the AARP Public Policy Institute and the Scripps Gerontology Center at Miami University in Ohio, draws primarily on data acquired from the Nursing Home COVID-19 Public File by the Centers for Medicare & Medicaid Services (CMS). Nursing homes are federally certified and are required to submit data to the government each week.
The analysis uses data from three consecutive four-week periods — Aug. 24 to Sept. 20, Sept. 21 to Oct. 18 and Oct. 19 to Nov. 15 — and one three-week period — Nov. 16 to Dec. 6 — which captures the latest data available. Data for the most recent three-week block was adjusted to a four-week rate in order to compare it directly to the previous analyses. Around 95 percent of the nation's 15,000-plus nursing homes submitted data for each reporting period. The next AARP analysis will be released in mid-January.
–Andrew Soergel contributed reporting.