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COVID-19 Cases, Deaths Drop Dramatically in Nursing Homes

Vaccines and herd immunity are delivering relief after 170,000 deaths

spinner image three nursing home residents at different tables getting covid vaccine shots
MediaNews Group/Orange County Register via Getty Images

COVID-19 cases and deaths in U.S. nursing homes have fallen dramatically in the first two months of 2021 after peaking around the holidays, according to a new report from the Kaiser Family Foundation that offers some good news for residents and staff who have been battered by the pandemic.

New weekly COVID-19 deaths in nursing homes have fallen 66 percent since late December, according to the report, which was published Wednesday and is based on federal data from the Centers for Medicare & Medicaid Services. New cases are down 83 percent over the same period. The report's findings track with AARP's COVID-19 nursing home dashboard, which shows nursing home infections peaked in the weeks leading up to New Year's Day but have since declined. The number of new cases and deaths outside long-term care facilities have also fallen from holiday highs.

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Experts warn that it's much too soon to declare victory in the fight against COVID-19 in long-term care facilities, and that long-term infection control issues and staffing shortages persist. The authors of the Kaiser report note that the decline in long-term care cases and deaths began around the time COVID-19 vaccines were first made available to residents and staff, who account for less than 1 percent of the U.S. population but 35 percent of the country's COVID-19 deaths. The virus has killed more than 170,000 people in long-term care settings, according to the COVID Tracking Project. “The data is clear. The vaccine is making a difference,” Mike Wasserman, M.D., a geriatrician and past president of the California Association of Long Term Care Medicine, says of the Kaiser report.

The federal partnership with CVS, Walgreens and other pharmacies tasked with delivering the first shots of two-dose vaccines from Pfizer and Moderna to residents and staff of nursing homes got off to a slow start late last year. But it has since picked up the pace, finishing its first round of nursing home shots in late January. CVS announced Wednesday that it had administered second-round vaccines at almost all of the nearly 8,000 skilled nursing facilities it's working with across the country.

But the Kaiser researchers stop short of saying the decline in cases and deaths is attributable to vaccines alone. Bill Sweeney, senior vice president of government affairs at AARP, notes that COVID-19 outbreaks were so severe in long-term care facilities around the holidays that the numbers “didn't have anywhere to go but down.” AARP's dashboard shows roughly 1 in every 51 nursing home residents died of COVID-19 between Dec. 21 and Jan. 17.

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A degree of herd immunity may also be contributing to the decline. More than 1.3 million long-term care residents and staff are known to have been infected — and that's likely an undercount. Justin Lessler, an associate professor of epidemiology at the John Hopkins Bloomberg School of Public Health, recently told AARP that state and county restrictions are likely also playing a role. “During the big COVID surges, control measures were put in place,” he said. “Some places had some fairly vigorous control measures — they reduced community transmission. Combined with the accumulated immunity in the population, [they have] been enough to turn the corner."

But plenty of hurdles remain, including that long-term care staff have been more reluctant than residents to get vaccinated. “It's not enough to celebrate the vaccine,” Sweeney says. “We need to commit ourselves to getting to the root of the problem and improving the way we take care of people in this country who need long-term services and support."

Watch: Why COVID-19 Killed So Many People in Nursing Homes

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