Nursing home deaths, cases tiny fraction of level during previous surges

Local Coronavirus Coverage

JOHNSON CITY, Tenn. (WJHL) – A year ago, nursing homes and other long term care facilities were battling devastating COVID-19 outbreaks that had them accounting for as much as half of all COVID deaths.

Today, in the midst of what is rivaling the winter as the worst surge yet, long term care cases and deaths are a tiny fraction of what they were between August and February.

Dr. Stephen May, medical director at the Sullivan County Regional Health Department, chalks the difference up to one primary factor.

“It’s obvious we’ve staved off a major outbreak in nursing homes,” May told News Channel 11 Tuesday.

“We’re seeing some increases but not near what we saw last year, and the big changer in that is the vaccine provided to the bulk of the residents. Greater than 90 percent of the residents have received the vaccine, and that’s the way you break the outbreaks that do occur within the nursing homes.”

News Channel 11 analyzed data from two four-week periods with similar numbers of total COVID cases reported in the seven-county Northeast Tennessee region.

From Nov. 13 to Dec. 11, 10,085 cases were reported along with a total of 176 deaths.

During that same period, area nursing homes and long term cares reported 285 new cases among residents — 2.8 percent of the total — and 64 deaths, or 36.4 percent of the total.

During that period, facilities operated under very strict guidelines.

May noted that the Centers for Medicare and Medicaid Services (CMS) has “a number of rigid standards as far as protecting patients, protecting staff, wearing masks, doing distancing and testing when the rates are high.”

He called those “very effective tools,” but said they proved little match prior to the rollout of vaccines in late December.

By contrast, the just-concluded period from July 30 through Aug. 27 had a very similar number of total cases with 9,610. Deaths totaled 88.

But this time, only 2.3 percent of deaths — two total — were in long term cares, both at The Waters at Roan Highlands. Only 13 resident cases were reported, or 0.14 percent of the total.

Since mid-May, Northeast Tennessee has recorded five nursing home deaths and 150 total deaths, putting nursing homes at 3.3 percent of the total.

Though the vaccine is the “chief difference maker,” May said he’s not ready to declare victory against the delta variant in terms of nursing home impact — especially with Northeast Tennessee currently at community spread rates higher than any state in the nation.

“We’re going to have to wait and see,” he said. “We’re still trending upward. We are still seeing clusters within those types of facilities, albeit it’s primarily in the staff and we’re not seeing the deaths associated.

“The way this disease is getting back into nursing homes is only 50 percent or less of the staff are vaccinated and they are carrying it back.”

That’s leading to a few breakthrough cases among vaccinated residents — and perhaps at a higher rate than would occur among younger people.

“Many of those are immunocompromised so even with the vaccine they may not get the best protection that we see in the younger age groups.”

Facilities report weekly to the Tennessee Department of Health (TDH). Statewide, the Aug. 6 report showed 135 resident cases, 9 resident deaths and 213 staff cases among currently active outbreaks.

Three weeks later, those numbers were 438 resident cases, 33 resident deaths and 745 staff cases.

Regionally, the numbers were 8 resident cases, 4 deaths and 18 staff cases Aug. 6. The Aug. 27 totals were 21 resident cases, 5 deaths and 36 staff cases in nine facilities.

That still pales in comparison to numbers from nine months ago. With case rates through the region even lower than they are now, long term care facilities had 23 active outbreaks that had accounted for a total of 654 resident cases, 81 resident deaths and 459 staff cases.

May said he thinks at some point “we will probably have to see a requirement for those who work in the health care industry to go ahead and get the vaccine.”

He’s seeing more mandates among health care providers, though none has yet occurred regionally. Vaccinations for hepatitis B, influenza and several other communicable illnesses are required by many health care providers already.

“I think this will become another industry standard,” May said. “We’re not there yet but I think it’s coming.”

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