Weekly COVID-19 infections in nursing homes in 20 states have increased since May. (AP graphic)

Despite efforts by the Trump administration to put up a protective shield around nursing homes, coronavirus cases are increasing in facilities in states hard hit by the recent COVID-19 onslaught.

An analysis of federal data from 20 states for The Associated Press found that the number of new weekly cases among residents nearly quadrupled from 1,083 to 4,274 in late May through late October. According to the study by health researchers Rebecca Gorges and Tamara Konetzka of the University of Chicago, deaths more than doubled from 318 per week to 699.

Equally worrying are the weekly cases among nursing home staff in gushing states, which have more than quadrupled from 855 a week ending May 31 to 4,050 a week ending October 25. This raises the alarm as infected workers who are not yet showing symptoms are seen as the most likely route for the virus to get into facilities. If these ignorant workers test positive, they will be excluded from caring for residents, adding pressure to the remaining staff.

The administration has allocated $ 5 billion to nursing homes, shipped nearly 14,000 rapid testers with the aim of serving each facility, and seeks to shore up protective equipment inventories. However, the data calls into question the White House’s broader game plan, which is pushing states to reopen while ensuring that people at risk can be cocooned even if the virus rebounds around them.

“Trying to protect nursing home residents without controlling community expansion is a lost battle,” said Konetzka, a nationally recognized expert on long-term care. “Someone has to take care of vulnerable nursing home residents, and these caregivers are moving in and out of the nursing home every day to provide easy access for the virus.”

The nation is setting records for coronavirus cases, which is in the cold season when many experts expect the virus to be harder to contain. The seven-day moving average for daily new cases was nearly 104,000 on Saturday, according to Johns Hopkins University.

Nursing homes and other long-term care facilities make up about 1% of the US population, but account for 40% of COVID-19 deaths, according to the COVID Tracking Project.

At Fort Dodge, a manufacturing and transportation center in northern Iowa, Julie Thorson said she knew she was going to have a bad week when several workers at the Friendship Haven nursing home tested positive last Monday. As president of the senior citizens’ community, Thorson contacted the county health department. “They basically weren’t surprised because they see it all over the county,” she said.

Residents also started testing positive. The facility had 11 new cases among residents as of Friday.

COVID-19 cases in nursing homes quadruple in flood conditions

This May 8, 2020, Registered Nurses Beth Andrews (above) and Erin Beauchemin are working with a patient in the COVID-19 intensive care unit at Harborview Medical Center in Seattle. (AP Photo / Elaine Thompson, File)

“I’ve been thinking all night about what’s worse, getting it hit and not knowing what you’re getting yourself into, or prepare it, prepare and prepare and then get hit,” she said.

In response to the study results, the federal Centers for Medicare and Medicaid Services issued a statement stating, “The bottom line is that the impact of the COVID-19 pandemic on nursing homes is complex and multifactorial.”

The agency noted several ways the administration has helped nursing homes and said its focus is now on ensuring residents and staff have “immediate” access to a vaccine once approved. But it added that institutions “have primary responsibility for the safety of their residents”.

“Often times, the likely causes of nursing home outbreaks are simply nursing homes that fail to follow basic infection control rules,” the statement said.

However, Konetzka said her research showed that the quality of nursing homes does not have a significant impact on cases and deaths when community prevalence is taken into account. “It’s not like the high quality facilities figured out how to do better,” she said. Other academic experts have come to similar conclusions.

St. Paul Elder Services in Kaukauna, Wisconsin, has been rated highly by Medicare and has had 72 COVID-19 cases among residents and 74 among employees, according to its Facebook page. The first case among residents was August 19 and 15 have died, said the facility’s president, Sondra Norder.

“The results here are really not much different than in New York at the start of the pandemic,” said Norder. “It has been called the perfect killing machine for the elderly, especially those who live in a community.” Kaukauna is a small town about 100 miles north of Milwaukee.

The study, which is based on data reported by nursing homes to the government, also raised other concerns:

– In the week leading up to October 25, about 1 in 6 nursing homes in surge states did not report having tested staff the week before. According to regulatory requirements, employees must be tested at least weekly in areas where the virus is spreading.

– During the same period, almost one in five nursing homes reported a lack of basic protective equipment such as masks and robes.

– Almost one in four institutions reported a shortage of nurses.

Most of the states in the study are in the middle and northern plains of the country.

The Commons, a senior community in Enid, Oklahoma that also includes a nursing home, is in a coronavirus hotspot. The oil and gas hub has a positive rate of almost 18%. A local mask mandate was shot down twice, said Steven Walkingstick, CEO of The Commons.

COVID-19 cases in nursing homes quadruple in flood conditions

In this file photo dated May 13, 2020, test swabs and sample tubes sit on a table at a COVID-19 testing site in the Abyssinian Baptist Church in the Harlem neighborhood of New York. (AP Photo / Mary Altaffer, File)

“Unfortunately, from my point of view, a mandate is required,” said Walkingstick. “I don’t want the government to be involved, but evidence has shown we won’t do it voluntarily.”

Walkingstick said he believes the US has gotten better at saving the lives of COVID-19 patients, but not at keeping the virus out of nursing homes.

Thorson, director of the Fort Dodge facility, said keeping the virus out was very stressful and it was demoralizing to see it break through.

“Don’t forget about us because we’re still here doing our best 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 are now seeing their highest hospital admission rates for COVID-19.

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