Virus Cases Spike In Nursing Homes; See Numbers In Maryland

MARYLAND — After seven weeks of declining weekly coronavirus cases, nursing homes in Maryland and across the United States are seeing a new spike in cases, according to a report recently released by the American Health Care Association and National Center for Assisted Living.

The report ties the increasing number of cases in nursing homes to surging cases in communities and comes as the United States continues to hit consecutive daily records related to the coronavirus.

This week, the country saw a record number of people hospitalized due to the virus. Nearly 1 million new cases of coronavirus were reported in the first 10 days of November across the United States, and Maryland saw three days in the last week with the highest number of cases reported in a 24-hour period.

In Maryland, state health officials say 17,191 cases of the virus have been reported in nursing homes and long-term care facilities. There have been 2,222 deaths at these facilities due to the coronavirus as of Nov. 11, according to the Maryland Department of Health, which account for 53 percent of the state's deaths from COVID-19, the disease caused by the virus.

To prevent outbreaks at nursing homes, Maryland has issued new guidance.

"To protect our loved ones, Marylanders should take all precautions, including all visitors getting tested prior to visiting a nursing home facility," Maryland Gov. Larry Hogan said at a Nov. 10 news conference. "Nursing home and assisted living program staff must minimize their contact and avoid all gatherings and work with their management on communicating early and often about all infection control issues at their facilities."

Maryland Health Secretary Robert Neall issued a public health advisory Nov. 10 that strongly encourages nursing homes with more than 50 beds to test staff members at least once a week. State officials say they recently sent rapid antigen tests to nursing homes across Maryland.

Neall also issued an order at the end of October requiring all nursing homes to maintain a 30-day private stockpile of personal protective equipment (PPE) by Nov. 30 and to have a 60-day private stockpile by Jan. 31, 2021.

As of Thursday, 115 of Maryland's 226 nursing homes reported having at least a 15-day supply of the required PPE, according to Maryland Matters.

Nationwide, more than 281,000 coronavirus cases and more than 63,600 deaths have been reported in U.S. nursing homes and long-term care facilities, according to the Centers for Medicare and Medicaid.

Among the states, Maryland ranks 15th nationwide for deaths per 1,000 residents and 20th for cases per 1,000 residents, the federal data shows.

After seven weeks of declining cases, nursing homes in 35 states reported a spike in cases starting in mid-September, according to the report released by the American Health Care Association and National Center for Assisted Living. New weekly cases in U.S. nursing homes grew by 44 percent between mid-September and mid-October.

During the week of Oct. 18, the report states more than 40 percent of new COVID-19 cases in nursing homes were from Midwest states with major spikes in community spread.

The report also shows an uptick in the number of coronavirus-related deaths within U.S. nursing homes.

Looking back further, an analysis of federal data from 20 states by the Associated Press found that new weekly cases among nursing homes and long-term care residents rose nearly fourfold from the end of May to late October. Resident deaths more than doubled.

Nursing home staff are also getting sick at higher rates. Weekly cases among staff in surge states more than quadrupled during that period, the Associated Press reported.

Nursing homes and other long-term care facilities account for about 1 percent of the U.S. population and 8 percent of total COVID-19 cases, but they represent 40 percent of COVID-19 deaths, according to the COVID Tracking Project.

Now, industry leaders are calling on Congress to pass additional relief legislation that would include $100 billion for more frequent, prioritized testing for staff and residents at nursing homes and long-term care facilities.

The Trump administration already allocated $5 billion to nursing homes, shipping nearly 14,000 fast-test machines and helping to shore up stocks of personal protective equipment. But Tamara Konetzka, a health researcher at the University of Chicago, told the Associated Press that nursing homes cannot be protected without controlling community spread.

“Trying to protect nursing home residents without controlling community spread is a losing battle,” said Konetzka, a nationally recognized expert on long-term care. “Someone has to care for vulnerable nursing home residents, and those caregivers move in and out of the nursing home daily, providing an easy pathway for the virus to enter.”

Officials with the Centers for Medicare and Medicaid Services, however, issued a statement saying that “the bottom line is that the COVID-19 pandemic’s effect on nursing homes is complex and multifactorial.”

Said the statement: “Many times, the likely causes of nursing home outbreaks are simply nursing homes failing to comply with basic infection control rules."

— By Megan VerHelst and Elizabeth Janney

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