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Latest wave of coronavirus cases fuels record number of nursing home outbreaks as the virus quickly spreads in long-term care facilities in the Midwest and Great Plains, while also reappearing in overwhelmed facilities by the first wave of the virus. .
More than 1,300 nursing homes across the United States have reported having three or more confirmed cases of Covid-19 in the first week of November – the highest number ever reported in a single week, according to an analysis by NBC News Federal Data. The figure does not include outbreaks in assisted living homes, which the federal government does not track.
Many of the new nursing home infections are emerging in the Midwestern states where the virus besieges the entire community, including Illinois, Ohio, Missouri, Indiana, Wisconsin and the ‘Iowa, which reported some of the nation’s largest weekly increases in suspected and confirmed resident cases, data showed. (Facilities report suspected cases when residents show symptoms of Covid-19 but have not yet received positive test results.)
The number of nursing home cases has also increased in rural areas, with peaks in the Great Plains. South Dakota facilities reported 253 new infections among residents in the week ending Nov. 8 – three times the number reported a month earlier. And across the country, a large number of facilities are reporting a staff shortage, and some are still struggling to acquire reliable personal protective equipment and testing.
“It’s a wildfire. You put it out in one place and then it shows up elsewhere,” said Bill Sweeney, senior vice president of government affairs at AARP, who urged Congress to provide more funding for testing, personal protective equipment and personnel for the 15,000 nursing homes nationwide.
Friendship Haven, which operates a nursing home and assisted living facility in Fort Dodge, Iowa, has had a few isolated cases of Covid-19 over the summer, but amid the state’s record rise , 12 staff and 14 residents have recently tested positive.
“Masks are still not acceptable here, and it’s very frustrating. The community isn’t really understanding, ”said Julie Thorson, President and CEO of Friendship Haven. “You worry about the inconvenience of a mask, and my staff have been sweating and crying through their masks since March.”
New epidemics are also emerging at facilities that were crushed by the first wave of the pandemic – which killed tens of thousands of residents in the northeast and other early hot spots – only for the virus to return .
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Jewish Senior Services, a nursing home in Bridgeport, Connecticut, killed 22 residents of Covid-19 in the spring; about 10 percent of staff have been infected, said Andrew Banoff, its chief executive officer. Personal protective equipment was so scarce that the facility resorted to purchasing supplies directly from a company in China, he said.
Within months, cases finally calmed down in the facility and in the wider region. In mid-June, Connecticut began requiring weekly Covid-19 testing for all nursing home staff and residents and funded all testing. Other states have implemented similar testing requirements, although not all pay for testing.
The nursing home was virus-free throughout the summer and into early fall. Then, in mid-October, as the number of cases started to rise again in Connecticut, the first staff member tested positive. Nineteen other staff and eight residents were also infected, Banoff said. Two of the residents died from Covid-19 last week.
“We knew we were late,” Banoff said. “But it was devastating when we all had to come in and call families – not just residents who tested positive, but those who were exposed by staff. We had to make 84 phone calls.
Jewish Elder Services and other long-term care facilities have better access to testing and personal protective equipment than the source. The federal government has also distributed billions of dollars in Covid-19 relief funds to nursing homes, along with rapid testing machines, although they are less accurate than laboratory tests.
But nursing homes across the country are still reporting shortages of protective equipment and delays in testing. As of the first week of November, 1 in 10 establishments said they did not have a week’s supply of N95 masks, according to federal data. Almost a third of all nursing facilities said they had to wait three to seven days to receive Covid-19 test results.
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Providers fear that access to protective equipment and testing will become more difficult as the number of cases continues to rise. The federal government unveiled new testing guidelines at the end of August, requiring staff members to be tested monthly, weekly, or twice a week, depending on a county’s overall positivity rate. . But nursing homes still struggle to access the tests, allowing staff members to administer them and cover the costs, according to LeadingAge, an industry group that represents nonprofit long-term care facilities. .
“Our calls are being ignored. The support we have received is insufficient and is running out quickly, ”Katie Sloan Smith, CEO of LeadingAge, said on Monday during a press call. “The virus is raging, infection rates are skyrocketing and the pool of financial support is depleting.”
The national stock – intended to serve as support for health establishments which have exhausted their supplies – is also facing deficits. In July, the federal government said it wanted a 90-day supply of essential personal protective equipment. However, last week the strategic national stockpile contained only about half of the 300 million N95 masks needed and less than 1% of the gloves needed to reach the goal, according to figures from the Department of Health and Human Services. .
Widespread staff shortages are even more worrying. According to the latest federal data, one in five nursing homes in the United States report a shortage of nursing assistants and 17% have a shortage of nurses. While adequate staffing in long-term care facilities has long been an issue, due to low wages and difficult working conditions, the pandemic has exacerbated staff shortages, which new research has linked to problems. higher rates of infection with Covid-19.
“We’re going to see more and more staff shortages across the country as staff get sick and really don’t want to work in conditions where they don’t feel protected. And he doesn’t feel supported in terms of salary or benefits, ”said David Grabowski, professor of health care policy at Harvard Medical School.
Victoria Richardson, who earns $ 14 an hour as a certified practical nurse at a Chicago-area nursing home, said her facility has been bleeding staff members since the start of the pandemic. When the first wave of the virus hit Forest View Nursing and Rehabilitation Center in the spring, management began paying a risk premium of $ 200 every two weeks, but stopped additional payments in August. she declared.
Staff at the facility are re-infected, federal records say, but the risk premium has not returned to Forest View or other Chicago-area nursing homes run by Infinity Healthcare Management , according to the Service Employees International Union Healthcare, which represents Richardson and other staff members. (Infinity Healthcare Management did not respond to multiple requests for comment.)
Richardson, 51, has struggled to pay her bills since her husband died of cancer in September, and she now fears losing her home. She is also still worried about contracting the virus, which has killed 18 residents of Forest View since the start of the pandemic. Even now, she said, staff members are struggling to get proper protective gear. On Monday, Richardson and nearly 700 other workers at Infinity Nursing Homes went on strike demanding higher pay and proper protective gear.
“I have to reuse the same mask for a week, and I’m not getting N95 unless I insist on having it,” Richardson said.
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