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Nursing home resident, staff COVID-19 cases on rise as virus surges in community

Detroit Free Press - 11/13/2020

The state's nursing homes are seeing an increase in coronavirus cases and deaths among residents and staff, and several groups are sounding the alarm to protect these vulnerable residents and those who care for them as the virus surges in Michigan and across the country.

On Thursday, AARP Michigan said new coronavirus cases and deaths in nursing homes are reflective of recent upward trends in Michigan's general population and that there are shortages in staff and personal protective equipment (PPE).

"COVID-19 is still spreading in the community. Continuing shortages of PPE and staff mean many facilities aren’t prepared for another wave," AARP State Director Paula Cunningham said.

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The American Health Care Association and National Center for Assisted Living also released a report this week that said new coronavirus cases are increasing in nursing homes across the country because of community spread in the general population. They represent more than 14,000 nursing homes and assisted living communities across the country.

The alarm comes as leaders from five health systems in Michigan said Thursday that hospitalizations from the coronavirus are doubling every two weeks in the state, and case numbers are growing "exponentially" at a rate of about 40% per week.

On Thursday, the state of Michigan reported there have been 236,225 coronavirus cases and 7,811 deaths since the pandemic began. About a third of the total deaths are nursing home residents, according to the data.

In a weekly report Monday, the state said there were 9,977 resident cases and 2,304 resident deaths from the coronavirus at nursing homes since March. Staff cases totaled 6,283 and there were 24 staff deaths from the virus, according to the state data.

Nursing homes have been particularly hard hit since the virus broke out in the spring, and officials were forced to shutter their doors to visitors for months in an effort to protect them.

Dr. Joneigh Khaldun, chief medical executive and chief deputy director for the Michigan Department of Health and Human Services, said Thursday "things are looking very grim" with the virus, with numbers increasing rapidly and no area of the state spared.

She said there are 747 active outbreaks, with long-term care settings in the top categories, as well as manufacturing, schools, health care settings and restaurants and bars.

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"We are monitoring the trend of increasing COVID-19 cases across Michigan with great concern," said Lynn Sutfin, spokeswoman for the state health department.

She said in the two-week period from Oct. 21 to Nov. 4, nursing facilities reported 854 new resident cases and 885 staff cases. In the same period a month ago, from Sept. 21 to Oct. 4, they reported 250 new resident cases and 292 staff cases.

More indoor visits in certain circumstance were permitted in nursing homes, with visitation rules linked to the risk level of an individual county, starting Oct. 26. Sutfin said cases were growing prior to this, as facilities reported 322 resident cases and 331 staff cases in the week from Oct. 21 to Oct. 28.

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Indoor visits are only allowed in areas where a risk level is A, B, C or D or as long as the facilities have had no new cases of residents or staff within the prior 14 days.

No indoor visitation is allowed at risk level E. As of Nov. 7, Sutfin said, nearly all counties were in risk level E with the exceptions of Alcona, Alpena, Montmorency and the city of Detroit.

Gov. Gretchen Whitmer said the second wave of the virus is "hitting us and it's hitting us hard" and "we are in the worse part of this pandemic to date." Hospitals are nearing capacity and burning through PPE, and she urged people to do their part for front-line workers, who could face staff shortages.

The Long Term Care Community Coalition said Thursday the latest federal staffing data indicates that most nursing homes in the U.S. were understaffed at the height of the pandemic in the second quarter of this year. Despite coronavirus relief aid, facilities haven't invested sufficiently in staff to meet residents' needs.

The AARP said it created a nursing home COVID-19 dashboard to provide four-week snapshots of the virus' infiltration into nursing homes and the impact on residents and staff. For the period Sept. 21 to Oct. 18, AARP states its dashboard represents that Michigan nursing homes had:

1.9 COVID-19 cases per 100 residents, up from fewer than one case per 100 residents in the previous four-week period 0.34 COVID-19 deaths per 100 residents, about three times the number from the previous four-week period 2.5 staff COVID-19 cases per 100 residents, up slightly from the previous period 25.9% of nursing homes without a one-week supply of PPE, down from 30% 36.3% of nursing homes with staffing shortages, up from slightly from the previous period.

Cunningham said there should be regular and ongoing testing and adequate PPE for residents, staff, inspectors and visitors; and daily public reporting of cases and deaths among other measures, which she said are in a plan drafted Aug. 31 by the Michigan Nursing Homes COVID-19 Preparedness Task Force.

The American Health Care Association and National Center for Assisted Living said during the week of Oct. 18, 41% of new cases in nursing homes were from Midwest states with major spikes in community spread in the upper parts of the region.

"As a result, the Midwest region saw a 120% increase in weekly COVID cases in nursing homes since mid-September," according to a release.

The groups said after seven weeks of declining cases in nursing homes through mid-September, cases in those facilities began to increase as more than 35 states started to see rising levels of coronavirus cases.

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They said weekly cases in nursing homes grew by 44% nationwide between mid-September and the week of Oct. 18; COVID-19 related deaths in nursing homes also rose slightly.

The groups said residents of long-term care facilities account for 8% of the nation's cases, yet 40% of its deaths. While death rates have decreased compared with the spring because of a better understanding of the virus, better treatments and government resources to help reduce spread, they said, there is concern the rising number of new cases in facilities will lead to an increasing number of deaths.

“As we feared, the sheer volume of rising cases in communities across the U.S., combined with the asymptomatic and pre-symptomatic spread of this virus, has unfortunately led to an increase in new COVID cases in nursing homes," said Mark Parkinson, president and CEO of AHCA/NCAL.

“It is incredibly frustrating as we had made tremendous progress to reduce COVID rates in nursing homes after the spike this summer in Sun Belt states. If everybody would wear a mask and social distance to reduce the level of COVID in the community, we know we would dramatically reduce these rates in long term care facilities," he said.

Contact Christina Hall: chall@freepress.com. Follow her on Twitter: @challreporter.

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This article originally appeared on Detroit Free Press: Nursing home resident, staff COVID-19 cases on rise as virus surges in community

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