Nursing home deaths on the decline as vaccination progresses, but hurdles ahead

Jan. 26—The rate of COVID-19 deaths among long-term care residents has begun to fall as more residents get vaccinated, though the trend is fragile and significant obstacles remain as the state broadens eligibility for vaccination.

"It could be the beginning of a potentially promising trend," said state epidemiologist Benjamin Chan, though he said it is too soon to say for sure if the declining deaths are connected to vaccinations.

In the last two weeks, nursing home residents accounted for less than half of the state's COVID-19 deaths — still a grim figure, but below the 80% of deaths that has been the norm since the beginning of the pandemic.

"That proportion is appearing to decrease," Chan said. The week of Jan. 11, Chan said, 65 Granite Staters died of COVID-19, 34 of whom were long-term care residents, or 52%. That's still too many, Chan said, but it could be a hopeful sign.

"It's still a very early trend," Chan said. "It's difficult, if not impossible at this point, to associate any cause."

But if the trend of fewer deaths in nursing homes continues, Chan said, it would point to the effectiveness of the vaccines.

Even as residents of nursing homes and long-term care facilities receive the second doses of the vaccine, Chan said the state will continue to fund regular testing of residents and staff to keep the virus at bay.

St. Teresa Rehabilitation and Nursing Center in Manchester has had two vaccination clinics, said administrator Luanne Rogers, the first on Dec. 28.

"I think it just brings hope to everybody," she said.

St. Teresa has seen outbreaks, and spates of COVID deaths, Rogers said. "It's heartbreaking," she said, to lose people you have been caring for and whom you have come to know. But Rogers said she hopes with almost all the residents now vaccinated, the outbreaks are over.

Despite difficulties in arranging the vaccine clinics with the pharmacies contracted to provide shots, administrator Chris Martin of Woodlawn Care Center in Newport said he's thrilled nearly all of his residents have received two doses of the vaccine.

Nursing homes, he said, are "the Chernobyl for COVID. We're the ground zero for deaths. Overall it's going to change the tide. I'm willing to put up with a lot of red tape, whatever it takes to get vaccines in folks."

Martin estimated 60% of his staff has taken at least one dose of the vaccine, with some employees waiting for the second clinic to take their first dose.

"People don't want to be the first," Martin said.

About 25 Woodlawn staff members have had COVID after an outbreak that ended in December, Martin said, and some of those people want to rely on any natural immunity they have developed for at least a few months before getting the vaccine.

At St. Teresa, about half of the staff got shots at the first clinic in December, Rogers said. More staffers took the vaccine during the second clinic, on Jan. 18, she said. Some want to wait a few more months, she said. So far, about 70% of her staffers have had at least one dose.

Brendan Williams, president and CEO of the New Hampshire Health Care Association, a trade group for nursing homes, said he had heard that staff members have been less likely to accept a vaccine than long-term care residents, especially the first time the vaccination team comes to a facility.

But after a few weeks of watching other staffers and the residents have no negative reaction to the vaccine, Williams said, more staffers are accepting shots at vaccinators' second visits.

Chan said CVS and Walgreens, the contractors handling instutitional vaccinations, have not broken down how many residents and how many staff have taken the vaccine, only the total number of first and second doses.

Chan said it is critical that staffers are vaccinated as well as residents, because they are more likely to pick up COVID-19 in the community and unwittingly bring it to the facility, exposing other unvaccinated staff members and residents.

Maintaining safe levels of staffing in nursing homes is also important for resident safety, Chan said, and getting staffers vaccinated will mean fewer are out sick or on quarantine.

With thousands of long-term care residents vaccinated, Granite Staters over 65 and with other health conditions that put them at risk of death or serious illness with COVID-19 are beginning to get appointments for their vaccines, though there are mounting concerns about vaccine supply.

"The next thing we need to do is bring deaths overall down," Chan said. "The number of people dying from COVID-19 remains too high, way too high."

Rogers said she's waiting for the day when families are vaccinated too — and can visit loved ones in nursing homes again.

"It's lovely to see your loved one on a video call or through a window," she said. "But those hugs are more important."

jgrove@unionleader.com

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