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COVID-19 cases plummet in Kentucky nursing homes, a key target for the vaccine

Lexington Herald-Leader - 2/19/2021

Feb. 19—Residents and staff at Kentucky's long-term care facilities have have been pummeled by the COVID-19 pandemic, accounting for 11.3% of the state's cases and 53.2% of coronavirus-related deaths in Kentucky.

No more.

The 403 active cases among residents and staff at long-term care facilities on Thursday was the lowest tally recorded since May.

A Herald-Leader analysis of state data shows that active cases in nursing homes, personal care homes and other long-term care facilities hit their peak in mid-December at more than 4,100 cases, just as residents began receiving the COVID-19 vaccine.

Since then, the numbers have plummeted.

"We are thrilled with the numbers," said Betsy Johnson, the director of the Kentucky Association for Health Care Facilities and the Kentucky Center for Assisted Living. "But we're always looking for continued support."

Long-term care facilities were a top vaccination priority for the state and federal government. More than 80,000 initial doses of Kentucky's limited vaccine supply have been distributed at the facilities.

Shawn Crabtree, director of the Lake Cumberland District Health Department, said there are two key factors driving the decrease in cases at nursing homes: the vaccine is working and "several folks already had the disease and recovered from it."

Even as the state hit its peak in cases in the first week of January, the number of cases in long term care facilities dropped among residents and staff.

That coincides with a drop in the COVID-19 incidence rate among people older than 70 in Kentucky, a group prioritized for vaccine distribution. The weekly incidence rates for Kentuckians in their 70s and 80s hit their peak in the first week of December and have dropped ever since.

The vaccine's reception in long-term care facilities was mixed. As of February 1, more than 70 percent of nursing home residents had been vaccinated compared to 45 percent of staff.

There were a number of reasons for the reluctance among staff — misinformation about the vaccine, timing of the vaccination visits, shift changes — but staff rates are falling alongside resident rates. Between December 11 and February 12, the number of active cases among staff dropped by nearly 85 percent, compared to 90 percent for residents.

The drop in cases likely played a role in Gov. Andy Beshear's decision Thursday to lift some visitation and activity restrictions in assisted living facilities (those not regulated by the federal Centers for Medicare and Medicaid Services). He said the state is waiting for federal guidance before loosening restrictions at most nursing homes.

Johnson said she still has concerns about getting vaccines to long-term care facilities moving forward, chief among them the ability to make sure new admissions and newly hired staff are able to get the vaccine.

The long-term care facilities were vaccinated by CVS and Walgreens under a federal contract that only included three visits to each facility. Now that those visits are finished, getting the vaccine to new residents may prove more difficult.

"I don't think this is the time for us to get lazy," Johnson said.

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