Nursing homes may be turning the corner on COVID

Vaccinations, nearly completed, could accelerate the trend

  Feb 4, 2021



NURSING HOMES have accounted for the bulk of deaths from COVID-19 in Massachusetts since last April, but that may be starting to change.

Long-term care facilities, which cater to older people with underlying health conditions, were once the epicenter of the coronavirus pandemic in Massachusetts. The disease swept through the facilities and the death toll climbed rapidly, with nursing home fatalities accounting for roughly two-thirds or more of total COVID-19 deaths for most of last year.

In November, however, the situation began to change, as COVID-19 deaths at nursing homes stopped being the driver behind the state’s rising death toll. The number of COVID-19 deaths at nursing homes still increased from November through January, but the key difference was that the increase was not nearly as fast as the death rate statewide. As a result, nursing homes accounts for a smaller and smaller percentage of overall COVID-19 deaths.

In November, COVID-19 deaths at nursing homes rose to 362, which represented half the total deaths from the coronavirus statewide. In December, the number of COVID-19 deaths at nursing homes increased to 574, but that was 35 percent of the 1,615 deaths statewide. In January, the trend persisted, with the death toll at nursing homes rising to 681, or 33 percent of the 2,051 deaths statewide.

On a cumulative basis since the start of the pandemic, nursing home deaths from COVID-19 now account for 56 percent of the total.

Officials in the nursing home industry aren’t claiming they have COVID-19 under control – on Thursday, there were 74 COVID-19 deaths in the state and 61, or 82 percent, were at nursing homes – but they say their facilities are weathering the storm better now because increased state funding has allowed them to hire more employees, equip the workers with personal protective equipment, improve infection control efforts, and test constantly for the coronavirus.

The officials say the situation is likely to improve even more in the near future as residents and staff at nursing homes complete their COVID-19 vaccinations. Nursing home residents and staff were second on the priority list behind COVID-facing hospital workers, and they could become a test case for the impact of the vaccine because the state tracks cases and deaths at the facilities.

A spokeswoman for the Baker administration said she was preparing a comment on the nursing home data, but then never followed through. (CLARIFICATION: The spokeswoman did submit a comment a day after the story was published, indicating that the administration has worked with the industry to reduce nursing home deaths, which are way down from their peak last April.)

Tara Gregorio, president of the Massachusetts Senior Care Association, which represents nursing homes, said more than 111,000 vaccine doses have been administered to Massachusetts nursing home residents and staff by CVS and Walgreens over the past several weeks. She estimated a total of 150,000 doses are required to vaccinate the industry’s 30,000 residents and 45,000 staff.

Industry officials say they still have work ahead to make sure everyone, particularly staff, gets vaccinated. “We continue to work with our residents, their families, and caregivers to encourage further uptake of the vaccine,” Gregorio said.

“I do anticipate that we will see a decline in fatalities as a result of the vaccine as well as the availability of new treatments, including monoclonal antibody therapy,” Gregorio said. “In addition, our facilities have seen an increasing number of residents recovering.  We are heartened that the rate of recoveries has increased to 80 percent.”

Dr. Asif Merchant, who oversees medical care at four nursing homes, is chief of geriatrics at Newton-Wellesley Hospital, and chairs the geriatrics committee of the Massachusetts Medical Society, said he has seen the quality of care improve dramatically at nursing homes. He said infection control, the use of personal protection equipment, and testing have all improved.

Merchant said two other factors may be playing a role in slowing the pace of deaths at nursing homes – the rollout of the COVID-19 vaccine and the relatively high incidence of people at nursing homes who contracted the coronavirus in the past and survived. Both, he said, would increase the nursing home population’s resistance to the disease and reduce the number of fatalities.

Merchant said it’s difficult to pinpoint one factor to explain the change. “It’s all of these things,” he said.