Post-Vaccination, Nursing Home Outbreaks Drop Significantly, Slowing Deaths
After a year of coronavirus outbreaks at nursing homes and assisted living centers, the worst may finally be over.
“The trends appear to be going downward in a good way,” said Bob Murphy, director of Colorado AARP. “You know, after a year, it’s about time.”
Outbreaks at the facilities are down 81% since early January, when vaccination efforts ramped up, dropping steadily from 288 at the start of the year to 54 this week, according to state data analyzed by KUNC. The state’s chief medical officer, Dr. Eric France, called the clinics, which wrapped up in February, “successful in vaccinating our most vulnerable.” Some 150,000 residents and workers were vaccinated, he said in a recent press conference.
About 38% of Colorado’s deaths due to COVID-19 have occurred in long-term care facilities and those numbers have declined, too, since the New Year.
The outbreaks have also left a legacy of coronavirus survivors. Some, like Tara Frechea of Greeley, are so-called long-haulers, still recovering from serious illnesses.
“I'm still not 100%,” she said in a Zoom call, “but I'm working on it.”
Frechea was among the first Coloradans to get the virus. She was at Centennial Health Care Center in Greeley in March of 2020, a time when Gov. Jared Polis declared a state of emergency and public health officials began to implement restrictions on visitors to facilities and require personal protective gear, like masks. From her nursing home bed, Frechea saw news reports about the pandemic hitting overseas.
“I just remember watching all that and then, I swear, like a day or two later, I was sick,” she said.
Frechea, who is in her early 50s but has been immunocompromised since a motorcycle accident as a teenager, was at the home recovering from a bout with pneumonia. Her temperature hit 104 and she was eventually taken to the hospital, where she was placed on a ventilator for weeks.
Frechea doesn’t know exactly how or when she got COVID. Last year, she alleged in a KUNC investigation that workers at the center were not always wearing PPE as the pandemic hit. The center disputed that, saying it "immediately began restricting visitors" and following "PPE guidance" as the state directed.
Dozens of people at the home at that time tested positive for the virus amid 22 deaths.
Months after the news, in the summer, inspectors found deficiencies at the center for infection control and prevention, a trend that held around the state, including dozens of cases where workers in facilities failed simple hygiene tasks, like proper handwashing or use of PPE.
From March of 2020 to the end of February — almost a year of the pandemic — state inspectors have issued 502 infection prevention or control deficiencies at nursing homes, 470 at assisted living residences, and dozens of others at similar facilities.
Murphy, with the Colorado AARP, said the deficiencies indicate outbreaks could have been prevented. He pointed to the spike in infections and deaths at facilities in the last quarter of 2020, saying managers were well aware by then of measures that could prevent the spread of the virus. He also noted the millions of dollars federal officials distributed to nursing homes.
“Where does that money go?” Murphy said. “Why did we have this horrible skyrocketing in cases and deaths at a time that we should have known better?”
Doug Farmer, CEO for the Colorado Health Care Association, a trade group for nursing and assisted living centers, said the money -- roughly $250,000 per nursing home -- went to keeping the industry afloat as homes dealt with pandemic-related worker overtime and costs for PPE and other supplies.
“At the same time, we are at 67% occupancy statewide,” Farmer said. “Compared to 2019, that represents a loss of revenue of at least $200 million over the course of a year.”
State deficiency citations are also in the millions of dollars for the industry, which Farmer said had to quickly adapt to changing federal, state and local guidelines.
“It would have been helpful if the government could have turned their surveyors and their expertise toward a more consultative role,” Farmer said. “Instead, following guidance from (federal health officials), there was an intense focus on finding fault in infection control practices, writing citations and issuing fines.”
He also pointed out that the spike in outbreaks at facilities in the final quarter of 2020 mirrored a substantial rise in infections in the general public. Asymptomatic care workers likely spread the virus in facilities, as even screenings like temperature checks likely failed.
Meanwhile, watchdogs like Murphy haven’t lost sight of the human toll at the facilities. He said the lessons to be learned from the deaths could fill a book, calling for accountability from officials and the care industry. One quick takeaway, he said, is how important workers are to the lives of residents they care for.
“I hope we learned the lesson there about those vital and, indeed, life-saving role that a well-trained staff can play,” he said. “In this case, it didn't always work out that way.”
Tara Frechea considers herself lucky to have survived. Her life isn’t back to normal yet.
“I've been having problems because I had a brain injury from having low oxygen for so long,” she said. “And so I forget a lot of words and things like that when I'm talking.”
Frechea said she needs help sometimes to get around and often uses a walker or cane when she’s out with the dogs. Her family, including grandkids, are a blessing to her right now.
“It's the best medicine,” she said, adding, “We’ve really been working hard on spending a lot of quality family time because we saw how close it can come to being taken away from you, you know, how fast.”