It turns out that no one takes COVID-19 seriously anymore, said Mollee Loveland, a caregiver who lives outdoors in Pittsburgh.
Loveland has noticed nursing home patients and colleagues dying from the virus.
Now she has a new concern: bringing COVID home and unknowingly infecting her daughter, Maya, born in May.
This tale was produced in partnership with KFF Health News.
“She’s still very young,” said Loveland, whose maternity leave ended at the end of June. Six months is the first time to vaccinate a baby against COVID.
Loveland is also concerned that the nursing home is experiencing a COVID surge in the summer, just like last year.
“It’s further amplified by respiratory disorders due to humidity, heat and heaviness,” he said.
Between the complex medical wishes of its patients and its proximity to others, COVID continues to pose a serious risk to the Loveland nursing home and the other 15,000 nursing homes in the United States, which house about 1. 2 million people.
Despite this risk, an April report found that only 4 in 10 nursing home citizens in the U. S. have received the most recent COVID vaccine, released last fall. The research used data from October 16, 2023 to February 11, 2024 and was conducted during the Centers for Disease Control and Prevention.
The CDC report also found that during January’s COVID peak, the rate of hospitalizations among nursing home citizens was more than 8 times higher than that of all U. S. adults over the age of 70.
The low vaccination rate is partly due to the fact that the federal government no longer foots the bill for administering vaccines, said Dr. Rajeev Kumar, a Chicago-based geriatrician.
Although the vaccine is still available to patients, doctors will now have to bill each person’s insurance company separately. That makes vaccinating an entire nursing home more logistically complicated, Kumar said.
Kumar is president of the Society for Post-Acute and Long-Term Care Medicine, which represents physicians working in nursing homes and settings, such as post-acute care, assisted living facilities, and hospice facilities.
“The demanding situations of navigating that procedure and arranging vaccinations, making sure someone can bill the facilities and raise money, that’s what’s a little bit more tedious,” he said.
(In April, after the study was published, the CDC indicated that adults 65 and older receive an additional dose of the updated vaccine if it has been more than four months since their last shot. This means that going forward, the maximum of nursing home patients who only received one vaccine in the fall or winter are not considered updated with the COVID vaccine. )
Another challenge is that Kumar and his colleagues face more skepticism about the COVID-19 vaccine than when it was first released.
“The population receiving long-term care is a microcosm of what’s happening across the country, and unfortunately, COVID vaccine hesitancy remains persistent among the general public. This is our most significant challenge,” according to an email from Dr. David Gifford. Lead medical officer for AHCA/NCAL, representing for-profit and non-profit nursing homes.
Caregiver Mollee Loveland has observed in her work that doubts and incorrect information arise among patients: “It’s the Facebook hole. “
But there are tactics to combat misinformation, and states are showing wide diversifications in the proportion of nursing home citizens who have recently been vaccinated.
For example, in North Dakota and South Dakota, more than 60% of nursing home citizens in those states have received at least one COVID vaccine since early October.
Sanford Health, a primary medical formula operating in the Dakotas, has controlled more than two dozen nursing homes since a 2019 merger with the Good Samaritan Society’s long-term care chain.
In some of those nursing homes, more than 70% of citizens have been vaccinated since the beginning of October; at a Sanford facility in Canton, South Dakota, the figure is more than 90%.
Sanford accomplished this by leveraging the length of the physical care formula to make vaccine distribution more efficient, said Dr. Jeremy Cauwels, Sanford’s chief medical officer. He also attributed an ongoing relationship with a South Dakota-based pharmacy chain, Lewis Drug.
But the best part is that many patients in Sanford’s nursing homes are cared for by doctors who are also contracted through the health care system.
In most nursing homes in North Dakota and South Sanford, those doctors provide number one care on-site, meaning patients don’t have to leave the facility to see their doctors.
Another advantage of this integration is that Sanford’s doctors and nursing home have access to the same patients’ medical records, helping them keep track of which patients have been vaccinated and which have not.
These salaried doctors have played a critical role in persuading patients to stay up to date on their COVID vaccines, Cauwels said. For example, a medical director who worked at the Good Samaritan Nursing Home in Guangzhou, a veteran doctor with close ties to the community.
“For us, a proper verbal exchange with someone who cares about you and who has a track record of doing so, resulted in far greater numbers than have been obtained nationally,” said Cauwels, who added that Sanford still has to work to succeed in the remaining patients who have not received the recent COVID vaccine.
Sanford’s good fortune shows that the duty to vaccinate patients extends beyond nursing homes, said Jodi Eyigor, director of nursing home quality and policy for LeadingAge, which represents nonprofit nursing homes. He said that number one care providers, hospitals, pharmacists and other physical care facilities stakeholders want to step up their efforts.
“What conversations took place before they walked through the doors of a nursing home, between them and their doctors?Because they probably see their doctors quit before they go into the nursing home,” said Eyigor, who notes that those other doctors are also regulated through Medicare, which is the federal fitness insurance program for adults 65 and older.
Still, nursing homes should teach patients — as well as staff — about the importance of COVID vaccines. Industry critics say one-on-one conversations, based on trusting relationships with doctors, are the least nursing homes can do.
But many services don’t even seem to be doing that, according to Richard Mollot, executive director of the Long Term Care Community Coalition, a watchdog organization that monitors nursing homes. A recent vaccination rate of 40 percent is unforgivable, he said. given the danger the virus poses to others living in nursing homes.
A study in the Journal of Health Economics estimates that from the start of the pandemic to August 15, 2021, 21% of COVID deaths in the United States occurred among people living in nursing homes.
The alarming rate of COVID vaccination is a symptom of larger disorders in the industry, according to Mollot. Patients’ families tell him about poor food quality and the general apathy of some nursing homes toward residents’ concerns. He also cites high turnover rates and poor and even harmful care.
These issues have intensified in the years since the COVID pandemic began, Mollot said, causing abundant tension throughout the industry.
“It’s led to a reduction in care, to more disrespectful interactions between citizens and staff, and just this lack of trust,” he added.
Mollee Loveland, the caregiver, also believes the industry is experiencing basic disruptions when it comes to day-to-day interactions between staff and residents. He said that the culprits of their jobs forget about the concerns of patients.
“I feel like if they did more with patients, they would get more respect from them,” she said.
So when directors announce it’s time for citizens to get the newest COVID vaccine, Loveland said, they simply ignore them, even if it puts their own health at risk.
This story comes from NPR’s journalistic partnership with KFF Health News.