Staff vaccination rates involved amid COVID surge in Texas nursing homes


COVID-19 is spreading again in Texas nursing homes.

Active cases among residents tripled in one month, from 389 on July 30 to 1,213 on August 30, according to Texas Health and Human Services. The 10-county region that includes Harris County is the second largest share with 241 active cases. .

The Houston health department has listed only two active nursing home cases as of July 7, but reported 46 cases as of August 11, the last day for which data is available.

These numbers are only a fraction of those reported in previous outbreaks – when nursing home residents accounted for about a quarter of all COVID deaths – but remain a concern for advocates for residents and healthcare providers. health. Infections among staff members appear to exceed those of residents, according to state data. Only 59 percent of staff are vaccinated, compared to 79 percent of residents.

“It’s disheartening,” said Patty Ducayet, the state’s long-term care ombudsman, a specially trained and certified volunteer who advocates for nursing home residents. “It concerns me that we don’t have enough staff in facilities that are vaccinated. And yet to some extent I hear a lot of reports from residents affected by COVID-19 who, if vaccinated, have really often a very mild case if not almost asymptomatic. “

Health and Social Services track regional and facility-specific data reported by nursing homes. There is a two week lag in the facility’s data, which includes active cases among staff, “to allow time to review the data so that clerical and reporting errors can be corrected.” according to HHSC spokesperson Helena Wright-Jones.

As of August 13, Texas recorded 870 active cases among residents – representing about 1% of state nursing home residents – more than double the number of cases compared to the 389 reported two weeks earlier on the 30th. July. During the same period, the number of active cases for nursing home staff increased by 121%, from 426 cases to 946.

Earlier this month, President Joe Biden announced that his administration would require nursing home staff to be vaccinated as a condition of receiving federal Medicare and Medicaid funding. It could go into effect as early as next month, according to the Associated Press. Texas does not currently require vaccines for nursing home staff.

Kevin Warren, president and CEO of the Texas Healthcare Association, said his organization supports providers who need the vaccine, but said Biden’s message could exacerbate existing staff shortages in the industry.

“It is of great concern to us when you isolate an area of ​​the healthcare continuum, given the staffing shortages that you are already seeing,” said Warren. “Those staff who choose not to (get the vaccine) will just go and work in another part of the health sector.”

It is not clear whether visitors contributed to the rise.

All Texas nursing homes now allow two essential caregivers, including family members, to visit each resident after being tested for COVID. For the record, Ducayet said staff members appeared to have played a bigger role in the spread.

“The information to which I have access does not indicate that visitors … were the main source of the introduction of COVID into the building,” she said.

Visits are necessary for the general well-being of residents, said Mary Nichols, who focuses on visitation issues through her Facebook page, Texas Caregivers for Compromise. People are also more likely to seek out the vaccine if their family members are among the most vulnerable nursing home population, she said.

“No one is more interested in the (people) at this facility than family members,” she said.

Douglas Loveday, a spokesperson for the Texas State Department’s health services, said a drop in vaccine effectiveness may be part of the reason for the rise in cases. Residents of nursing homes were among the first to become eligible for the vaccine in December 2020.

Some studies suggest decreased immunity over time – a finding that persuaded federal health officials to recommend booster shots starting the week of September 20. The highly infectious nature of the delta variant likely drives the numbers up as well, Loveday said.

“Any increase in COVID-19 cases in long-term care facilities and assisted living facilities is most likely a combination of a much more contagious variant and some level of waning immunity,” he said. he declares. “And the cases, regardless of the context, reflect what is happening in the communities around them. “

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