My morning in a Tweet:
I’ve spent the morning scouring CDC vaccination, booster, case & death data for NHs. CDC reports all rates by 1,000 resident weeks (even staff data). Peak #COVID19 death rate among residents was 5.6 in December 2020. Nadir was 0.06 in late June 2021. We are now at 1.2.
Peak death rate among staff was 0.06 deaths/1,000 resident weeks in late November, 2020. We are now at 0.02. Nadir was June/July 2021 at <0.01. Of note, peak staff death count was 69 individuals in one week in July 2020. Latest count is 26 in a week.
Since July, 80+% NH residents have been vaccinated. Since mid-October, 85+%. Presently ~87%. Since November 1, 25+% boosted residents. Since December 5th, 53+%. Since January 2, 63+%. Now ~66%.
Since July, 60+% of staff have been vaccinated. Since mid-October, 74+%. Since December 5, 80+%. Since November 1, 12+% boosted. Since December 5, 23+%. Since January 2, 29+%. Now ~32%.
Why did I spend my morning scouring the data? Because I’m frustrated by the perceived lack of focus on NHs. Plus, I’m trying to make sense of our strategic plan. At the end of the day, I’m a geriatrician who cares about vulnerable older adults and their incredible caregivers.
Interim conclusions: Vaccines & Boosters matter in NH residents. Death rate is 10x from nadir, 20% less than peak, but only 66% of residents are presently boosted. Vaccine & Boosters matter in NH staff. Death rate is ~4x above nadir, and ~1/3 from peak, but only 32% boosted.
Nursing home residents and the staff that care for them in often old, poorly ventilated facilities are the proverbial canaries in the coal mine. Total deaths from Omicron continue to rise nationwide. Cases will subside, leaving 10’s of thousands more dead in its wake.
It would be helpful if @CDCgov posted hospitalization and death rates by vaccination status. This would be particularly helpful in #PALTC settings. We still have limited data from ALFs and memory care facilities. @AMDApaltc @CALTCM @AmerGeriatrics
It would be helpful if @WHCOVIDResponse had a #PALTC “war room” manned by experts in #Geriatrics, LTC Medicine, ID, LTC operations & Public Health. With >640k older adult deaths & ~250k deaths in LTC, this should not be an afterthought. @DorisMatsui https://matsui.house.gov/news/documentsingle.aspx? DocumentID=2021
Provisional death counts for week ending 1/15: 85+=2,240
75-84=2,239
65-74=1,919
55-64=1,248
45-54=541
Blacks & Hispanics continue to be significantly over represented among deaths.
NH & community disparities are being “looked at,” meanwhile, more people of color continue to die. “Looking at” disparities is not enough. “Encouraging” vaccinations & boosters among NH residents & staff is not enough. @CMSGov should acknowledge we’ve fallen short.
History will not look kindly on how we cared for older adults, particularly those of color, throughout the pandemic. It’s not time for blame, however, it’s time for action. After nearly 2 yrs, @POTUS @WHCOVIDResponse @CMSGov @CDCgov @HHSGov @ASPRgov need to focus on older adults.
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