Mary Perkins gets her Covid-19 vaccine at Life Care of Acton, a skilled nursing and rehabilitation center in Acton, Massachusetts on Dec. 28, 2020.

Nearly a Year into the Pandemic, Nursing Home Deaths Decline

A new report on Covid-19, released on Tuesday, shows that cases dropped 82 percent in American nursing homes between December 2020 and February 2021. Nursing home resident deaths, which have accounted for around one-third of Covid-19 fatalities in the United States, have dropped steadily too — an apparent result, the report said, of widespread vaccination in facilities.

The report’s publisher, the American Health Care Association and the National Center for Assisted Living, had good reason to trumpet the data: The group is the major industry organization representing long-term care facilities. The report comes as the industry, along with some of the policymakers tasked with overseeing it, are under sustained scrutiny for their handling of the pandemic. And it arrives amid severe financial strain for many facilities.

Since February 2020, when a Covid-19 outbreak began at a Seattle-area nursing home and killed dozens of residents, the virus has torn through facilities across the country. At least 172,000 staff and residents have died from the disease. Analysts have argued that chronic issues in the industry — including understaffing, overcrowding, and poor infection control — have fueled the deaths.

Recently, new research and reporting have raised further concerns about the industry and its regulators. A study published Monday in the journal Health Affairs found that extremely high staff turnover rates at nursing homes may have helped drive the Covid-19 death toll. A new working paper on nursing home care from the National Bureau of Economic Research finds that when private equity firms take over facilities — a common occurrence — death rates rise and quality of care falls. (The study only looks at pre-pandemic data, but the authors say the issues “have become more urgent” during the Covid-19 pandemic.)

Some policymakers are also facing questions about how they handled the crisis. In New York state — where some nursing homes in spring 2020 resorted to storing the bodies of Covid-19 victims in refrigerated trucks — Gov. Andrew Cuomo’s administration hid thousands of nursing home deaths from lawmakers and the public. In Pennsylvania, Republican legislators plan to investigate Gov. Tom Wolf’s oversight of nursing homes during the pandemic.

Despite that reckoning, the data summarized in the AHCA/NCAL is more than just industry spin: Pandemic conditions are indeed improving in nursing homes across the country. A report from the Kaiser Family Foundation, released last week, found that deaths among nursing home residents had begun to drop in December amid a vaccination campaign, even as Covid-19 death rates rose elsewhere. More than 2.5 million staff and residents have now received a full two-dose course of either the Moderna or Pfizer-BioNtech Covid-19 vaccine, and cases and deaths continue to fall.

Just this week, Tennessee and Michigan joined the growing list of states lifting their restrictions on visits to nursing homes and other long-term care facilities. Federal guidelines still call on facilities to restrict visitation, but advocates and residents have begun asking officials to revise the guidelines. “The depression and sense of aloneness affecting my fellow residents, it’s terrible,” Richard Fornili, a nursing home resident in Georgia, told Kaiser Health News this week. “Having our relatives come back in to see us, it’s an absolute necessity for our well-being.”

Also in the News:

• Could pooled testing, a cost-cutting tactic aimed at boosting Covid-19 testing capacity, be the key to safely reopening schools? At The Atlantic, Katherine J. Wu reports on a pilot project underway in Massachusetts that could help determine the answer. Under the scheme, the state will foot the bill for students to be tested in pools, with swabs from up to 25 students combined; if the pool returns positive, the students would each take a follow up test to determine their status. Already, 300,000 students and staff are being tested every week, the kind of mass testing experts say is critical for catching cases before they grow into outbreaks. But several of the districts that were hit hardest by the pandemic, and forced to switch entirely to remote learning, are being squeezed out of the pilot, Wu reports: The state is supporting testing only in schools that have already reopened for in-person learning. Even in eligible schools, the plan is creating logistical tangles, and the burden of collecting and prepping samples is straining school nursing staffs. Still, Wu writes, “The Massachusetts model is proof that such a system can be implemented, and is likely to make a difference.” (The Atlantic)

• Brazil set a new record for Covid-19 deaths in the country this week, as a new and alarming surge of infections — apparently driven by a new variant of the coronavirus — continued to spread. Recent studies of the Brazilian variant — which have not yet been published in scientific journals — indicate that it is adept at reinfecting people who have previously had Covid-19. The research has raised concerns that the variant, known as P.1, could be better at evading the immune protection conferred by vaccines. But experts say even in that scenario, vaccines would likely protect against severe cases of Covid-19. For now, the vaccine rollout in Brazil has been slow, and P.1 is spreading. Brazilian health officials recently warned that many of the country’s hospitals were in danger of once again being overrun by patients with severe coronavirus infections. The situation in Brazil is so troubling that some scientists have warned publicly that the country’s exploding Covid-19 cases — at numbers that could allow even more variants to evolve — pose a risk to the rest of the world. The rise of new variants in the U.S. led Centers for Disease Control and Prevention director Rochelle Walensky to urge Americans to keep protective measures in place. “Please hear me clearly,” she said this week. “At this level of cases with variants spreading, we stand to completely lose the hard-earned ground we’ve gained.” (Multiple sources)

• Under President Joe Biden, the Interior Department — which oversees some 500 million acres of public lands, including land used for oil drilling, national parks, and wildlife refuges — is making major moves on issues related to climate change and the environment, according to new reporting in The New York Times. Among them: suspending drilling leases in the Gulf of Mexico, freezing drilling in the Arctic National Wildlife Refuge, and delaying rollbacks on the protections of migratory birds and the northern spotted owl. The department has also started the process to restore three national monuments — two in Utah, which the Trump administration had planned to open to mining and drilling, and one off the coast of New England, which Trump opened to commercial fishing. And although Biden’s pick for Secretary of the Interior, Rep. Deb Haaland of New Mexico, still faces what may be a tough Senate confirmation vote, the administration has already filled 50 other high-level positions at the agency. According to the Times, even critics of the administration are surprised by the agency’s speed. Nicolas Loris, an economist with the Heritage Foundation, a conservative think tank, told the paper: “They’re obviously moving forward quickly and aggressively.” (The New York Times)

• On Wednesday, British multinational media company Daily Mail and General Trust, which owns The Daily Mail, announced it had purchased the respected science magazine The New Scientist for 70 million pounds, or around $97 million. Founded in London in 1956, The New Scientist has a weekly circulation of 134,000 for its print and digital editions and refers to itself a “the world’s most popular weekly science and technology magazine.” The chairman of the Trust, Jonathan Harmsworth, better known as Lord Rothermere, said that the deal would help The New Scientist grow as “the go-to publication for anyone interested in the scientific world around us.” The purchase of the storied science magazine by the owners of The Daily Mail — known for its lurid headlines, the tabloid was largely banned as a source by Wikipedia editors in 2017, who cited it for “poor fact checking, sensationalism, and flat-out fabrication” — raised some eyebrows among readers and science journalists. “What a blow to science reporting,” astrophysicist and science writer Katia Moskvitch wrote on Twitter in response to the news. (The Guardian

• And finally: In the state’s first hunt since the Trump administration removed wolves from the endangered species list in January, the Wisconsin Department of Natural Resources reported hunters killed more than 216 of the animals, far exceeding the established quota of 119 for non-native hunters. The DNR initially planned to begin its wolf hunting season — which is required by state law if the animal is not listed under the Endangered Species Act — in November 2021, but a hunter advocacy organization successfully sued to force the DNR to begin the season last month. The hunt has prompted backlash from animal rights groups, who had fought to keep federal protection for the animals, as well as the local Ojibwe tribes. The Ojibwe, who were allocated 81 wolves, consider the animals sacred and do not typically participate in the hunt. “Our tribal communities are disappointed and condemn the overage on the state’s part,” Dylan Jennings, a spokesperson for the Great Lakes Indian Fish and Wildlife Commission, which represents 11 Ojibwe tribes, told The Wisconsin State Journal. “It speaks to some of the lack of enforceable management practices and lack of tribal consultation.” (The Wisconsin State Journal)

“Also in the News” items are compiled and written by Undark staff. Deborah Blum, Brooke Borel, Lucas Haugen, Jane Roberts, and Ashley Smart contributed to this roundup.

Michael Schulson is a contributing editor for Undark. His work has also been published by Aeon, NPR, Pacific Standard, Scientific American, Slate, and Wired, among other publications.