Karen Dannin knows what it’s like to get COVID-19 in a nursing home.
The 87-year-old retired dental hygienist came down with the virus last December, while recovering from surgery at the Bethany Home on Providence’s East Side.
Dannin has chronic obstructive pulmonary disease or COPD, which can cause difficulty breathing, so her risks associated with COVID-19 are especially high.
But at the time she contracted the virus, Dannin was up to date on her vaccinations and her symptoms were mild. She spent 12 days in isolation.
“Did I like my own company? I found out that I did,” she said. “But I don’t want to have to do it again.”
Now, there’s a COVID outbreak in her nursing home. Dannin is due for another shot, but the new COVID-19 vaccine has not yet arrived.
“We called our pharmacy,’’ Bethany Home’s administrator, Stephanie Igoe, said. “We found out that it’s backordered. And they have no idea when it’s coming.”
The coronavirus ravaged nursing homes nationwide during the first two years of the pandemic, before vaccines and treatments were widely available.
Now, reported distribution problems among vaccine manufacturers and high demand for the new COVID-19 shots have delayed their arrival in nursing homes and assisted living facilities across the country, just as the predicted fall infection rates climb.
COVID-19 outbreaks
In Rhode Island, where many nursing homes have yet to begin vaccinating their residents, nearly three-quarters of all nursing homes and assisted living centers have reported COVID-19 outbreaks over the past two months, the state Department of Health said in a Sept. 29 email to facility administrators obtained by The Public’s Radio. The department said that it’s been receiving reports of 100-plus cases each week since the start of August.
As of Thursday, Oct. 5, just over one third – 35% – of all nursing homes in Rhode Island had reported COVID-19 infections, down from 55% as of Sept. 28, according to data updated weekly by state health officials.
Among the largest reported outbreaks was at West Shore Health Center, in Warwick, which reported 14 residents contracted COVID-19 during mid-September, according to state health data. (The infections were down to 11 as of Thursday, the state reported.)
“The good thing right now, knock on wood, is most people [testing positive] have not been sick,’’ said Kelly Arnold, chief operating officer of Health Concepts, Ltd., which operates six nursing homes in Rhode Island. Most of those with infected, she said, are “barely symptomatic.”
At West Shore, “there’s been a little bit of delay because they had an outbreak amongst their staff,’’ Arnold said Tuesday. The staff are still in the process of getting residents or their families to sign the required consent forms for the shots, she said.
Arnold said that the timing of the outbreak was another factor. “Obviously you can’t do any vaccinating while residents are sick,’’ she said, ‘’so you know, we’re kind of waiting for that.”
In an email Thursday, Arnold walked back her earlier statement, saying, “There has been no delay at West Shore or any of the facilities to give out the COVID vaccine.”
Before any vaccinations can begin, Arnold said, nursing homes have to obtain doctor’s orders, family and/or resident consents, and discuss whether to administer the COVID and flu vaccines together or separately.
All six of Health Concepts’ nursing homes “have either begun the vaccine clinics or they have been scheduled within the next couple of weeks” for both COVID and flu vaccines, she said in the email.
Vaccine distribution delays
The process of getting the vaccines is different this year, since the federal government stopped purchasing and distributing the COVID vaccines.
Nursing homes now have to buy the vaccines from long-term care pharmacies and bill insurers, which are supposed to cover 100% of the cost.
The upfront cost is $144 per patient per vaccine, said Igoe, Bethany Home’s administrator.
In Rhode Island, nursing homes also can order COVID vaccines for free through the state vaccination program. State health officials collect orders from approved facilities and send those to the federal Centers for Disease Control and Prevention, which purchases the vaccines from manufacturers. Depending on which manufacturer the vaccines are ordered from, the CDC either ships the doses directly to the long-term care facilities (for Moderna) or they are shipped from a private distributor (for Pfizer).
As of last Tuesday, the CDC and vaccine manufacturers had shipped just 410 of the 1,000 COVID vaccine doses the state ordered for Rhode Island nursing homes and assisted living centers, according to state shipping data.
“CDC opened the ordering process before they had enough vaccine to meet the demand,’’ said Joseph Wendelken, a spokesman for the Rhode Island Department of Health. “Their inventory is catching up now, but they did not have enough vaccine from the manufacturers right away to meet the initial demand in its entirety.”
Who wants the new COVID-19 vaccine?
Nationwide, two-thirds of all seniors and about half of all adults in the U.S. intend to get the new COVID vaccine this fall, according to a survey published Sept. 27 by the nonprofit Kaiser Family Foundation, or KFF.
Nearly 65% of Rhode Island nursing home residents were up to date on their COVID vaccinations as of Aug. 20, meaning they received the second booster available before last month’s new shot. But less than 34% of Rhode Island health care staff are up to date, according to a dashboard of federal data published by AARP.
“We have about 90% of our residents who are definitely interested in getting the vaccine,’’ said Barbara Langshaw-Bettez, an infection control nurse at Bayberry Commons, a 110-bed nursing home in Burrillville. “Unfortunately, I’ve only had about 20 [out of 120] staff sign up formally to receive it.”
Getting employees vaccinated against COVID is key to preventing the spread of infection in nursing homes, since workers are more likely than residents to pick up the virus in the community when the infection levels rise.
As of Thursday, Oct.5, 10 staff and one resident at Bayberry Commons had gotten the new COVID shots, which the home ordered through the state, Langshaw-Bettez said. To encourage more staff to get the vaccine, she said, they’re planning to offer a pizza party or raffle for the hall with the most vaccinated staff.
“We’ve proven through all different waves of the pandemic that we can do this, it’s just, it’s going to take a little bit of time to get the updated vaccine available freely,’’ said John Gage, CEO Rhode Island Health Care Association, a trade group that represents 63 of the state’s for-profit nursing homes. “And you’ll see that ramp up over the coming weeks.”
But the ramp-up can’t come soon enough for Igoe, the administrator at Bethany Home. She feels for her residents who tested positive and have to eat meals alone in their rooms. And she worries that residents whose immunities have waned will get sick.
Even though the days of lockdowns and visitor restrictions are over, Igoe said, the number of people visiting Bethany Home since the outbreak is way down.
“This virus is so contagious, that if you didn't get that shot, or if you haven't had COVID lately,’’ she said, “I wouldn't go into a nursing home right now.”
Update: On Tuesday, Oct. 10, Bethany Home received 30 doses of the new COVID-19 vaccine. So far, about 10 of the nursing home’s 70 employees have received the shot.
Health Reporter Lynn Arditi can be reached at larditi@thepublicsradio.org. Follow her on X/Twitter @LynnArditi
