In Line for Vaccination, and Not Getting Younger

Ruth Ann Platt, watching news on television about effective vaccines for coronoviruses, could not wait for her to reach her nursing home in Gainesville, Ga. “I thought it was a great thing from the get-go,” he said.

When 88-year-old Ms. Platt moved to New Horizons Lanier Park last year after surgery for a fractured femur, the facility had already imposed stricter restrictions to prevent an outbreak of Kovid-19. “I’ve been living in this room for seven months,” she said.

She has yet to share a meal with another resident, attend a concert or take an art class. The hair salon is closed, she said, “soon I’ll be Rapunzel.” She is troubled by video chatting with her children, grandchildren and eight great-grandfathers as an alternative to traveling.

Happily, she received a second dose of the modern vaccine last month. New Horizons, a part of the nonprofit Northeast Georgia Health System, grew out of a federal partnership that relies on CVS and Valgrens to serve long-term care facilities. Using its own pharmacy and nurses, it quickly began vaccinating residents starting on 29 December.

Now, Ms. Platt said, “I’d love to find someone who plays a good game of Pinole.”

Report cards for vaccinations in long-term care facilities whose residents were supposedly standing at the front of the line show a mixed performance.

Nationally, nearly 3.4 million long-term care residents and staff members have received at least one shot, the Centers for Disease Control and Prevention informed of on Thursday; Nearly 800,000 were found in two.

As of mid-January, Medicare data showed There was a drop in cases in long-term care facilities Approximately 46 percent compared to four weeks earlier, reflecting a drop in cases nationwide, but perhaps also the effect of vaccination.

But experts and advocates have expressed profound disappointment over the slow initial rollout, given that an estimated five million people live or work in long-term care. “Nothing is clear about long-term care,” said David Grabowski, a health policy researcher at Harvard Medical School.

They worry about even more sluggish rates at assisted-living facilities and about workers who are suspicious of vaccinations.

Last fall, Trump administration contracted With two large pharmacy chains that agreed to keep three clinics in each facility: the first dose, the second dose and the first one left to catch any stragglers.

Vaccination speed has increased significantly. Vulgance The number of doses increased from 185,000 in December to 1.3 million in the previous month. It has completed the first dose in all 5,529 of contracted households and is expected to deliver the second dose by 25 February and the third journey by mid to late March.

Likewise, CVS, which has a large program, Of the 7,822 nursing homes, all have been given the first dose and this is about 77 percent of the second dose.

Company officials emphasized that when the Centers for Disease Control and Prevention prioritized long-term care for vaccination, individual states earmarked for these programs began.

“We were actually planning a national rollout on the same date,” said Chris Cox, senior vice president of pharmacy business at CVS. “We were ready to leave.” While almost all states activated nursing home clinics on December 21 or 28, most did not launch aided clinics until January, often weeks later.

The virus did not wait. Long-term care transition peaks during December A Kaiser Family Foundation Analysis; The deaths occurred in several states. Although long-term care residents and staff members account for just 5 percent of the nation’s Kovid-19 cases, they represent 37 percent deaths.

With a Swifter response, “we could have more nursing home residents vaccinated more effectively four to six weeks in advance,” said Dr. Pediatrician and past president of the California Association of Long Term Care Medicine. Michael Wassman said. “It’s a lot of deaths that could have been prevented.”

Future business students can investigate the scheme for years. Dr. “It was never easy, with over 30,000 facilities and millions of residents and employees,” said Grabowski. “The states and federal government were happy to pursue it in the private sector.”

Initially, facility administrators had to grapple with cumbersome consent forms, a problem that has been resolved. CVS and Walgreens officials also report scheduling clinics several times to contact certain facilities.

Administrators, for their part, questioned the three-trip plan. How will these clinics reach staff members who worked night and weekend shifts? Or newly recruited people, who are returning from hospitals and who have been discharged after only one dose? The CDC is reportedly working on a transition plan.

In addition, although the chain updated the number daily, “we don’t have the level of information we still want,” said Tricia Newman, executive director of the program on Medicare policy at the Kaiser Family Foundation. The total number does not reflect which facilities the companies visited or the proportion of residents and staff members they vaccinated.

Residents have responded enthusiastically. The CDC has estimated During the first month of the program, in nursing homes with clinics, an average of 77.8 percent of residents received their first dose.

“People who live in nursing homes will do anything to reconnect with the outside world and the people they love again,” said Dr., a geriatrician at Indiana University School of Medicine. Said Kathleen Unro, who practices in the nursing home Northwest Manor. In Indianapolis.

One of his patients was initially suspected. Norma Ware said, “I didn’t want to be a guinea pig, 86.” I am not crazy about shots anyway. “But after a conversation with her family and” a very friendly nurse “, she received both supplements and became a believer.

Big problem: a reluctant employee. The CDC reported that in nursing homes with clinics, only an average of 37.5 percent of staff members were vaccinated in the first month.

Other health care workers have also shown hesitancy. But in nursing homes, in particular, many activists are women of color, who have long been familiar with inequalities in health care and mistrust of the medical establishment.

“They were badly paid and overworked before the epidemic,” Dr. Grabowski said, noting that the workers had suffered a lack of personal protective equipment and additions: “They did not get sick leave or danger pay. So now we are saying, ‘You need to get vaccinated.’ I am not surprised that many people are saying, ‘Wait a minute, why?’

Yet long-term care workers are in the grip of Kovid-19; They can also transmit viruses as they enter and leave facilities and complete other work.

At two New Horizons homes in Gainesville, the medical director, Drs. Swati Gaur, has organized six staff town halls, including one person or online, for night shifts at 2 am, and has offered prizes such as free food. Dr. Gaur said about half of the workers have been vaccinated.

“As soon as their colleagues are vaccinated, their friends and colleagues and colleagues, those numbers will increase,” Dr. Wasserman predicted.

The sluggish pace of vaccination in assisted-living facilities, which has also experienced fatal outbreaks, has also caused concern. In some states, about half of the residents have also received the first dose.

Nonetheless, at some point in March most residents with long-term care and many staff members are likely to have either Pfizer or Moderna vaccine protection. Then what?

For residents, the top priority is to be able to see and embrace their families. Geriatricians fear that, for residents, those social isolation from coronovirus increases the risk.

“We absolutely need to look at sanctions that promote quality in long-term care,” said Robin Grant, director of public policy and advocacy at the National Consumer Voice. “The residents are pained. This cannot continue. “Both Medicare and the CDC are said to guide how and when to resume family visits.

Vaccinated residents can gain contact with each other, gradually returning to communal food and activities. “The goal is to get these residents out of their rooms,” Dr. Gaur said.

Ms. Platt gave some hasty advice that day. “This is no time for fear,” he consulted fellow residents. “Get your shot. Just take your shot and get on with your life.”

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