Anxiety grows as long-term care awaits COVID-19 vaccines

Frustration is increasing with the pace of COVID-19 vaccinations in long-term care settings, where some homes are still waiting for the first vaccines while defending themselves from a virus that can devastate their residents.

The main drugstore chains in charge of giving injections in these places are well advanced in vaccinating residents and asylum workers. But some other types of group residences will not receive their first doses until mid-February or later, despite being among the top priorities for injections.

CVS and Walgreens have launched a massive vaccination campaign in almost every state and say they are following the schedule. But advocates and resident experts are concerned about delays in delivering vaccines that have been available for more than a month.

“Every week you wait and aren’t vaccinated is a big deal here,” said David Grabowski, professor of health policy at Harvard Medical School. “My impression is that this process is still too slow.”

Government officials placed residents and long-term care workers among their top vaccination priorities after they authorized the emergency use of vaccines from Pfizer and Moderna last year. This includes the two nursing homes, where residents receive medical care 24 hours a day; assisted residences, where people generally need less help; and other types of collective homes.

Vaccination then advanced rapidly in some states like West Virginia, which was not dependent on drugstore chains, and Connecticut.

But – as with other aspects of implementation – the results were generally unstable. In many places, home operators and relatives of residents watched in frustration as states opened up the vaccine’s eligibility to other populations before work in long-term care homes was completed.

Laura Vuchetich says her elderly parents live in an assisted living community in Milwaukee and are in need of injections. But they have been told they will not receive them until mid-February, even as pharmacies are starting to distribute hundreds of doses to younger people, including a friend of hers in good health.

“They should be at the front of the line,” she said. “They are in the mid-1980s and my mother had a heart attack last year. It is simply disconcerting to me. “

These houses were hard hit by the coronavirus.

A federal government study last fall found that an average of one death occurred among every five residents of COVID-19 assisted living institutions in the states that offered data. This compares to a death among 40 people with the virus in the general population.

The government has commissioned CVS and Walgreens to administer vaccines at long-term care facilities in almost every state. Each vaccine requires two injections a few weeks apart, and CVS and Walgreens say they involved first-rate nursing homes.

The networks plan three visits to each location. CVS spokesman TJ Crawford said that most residents will be fully vaccinated after the second visit, and the vast majority of assisted homes and other homes will have their third visits in mid-March. Some clinics will be closed in April.

While they wait, people who work and live in these locations are stuck in limbo, hoping the virus will not spread to them or come back, said Nicole Howell, who runs a California-based nonprofit that advocates for long-term care residents. duration.

“They are essentially at the front door fighting this disease with disinfectant and limited staff,” said Howell, executive director of Ombudsman Services for Contra Costa, Solano and Alameda counties.

Severine Petras watched an outbreak of COVID-19 develop in a Pennsylvania nursing home that his company operates a few weeks before the first vaccines arrive. The CEO of Priority Life Care said the recent outbreak affected a “significant” number of employees and some residents, including a person who died.

Vaccine scheduling has been slow in this state, she said.

“We should have had at least one round of vaccines there,” she said. “It would have helped tremendously.”

Petras said he was frustrated in part because it was widely known that COVID-19 cases would increase after the holidays. She would have liked the vaccines to have been programmed earlier to protect against this.

As of Sunday morning, 3.5 million doses were administered in long-term care facilities, according to the Centers for Disease Control and Prevention. That is about a third of the nearly 10 million vaccines that Grabowski estimates will be needed to fully protect residents and employees.

“It’s almost like we’re doing it the other way around, where they hired pharmacies and we let them set the schedule instead of saying, ‘This is the schedule you need to stick to,'” he said.

Drugstore chains faced several challenges. In some places, a high percentage of employees refused doses on initial visits. Companies also had to open thousands of clinics and reschedule some in locations where COVID-19 outbreaks developed.

CVS and Walgreens say that states have determined when they could start giving vaccines in assisted living facilities, and they finished first dose clinics when they were able to start in December. But other states did not allow them to start until mid-January. They also say they are employing thousands of employees in this effort.

Even so, Grabowski and Howell say that outside assistance may still be needed to speed up efforts in some areas.

In New York, the Empire State Assisted Living Association contacted state regulators because some homes had initial clinics scheduled for March, said executive director Lisa Newcomb. These clinical dates were then moved mainly to the end of January.

“We had some members who were very, very upset about having to wait until March,” she said.

In Florida, the state brought in an outside company to help deliver vaccines if drugstore chains were unable to schedule a first clinic by the end of January.

Innovation Senior Living CEO Pilar Carvajal said the company called one of its homes that had no appointment date for the clinic and showed up the next day to start applying the vaccines.

She said vaccination should be completed at her six home care facilities in Florida by the end of March. Then she can stop worrying about employees who are bringing the virus to work after doing something as simple as going out to eat.

“This is the only thing that we cannot control,” she said. “The sooner we can be vaccinated, obviously the safer we are.”