For some long-term care residents, the vaccine arrives too late

By Hannah Critchfield

Even with North Carolina entering the second phase of its vaccination plan, some long-term residents still await the COVID-19 vaccine.

For Barbara Fischer, an 83-year-old dementia patient in Brookdale Meadowmont, may be arriving too late.

When the state announced that people in long-term care facilities would be among the first to receive the vaccination and that the initial doses would arrive in mid-December, Ester Amy Fischer thought her mother’s group would receive the vaccine within weeks.

The Chapel Hill facility had been dealing with an outbreak of COVID-19 since late November, and although the memory unit where his mother resided remained uninfected, that stability seemed more fragile with each passing day.

Some families and employees say the pace of deployment is too slow for high-risk loved ones living in these crowded environments, where virus outbreaks can spread like wildfire afterwards.

“Honestly, when I first heard about the CVS-Walgreens program, I thought it was a good idea,” said Fischer. “But I think the problem is that there was simply not enough supervision at the state or municipal level – so when they were not delivering the vaccine quickly enough, there was no way for states or counties to intervene.”

A federally administered / privately administered implementation

Residents and employees in long-term care institutions are responsible for about 40 percent of all COVID-19 deaths across the country.

In mid-December of last year, the federal government seemed optimistic about the vaccine implantation in these houses, with the Secretary of Health and Human Services, Alex Azar, declaring that all nursing home residents could be vaccinated by Christmas.

But vaccine approval came only in mid-December. So, there have been different speeds for vaccine launch at the site, with wide variation by state.

Brookdale Meadowmont, an assisted living unit in Orange County that provides care for Alzheimer’s and dementia patients, is getting the vaccine through CVS Health, according to Heather Hunter, a spokeswoman for Brookdale Senior Living, the company that oversees the home. .

CVS Health has administered the vaccine to 630 long-term care facilities in North Carolina since the effort began in late December, according to Joseph Goode, a CVS spokesman.

Two hundred and sixty-nine facilities that chose the company as their vaccine partner are still waiting.

The Brookdale Meadowmont facility is one of them – the long-term care facility is scheduled to receive the vaccine on January 26, Hunter confirmed.

“As part of the Phase 1 distribution, vaccinations are already underway in Brookdale Senior Living communities across the state and country,” she said. She also confirmed that the facility is still experiencing an outbreak of coronavirus.

Walgreens, the vaccine’s other long-term care partner, declined several requests for comment on the number of collective homes that have already received doses under their contract.

For elderly residents like Barbara Fischer, the delay had dire consequences.

She tested positive for COVID-19 on January 4, according to Fischer’s daughter, Ester, and is still battling the disease weeks later.

“Her oxygen is normal, but she is not going to wake up. I talked to her doctor over the weekend, and she really isn’t feeling well, ”said Fischer. “I really think that the installation did the best they could do [to contain the spread] – but they need the vaccine. “

A memory care worker, who asked to speak without being identified by North Carolina Health News for fear of losing his job, confirmed that this was the date the outbreak hit the ward.

“People in a memory care unit cannot socially distance themselves,” said the worker. “You know, they want to hold hands with each other; they are things they do that they don’t know they are doing.

“It is difficult to try to keep them apart because six feet for them means absolutely nothing. Therefore, they should be at the top of the list, because they are more susceptible to catching him, just like the doctor in the emergency room ”.

The worker also tested positive for COVID-19 two weeks ago, at the same time as resident Barbara Fischer. Infection also poses a high risk for workers, who live with elderly family members.

States help to set priorities

Although the federal government is coordinating these vaccinations for residents and long-term care workers, a CVS spokesman said the company is still prioritizing which collective residences should come first based on each state’s guidelines.

“Some states have chosen to activate the program for certain long-term care facility residents (for example, those in qualified nursing facilities) before others,” said Goode in an e-mailed statement. “We schedule clinics by geography and based on available weekly allocation, readiness of facilities and personnel to send to LTCs in that community.”

Qualified nursing facilities are for people who require significant medical care and are considered medical facilities. Because they are regulated by federal authorities, who made the decision to hire pharmaceutical companies to administer the vaccines.

Assisted living facilities like Brookdale Meadowmont, which tend to have fewer medical staff on site than nursing homes, however, often house people at risk for the worst results of the virus, including those with developmental disabilities and dementia.

“Although elderly people living in assisted living communities have many of the same risk factors as elderly people living in nursing homes, they are generally less medically impaired,” said Sheryl Zimmerman, co-director of the Care Program. Aging, Disability and long-term care at the University of North Carolina School of Social Work. “We certainly can’t forget about them and, in fact, of all COVID-19 deaths that occur in long-term care settings, those in assisted living are responsible for about 30 percent of deaths.”

There tend to be more private rooms in the assisted living facilities, Zimmerman noted, as well as fewer employees. Both decrease the risk of spreading COVID-19, which may help explain why some states are prioritizing qualified nursing homes first.

North Carolina has prioritized qualified nursing facilities for scheduling “when possible,” according to Catie Armstrong, a DHHS spokesperson.

“For me, if you wait to vaccinate people in memory care, you don’t really give them a chance to fight,” said the Brookdale Meadowmont official. “All elderly people, especially those with underlying problems, should be vaccinated.

“However, if you are capable of simple instructions, such as social distance and washing your hands, you should be eliminated from that list, and the person who cannot do these things needs to be eliminated.”

‘Too late for my mom’

For now, Fischer tries to keep in touch with his mother virtually.

“I do faceTime her once or twice a day and just talk to her, even though she is sleeping,” said Fischer.

She doesn’t know if her mother is going to recover.

“I kept fighting [for faster vaccinations], although it’s too late for my mom, ”she said. “I care a lot about the other residents and the staff who work there – I kept writing to the governor, DHHS and my county’s health department. I was trying to see if anyone could do anything.

“I understand that it is a federal program,” she added. “But it’s like they aren’t even sure what is going on.”

The official who spoke to NC Health News is no longer waiting for the vaccine.

“I will receive my first dose next week,” said the worker. “Orange County is offering this.”