Governors urged to prioritize long-term care residents, staff for COVID-19 vaccine

The American Health Care Association and National Center for Assisted Living are urging governors and public health authorities to prioritize residents and staff of long-term care facilities in the first wave of COVID-19 vaccine distribution.

Mark Parkinson, President and CEO of American Health Care Association and National Center for Assisted Living (AHCA/NCAL), said during a press conference that it became clear that long-term care residents have a particularly high risk for mortality with the novel coronavirus early in the pandemic, and that “we now know from the data that a long-term care resident is over 600 times more likely to die of a [COVID-19] infection than a person that’s in their 20s.”

Recently, the HHS distributed $523 million in performance payments to nursing homes that reduced their COVID-19 cases and deaths from September to October to incentivize them to lower cases and to assist in their response to the pandemic.

The high mortality rate in long-term care facility residents, in addition to the recent increase in cases in these facilities and in the general public, has led the AHCA/NCAL to make recommendations for the rollout of the COVID-19 vaccine.

“First, we’re asking every governor and every public health official to make the residents and employees of long-term care facilities the absolute first priority for receiving the vaccine,” Parkinson said. “And secondly, we’re asking them to set a goal — a goal with a specific date of having every single resident and every single staff member in those facilities receive the second dose of vaccine by March 1.”

He said that if this is accomplished, tens of thousands of lives could be saved.

“It is a staggering statistic that less than 1% of the COVID-19 cases in the United States have been people in long-term care, but over 40% of the deaths have occurred there,” he said. “And as tragic as that statistic is, it gives us an incredible opportunity to make a huge difference in the mortality rate just by focusing the initial rounds of vaccine distribution and actual vaccination on this very vulnerable population.”

David Gifford, MD, chief medical officer of AHCA/NCAL, said that while this is a “monumental task,” they are working on the logistics of this goal with the CDC, pharmacy chains Walgreens, CVS and others.

“We expect, really, in the next couple weeks, to start seeing vaccine in the arms of the residents of our buildings out there,” he said.

Parkinson noted that although the CDC and states have indicated that health care workers and long-term care facility residents should be the first wave of COVID-19 vaccine distribution, there will likely not be enough vaccines for everyone in this group for the first round.

“Everyone in the top tier certainly needs to be vaccinated, and we’re not in any way suggesting that there are health care workers that are in that top tier that shouldn’t be vaccinated; we totally get that,” he said. “But what we are saying is that with that limited supply that’s going to be available over the next few weeks, the absolute top of that top tier should be long-term facility residents and the folks that take care of them.”

This is because, he said, the data suggests that this could cut the overall COVID-19 mortality rate by 40% in the U.S.

Later, Gifford said that while they do not expect federal, state or facility-level mandates for residents to get the vaccine, many families and residents are looking forward to getting the vaccine.

Parkinson added that although some of the general public have said they would hesitate in getting the vaccine, the same hesitation is unlikely in those living and working in long-term care facilities because of the high mortality rate among residents.

“Tragically, our people have seen, upfront, how horrible this virus can be, and so I would assume that the adoption rate would be much higher among workers and residents in facilities,” he said.

References:

• AHCA/NCAL. AHCA/NCAL Renews Calls For Governors To Prioritize Long Term Care Residents And Staff For Vaccine Distribution Following FDA Approval. https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/AHCANCAL-Renews-Calls-For-Governors-To-Prioritize-Long-Term-Care-Residents-And-Staff-For-Vaccine-Distribution-Following-FDA.aspx. Accessed December 16, 2020.
• HHS. Trump Administration Announces New Half Billion Incentive Payment Distribution to Nursing Homes. https://www.hhs.gov/about/news/2020/12/07/trump-administration-announces-new-half-billion-incentive-payment-distribution-to-nursing-homes.html. Accessed December 17, 2020.