PROVIDENCE — Rhode Island nursing homes, once the epicenter of the state’s COVID-19 crisis, are now seeing heartening signs of progress as the vaccination campaign there wraps up.
New infections among these residents dipped to about 15 in the past two weeks. That compares to nearly 400 new cases in the last two weeks of December, just as the second wave crested and the vaccinations began. Hospitalizations and deaths have also declined significantly.
The COVID toll has declined everywhere since the winter peak, but it’s been even more profound in nursing homes. State health officials say that shows the vaccinations, which began on Dec. 28, are working.
“The fact that the vaccines have worked so well in the nursing home population is extremely encouraging to me,” said Dr. James McDonald, medical director at the state Department of Health.
Scientists are still learning how well the vaccines stop people from spreading the virus, but experts say signs on that front are promising. And the vaccines have also been shown to prevent people from having the symptomatic disease the virus causes. According to McDonald, from mid-December to mid-February, COVID hospitalizations among residents of long-term care facilities were down 87 percent . In the rest of the state, they were down 54 percent. Deaths were down 87 percent among long-term care facility residents, and down 66 percent everywhere else.
“You don’t need to be a statistician to say, gee, these are really different numbers,” McDonald said.
Things like access to and use of personal protective equipment have been just about the same for months, McDonald said, so that doesn’t explain the dip. The number of people in nursing homes has been relatively consistent since the winter’s surge, too. Only a few things are different now: The availability of vaccines, as well as treatments called monoclonal antibodies, which might have played a role in keeping hospitalizations down.
The fact that Rhode Island hasn’t seen much of the new virus variants — seven cases of the so-called UK variant identified so far — is also probably helping the situation, McDonald said. That’s also a reason why Rhode Island still can’t do what places like Texas and Mississippi have done, which is to open things way back up, he said.
“Why people are rushing to reopen their economies and risk introduction of the variant — it doesn’t have any basis in science to me,” McDonald said.
All told, since the beginning of the pandemic a year ago, at least 1,445 nursing home residents in Rhode Island have died after contracting COVID-19 as of March 3, according to state statistics. Another 165 to 169 residents of assisted-living facilities had died.
But since vaccinations began, no nursing home resident has died two or more weeks after their second vaccine dose, Dr. Nicole Alexander-Scott, the director of the state Department of Health, said recently.
That shows the vaccines are “extremely effective,” she said, adding: “When your time is available, go get vaccinated.”
Similar declines in nursing home cases are playing out nationally. Every state prioritized nursing home residents early on, and some started even sooner than Rhode Island did, so the success is not unique to the state.
According to a review of national statistics by the Kaiser Family Foundation, new cases among nursing home residents dropped 83 percent since the rollout of the vaccines, while they’ve only decreased 45 percent among non-nursing home residents. That suggests, but doesn’t prove, a link between the vaccines and the declines — which could be influenced by other things, too, according to the review.
In Rhode Island, the last round of nursing home vaccinations took place in early March. Like most other states, Rhode Island took part in a national partnership with CVS and Walgreens to vaccinate staff and residents of nursing homes and other group living settings. The program in Rhode Island uses the Pfizer vaccine, which requires two doses.
According to the latest data update, no single nursing home in Rhode Island had more than four cases in the last two weeks.
One of the only homes that has even had multiple cases recently was the Respiratory and Rehabilitation Center of Rhode Island in Coventry. They had three resident cases and one staff case, according to Dr. Richard Feifer, chief medical officer of parent company Genesis Healthcare. Those who tested positive had either chosen not to get vaccinated, or had only had one dose, Feifer said.
“This is unquestionably the biggest vaccination effort ever undertaken and will help prevent further tragedies, especially in this vulnerable population,” Feifer said.
Things now look even better than they did during the summer lull in infections, according to the state Health Department. With that, the state recently allowed visitation to resume at nursing homes, but under strict rules, some of which have left administrators puzzled: You must maintain six feet of physical distance, even though brief physical contact, like hand holding or hugs, is allowed.
Still, challenges remain, especially with new and more transmissible variants of the virus emerging in Rhode Island and elsewhere.
For one, not everybody in the nursing homes has opted to get vaccinated. At the facility in Coventry, according to Feifer, 93 percent of residents and 79 percent of staff took the vaccine. Some homes in Rhode Island have reported fewer than 50 percent of their staff taking the vaccine.
For another, the homes will also need continued vaccinations because they’ll continue to accept new patients and welcome new staff, said Scott Fraser, president and CEO of the Rhode Island Health Care Association.
The association, which represents mostly for-profit homes in Rhode Island, has been told that the state is seeking vendors to do it, Fraser said.
“Yes, the vaccination program has worked well,” Fraser said. “And we want to make sure it continues to protect the residents and the staff.”