COVID-19 Cases and Deaths in Long-Term Care Facilities through June 2021

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The Kaiser Family Foundation (KFF) posted a data report by the same title as this blog on August 2, 2021.

“This data note examines state reported LTCF data from 42 states plus Washington DC through the end of June 2021 to examine patterns of COVID-19 cases and deaths among LTCF residents and staff. While most states report record low deaths and cases in LTCFs, a handful of states have seen an uptick in deaths, and 12 states report higher cases in June 2021 than a previous period. Ongoing tracking to assess the impact of the Delta variant on long-term care facilities at the state-level can highlight the effect of this recent wave on LTCFs. (Bolding and italics above added by me.)

LTCFs include a range of facilities, including nursing homes, assisted living facilities, and other congregate care facilities for people with disabilities or older adults. Data in this analysis is as of the week of June 27th, 2021.

In most states, COVID-19 deaths in LTCFs have continued to fall, with 14 states reporting zero or close to zero weekly LTCF deaths per 100,000 state residents in June 2021. In 11 of these states, zero deaths per 100,000 state residents are rounded values that represent a very small number of LTCF deaths, while Washington DC, Montana, and Rhode Island reported real zero LTCF deaths in June 2021. 21 additional states reported an all-time low LTCF death rate (but not zero) in the most recent month of data available for the state (June 2021 for most states and May 2021 for Florida) (Appendix Table 1). Overall, the average weekly number of COVID-19 LTCF deaths per 100,000 state residents was 0.1 in June 2021, a decline of 96% from December 2020 (when average weekly deaths were 1.6 per 100,000). This decline ranges from 77% in Wisconsin to 100% in six states (California, Connecticut, Washington DC, Massachusetts, Montana, and Tennessee).

However, five states reported an increase in COVID-19 deaths in LTCFs compared to an earlier period. In June 2021, average weekly deaths were higher than earlier months in Colorado (April 2021), Georgia (May 2021), New York (September 2020), and Wisconsin (July 2020) (Appendix Table 2). Louisiana reported slightly higher deaths in April 2021 (the most recent month available) compared to October 2020. Across all five states, however, LTCF deaths in the most recent month were still substantially lower than their peak.

The highly transmissible nature of the Delta variant may impact this trend of decreased LTCF cases and deaths. Preliminary federal data show a slight uptick in national nursing home cases and deaths in the first weeks of July 2021. Given the steady decline of LTCF cases and deaths since January 2021, additional weeks of data are necessary to understand whether this slight uptick is due to a data anomaly or the rise of the Delta variant in surrounding communities. While current data show that many of the recent hospitalizations and deaths due to COVID-19 are among unvaccinated individuals, many people in these facilities have pre-existing health conditions that could put them at high risk of illness or death if they experience a breakthrough infection, regardless of vaccination status. Ongoing tracking and analysis can shed light on the impact of increased community cases, given the close ties between community spread and LTCF cases and deaths.

While LTCF cases and deaths have been steadily trending downward since the vaccine rollout, there are still several factors that prevent the long-term care crisis from coming to an end, including the rise of the Delta variant and low vaccination rates in some parts of the country (both in and out of LTCFs). These factors will be important to consider as policymakers use the experience of the pandemic in these settings to inform policy moving forward.

  • Most notably, the heavy toll that COVID-19 took among staff and residents at LTCFs highlighted the key role that timely, standardized, comprehensive data can play in policy—and the problems that can arise when it is absent.
  • The rollout of the long-term care partnership to deliver vaccines to residents and staff, while not perfect, had a nearly immediate effect that was evident in the data.
  • Lastly, the experience of tracking COVID-19 in LTCFs highlights the importance of targeted or local efforts to understanding data across states.”

There are 2 tables in the Appendix that you should also look at:

  • Average Weekly Long-Term Care Deaths Per 100,000 State Residents, April 2020 – June 2021
  • Average Weekly Long-Term Care Cases Per 100,000 State Residents, April 2020 – June 2021

This data report is through June 2021.  We can expect July 2021’s report to look different and not in a good way.