Nearly a year after the coronavirus tore through Louisiana nursing homes and left thousands of residents dead, new infections reached their lowest point this past week, a sign that the threat the nearly yearlong pandemic has had on the elderly is close to rounding a corner.
Since the late-December rollout to vaccinate millions of Americans living in nursing homes and assisted living facilities, new cases and deaths in those homes have fallen steeply. That downtrend is likely a result of an overall drop in cases within communities, as well as more of the state's most vulnerable residents receiving the life-saving shots, health experts say.
Only 19 of the state’s more than 270 nursing homes reported having at least one case or more in the past week, for a total of 47 infections overall. That's the lowest level recorded since the Louisiana Department of Health began publishing case counts within long-term care homes. Thirteen of those homes reported only one resident testing positive for the virus.
Cases in nursing homes have also fallen more than 90% since a post-holiday surge of infections, an encouraging sign that centers housing the elderly are near a turning point in shielding the state’s most vulnerable residents from COVID-19 after a lengthy dark period.
“It provides great relief to the experience we’ve been having month after month,” said Louisiana AARP Director Denise Botcher. “While it’s tremendous relief, we shouldn’t drop our guard. We should do everything we can to protect residents and staff because there’s a lot we don’t know.”
The virus has been especially deadly in settings where elderly people live in close quarters and often have underlying conditions that enhance the virus’s deadliness. Roughly one-third of the nation's more than 500,000 deaths were long-term care residents, a figure that mirrors Louisiana's human toll.
Despite taking steps to seal off their campuses to visitors and enacting other policies, the virus still managed to seep in. It also exposed other problems, such as low staffing and struggles to control infections — issues predating the virus's global outbreak.
Many long-term care facilities were caught flat-footed when the virus gained a foothold in Louisiana, leading to some of the grimmest days in the early weeks of the pandemic.
The steepest rates of infections happened last April, and more than a thousand residents died from the virus by the end of May, according to health department records compiled by The Advocate and The Times-Picayune. The first few months alone accounted for 40% of the more than 2,750 fatal cases tied to the virus as of last week.
”We didn’t close them down quick enough,” said Tulane Epidemiologist Susan Hassig. “It was probably in a lot of nursing homes before we even knew.”
The virus has continued to haunt nursing homes as cases within facilities mirrored large outbreaks in communities during the summer and, recently, after the holidays. It’s also had secondary effects that have led to worries about resident’s welfare worsening because of the prolonged isolation.
Lockdowns left family members with little knowledge about how their loved ones were faring for months. Even after the state allowed in-person visits in September, they are still in tightly-controlled and physical contact, like hugs, are not allowed.
State health leaders say it’s still too early to tell when restrictions can be relaxed, and officials have grown worried about emerging variants of the virus that are more contagious and will likely require more people to get vaccinated than initially thought.
Cases throughout Louisiana have dropped since the third wave hammered the state around the holidays, and so too have hospitalizations and deaths. That downturn is likely driving down the number of infections at long-term care homes, said Theresa Sokol, Louisiana’s acting state epidemiologist.
"It's clear that they're aligned. When we see increases in the community, that's when you have more introductions into the facilities and you have more transmission in the facility,” she said.
Vaccines are also beginning to show their ability to protect people from infections.
Drugstores CVS and Walgreens were tapped by the Trump administration to administer vaccines to long-term care and assisted living centers, a program that has at times been criticized for its slow pace and missteps.
Some nursing homes were holding onto shipments of vaccines — sometimes for weeks — before clinicians came to administer them. The sluggish pace led to pushes from states to take vaccines from those caches to be used elsewhere.
Nevertheless, CVS said it’s completed two visits each to 130 long-term care facilities and Walgreens has completed 86% of its second visits to more than 144 facilities that it’s partnered with. Both are in the early stages of returning for a third and final visit to administer remaining booster shots to residents and staff.
Another possibility for the sharp decline within nursing homes could be due to the thousands of residents and staff who’ve already contracted the virus, even unknowingly.
More than nearly 14,000 residents and over 10,000 employees have tested positive for the virus since March, according to the latest state health department data. Though the number of people living in nursing homes changes, an average of about 22,000 people have been living in nursing homes since last May.
“Even if they haven’t gotten both doses into the arms of residents, the fact that many of them would have had preexisting covid exposure is something to factor in,” Hassig said. “At least getting the first dose in could very well provide substantial benefit.”
More than a half-million Louisianans have received the vaccine, and the recent authorization of a one-dose shot made by Johnson & Johnson could give the effort to inoculate Americans a jolt in the coming weeks.
Vaccinations are the key to a return to normalcy and curbing the number of people who get severely sick and require hospitalization, Sokol said.
"That is our best hope that we're seeing the light of the end of the tunnel,” she said. "But It's not behind us yet, we're still going to have to be very vigilant.”