The Biden admin is frustrated with nursing homes as senior rates plummet and new variants spread

The Biden administration — increasingly frustrated by low vaccination rates in nursing homes — is forwarding lists of zero-vaccinated seniors’ facilities to state regulators for review and possible penalties, which could include fines. The government is also contacting governors to urge them to increase their vaccination rates.

Meanwhile, the Covid 19 cases are piling up across the country. More than 470,000 new infections were reported in the last week, a 50 percent increase since Thanksgiving, and nearly 3,200 people over the age of 70 are hospitalized with Covid-19 every day on average.

The surge, fueled in part by holiday meetings and the new fast-porting variant XBB.1.5, is worrying White House officials so much that they are planning to launch another push in the coming month aimed at older Americans who are see them as particularly vulnerable to the virus after a six-week push that yielded modest results in the new year.

“Obviously people are fed up with Covid,” said Ashish Jha, the White House Covid response coordinator. “A lot of people I know say, ‘I got three or four shots, why do I need another one?'”

Despite a concerted effort by the White House to increase the number of people over 65 who got their booster booster before the holidays, only 38 percent of seniors got the shot, compared to 94 percent of seniors who got it, according to CDC data have received their first two shots.

The numbers are far worse in the Southeast, where fewer than a quarter of seniors in several states have received their updated booster.

“You have a conundrum, on the one hand, getting an injection in the US has never been easier. You can go to any pharmacy and get them for free – and we know that won’t be the case forever. On the other hand, the bivalent booster just isn’t getting the interest and acceptance that we think it should have,” said Joseph Kanter, Louisiana state health commissioner. “But it’s hard for people. Everyone is traumatized. People react differently.”

Nursing homes, which were key to spreading gunshots when they first became available, are of particular concern to state and federal officials. While 86 percent of nursing home residents received their first vaccinations, less than half of their vaccinations are up to date, according to CMS data.

Federal health officials are taking a carrot-and-stick approach to increasing those vaccination rates: For example, implementing a policy that allows nursing homes to vaccinate their residents while drawing the attention of state regulators to nursing homes where no one is vaccinating is. CMS Administrator Chiquita Brooks-LaSure also wrote to governors in the states with the five lowest vaccination rates in nursing homes, asking them to step up.

While their vaccination coverage is three times that of the general public, the nursing home industry has acknowledged it has more work to do and in November shared an “all hands on deck” strategy with the Biden administration to get it done do.

“Nursing home providers make every effort to encourage residents to roll up their sleeves, but increased adoption requires a concerted effort by public health officials, other health care providers, and the general public,” according to the American Health Care Association and the National Center for Beveraged A statement said it would live. “We remain focused on continuing our education efforts, addressing misinformation and COVID fatigue, and working with administrators and other stakeholders to improve bivalent refresher rates in nursing homes.”

The administration is also urging hospitals and nursing homes to be more proactive in offering the shots, e.g. B. Giving them to people who have come to the hospital for other ailments before they are discharged and increasing home deliveries.

At the same time, the White House is exploring ways to distribute the vaccines through a network of advocacy organizations that work with older Americans, like the AARP and the nonprofit organization LeadingAge. The government has also been seeking more funding for senior centers through various federal programs to better target their immunization campaign — including $125 million for accessible immunization clinics, home immunizations, and $350 million for health centers to host immunization events.

Meanwhile, an average of 70 percent of new daily hospitalizations in the past week for patients with confirmed Covid-19 were ages 60 and older, according to CDC data. And people over the age of 65 – who have long been at risk of the virus’ most serious health consequences – account for the largest proportion of deaths from Covid-19 than at any other point in the pandemic, according to an analysis by the Family Foundation.

“It seems like we’re in this cycle where we haven’t learned anything from what happened before,” said Krutika Kuppalli, infectious disease physician and chair of the global health committee of the Infectious Diseases Society of America. “People want to get back to normal and I think that’s part of it. I also think people don’t remember – three years before the start of year four of the pandemic – how bad it was at the beginning.”

Federal and state health officials said a new wave of misinformation – coupled with ongoing disinformation about the Covid vaccine – has complicated efforts to increase the number of people who have received the updated booster as XBB 1.5 proliferates.

“All the evidence to date suggests that this is the most immune-preventable version of the virus that we have seen and may be more contagious,” Jha said. “Is it worrying? Yes. But the fundamental problem, I think, is that it’s not a reason to fear, it’s a reason to act.”

In Mississippi, where 1 in 5 seniors have received the updated refresher, the lowest rate of any state, health officials claim the problem isn’t availability — it’s interest.

“One of the biggest issues we’re hearing is that individuals and families are not interested in getting additional vaccinations,” said Paul Byers, the state’s epidemiologist. “We are working on several efforts to increase understanding of the importance of the updated booster shot, particularly for those in long-term care and those aged 65 and over.”

In Louisiana, where uptake of the bivalent booster is slightly higher than in Mississippi, Kanter blamed the low vaccination rates on a combination of an intense focus on flu shots, declining federal funding, and “institutional fatigue.”

“Our care homes have done a really good job of getting the booster out, but there’s still work to be done,” Kanter said. “To be honest, people are tired. Some of the messages were confusing and we’ve also prioritized flu vaccines this season for good reason, but it’s difficult for people.”

And in South Carolina, Brannon Traxler, director of public health at the state Department of Health and Environmental Control, said the state is focused on making sure seniors and those in long-term care facilities have the information to make an informed decision, and then access to a shot if you want it.

“While refresher rates are better in this older population, they’re still not what we’d like to see and what would really make such a difference in these hospitalizations and severe cases in this population,” Traxler said.

Health officials are also equally – if not more – concerned about the lower than hoped uptake of Covid therapeutics like Paxlovid. In tacit acknowledgment that the Biden administration is running out of ways to increase vaccination coverage, federal officials also plan to increase their promotion of treatments like Paxlovid as an alternative that can keep people out of the hospital.

Both state and federal health officials consider Paxlovid a key tool to help mitigate the impact of Covid-19 for those who are reluctant to receive the vaccine.

“People may not make the choice to do the prevention, but if they test positive, especially if they’re in a high-risk category… we want them to have access to Paxlovid quickly,” said North Carolina Secretary of Health Kody Kinsley. “This is an endurance challenge at this point.”

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