Disproportionate share of Delaware COVID deaths involve nursing homes

DOVER — Delaware’s latest weekly update on COVID-19 in the state’s long-term care facilities included 19 additional deaths and 303 new cases, although the large jump partially stems from a review of the data. Those statistics also do not count employees, information the state hopes to compile and share at some point.

The Division of Public Health said 247 of the 388 coronavirus-related deaths in the state have involved nursing home residents, equivalent to about 64 percent. That’s despite the fact just 990 of the 9,773 positive cases, or 10 percent, have involved residents.

According to DPH, the recent increase in total cases from nursing homes or similar facilities is mostly due to changes to the data.

“A quality review of the long-term care case data resulted in an adjustment to the total number of cumulative cases among long-term care residents; additional cases were added to the total count,” the agency said.

“In addition, after further consideration, DHSS has removed Delaware Psychiatric Center (DPC) from the list of long-term care facilities with COVID-19 related cases and deaths. DPC is an acute-care facility rather than a long-term care facility. Due to this change, DPH has removed three deaths from the total number of deaths among residents of long-term care facilities.”

The agency did not offer more specific information on the change.

DPH identified 30 facilities as having had at least one resident death stemming from COVID-19. Ten have seen double-digit fatalities, with Harrison House Senior Living and Genesis Healthcare’s Milford Center combined accounting for 27 percent.

However, Milford Center has not seen any deaths in at least three weeks, while Harrison House’s total jumped from 25 to 35 over the past seven days.

According to a spokeswoman for the Department of Health and Social Services, DPH’s parent agency, 11 places have been cited for COVID-19 deficiencies since March. Those are Little Sisters of the Poor, Milford Center, ManorCare Health Services’ Pike Creek facility, Millcroft, Brandywine Nursing and Rehabilitation Center, Governor Bacon Health Center, Pinnacle Rehabilitation and Health Center, Harrison House, Hillside Center, Westminster Village and Weston Senior Living Center.

While there have been some delays in getting testing materials to the homes, the state sent them slightly more than 39,000 kits in a 24-hour span toward the end of this week, DHSS spokeswoman Jill Fredel said.

“When the state announced universal testing of long-term care (LTC) facilities two weeks ago, the process was already in place for the use of nasal swabs,” she wrote in an email. “When the majority of facilities expressed the desire to use a cost-free, more simplistic test, the Division of Public Health quickly worked with Curative Inc on behalf of the facilities to initiate a computer software change to meet their needs, and ensured the availability of the test kits for these facilities. DPH is appreciative to Curative for stepping up and making the programming change to create a log-in process just for LTC facilities in such a short time frame.”

Some facilities are using their in-house labs “or are pursuing other testing options since the use of the Curative test is not mandatory,” according to Ms. Fredel.

Preliminary data from the federal Centers for Medicare & Medicaid Services indicates only four states (New Jersey, Connecticut, Massachusetts and Rhode Island) have a higher rate of COVID-19 in nursing homes than Delaware. About 19.2 percent of residents in the First State have contracted the virus, per the data.

The same numbers also report the state is 11th in per capita deaths involving long-term care residents, at 4.4 percent.

According to a Thursday analysis from the Kaiser Family Foundation, 16 percent of cases across 43 states have involved nursing homes, while 45 percent of deaths across 41 states have involved these facilities. In other words, the average state has a larger share of COVID-19 cases from nursing homes than Delaware while also having fewer long-term care resident deaths when adjusted for population size.

Sizable impact

Asked Friday about the sizable impact coronavirus has had on long-term care homes, Gov. John Carney said every state has seen significant death totals in nursing homes and other centers because individuals living in them are simply more susceptible to the virus. He also admitted the efforts to stop the spread there, chiefly through frequent testing of residents and employees, is not proceeding as quickly as he hoped.

“I think the other reality is the people in nursing homes work in several nursing homes,” he said. “They often don’t get paid a lot of money, so they need to work. Maybe they’re feeling a little bit sick and so they come to work anyway because they need the money when maybe they should have stayed home because they have the virus.

“What I do know is that as we move forward this is where we really have to lean into and we need better cooperation from nursing homes and nursing home workers to get it right.”

It’s unclear exactly how many workers in these facilities have caught the virus. Long-term care centers are required to send to DPH daily reports on the number of cases and deaths, including ones involving staff, but that information is not public.

“Our data system is not currently set up in such a way that it would allow us to easily break out individuals who have either tested positive, or who have died, by a specific industry or company,” DPH spokeswoman Stacey Hofmann wrote in an email. “As we gain more analytical strength in our data surveillance systems, we hope to report this information out, but we have no timeline for this yet. The information on staff illness that facilities report on the forms you have noted are for internal use and does not get entered into our system until it has been verified.”

The state announced just 27 new overall cases and two new fatalities on Friday. According to DPH, 128 people were hospitalized for COVID-19, the lowest level in two months. Twenty-six were critically ill.

DPH said 5,631 people have recovered, meaning they’ve gone a week without symptoms.

The state’s first confirmed case came on March 11. There were 9,241 cases, 183 hospitalizations and 356 deaths one week ago and 6,320 cases, 289 hospitalizations and 213 deaths as of May 8, four weeks before the latest data.

So far, about 1.02 percent of Delawareans have tested positive for the virus. DPH said there have been 66,729 tests, although that figure is preliminary and does not include an unknown number of results that are pending.

Total hospitalizations and the percentage of new positive tests are trending downward, prompting Delaware to take steps toward reopening. Many businesses were allowed to open with strict limits Monday, and more restrictions will be waived in the coming weeks.

Still, officials warn the virus is not beaten yet, urging Delawareans to continue social distancing and wearing face coverings in public.

The most recent deaths involved a 78-year-old Kent County woman and an 87-year-old woman from Kent. One of the two was a resident of a long-term care facility.

The next update on long-term care center cases is expected Friday, June 12.


Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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