PROVIDENCE, R.I. (WPRI) – Once the epicenter of the public health crisis in Rhode Island, nursing homes have seen a sharp decline of new coronavirus cases in recent weeks, while infections are growing more rapidly among younger adults, teenagers and children.
The R.I. Department of Health on Wednesday updated its list of nursing homes affected by COVID-19, showing about 32 new cases across five facilities over the last two weeks. That’s a far cry from mid-May, when the state reported roughly 667 new cases across 42 nursing homes over a two-week period.
“It’s a long way from where it’s been,” said Scott Fraser, president and CEO of the Rhode Island Health Care Association, which represents nursing homes across the state.
Looked at a different way, nursing home residents — who make up less than 1% of the state’s population — accounted for less than 3% of total cases over the last two weeks. In May, they represented nearly 20% of the two-week total.
Fraser said a major driver of the decline is the implementation of weekly surveillance testing of residents and staff, regardless of symptoms, which started a couple months ago.
“One of the insidious parts of the virus is that somebody can be asymptomatic and feeling absolutely fine for seven to 14 days and all during that time they’re spreading the virus,” Faser told Target 12. “The sooner we know if someone is positive, the sooner we can do something about it, either sending a staff member home, or placing a resident in quarantine.”
The lower numbers come as a welcomed sign to an industry where more than a third of its resident population – totaling about 7,500 people at the start of the pandemic – has contracted the disease.
As of last month, resident population had declined to roughly 6,100 people, according to the U.S. Centers for Medicare and Medicaid Services, which Faser attributed to fewer admissions, decreased demand for rehabilitation services, and deaths.
In addition to the regular testing, state health officials attribute the slowed pace of new cases to their “infection prevention interventions’ strategy” – which includes a rapid-response team of R.I. National Guard members and state health officials. The group responds to nursing homes whenever there are signs of a potential outbreak.
The team “gets on-site to help homes with issues right away, and we are providing infection control technical assistance to all homes on a weekly basis,” Health Department spokesperson Joseph Wendelken said. “Homes also have more PPE, and some of the staffing issues have improved in many places.”
But Wendelken warned against taking any sort of victory lap, saying residents in congregate care settings such as nursing homes and assisted-living facilities “are still very vulnerable.”
Indeed, while new cases are low across the 49 nursing homes that have reported coronavirus infections at least once during the pandemic, the disease continues to crop up in new facilities.
In Pawtucket, the state reported a new cluster of 16 cases at Pawtucket Skilled Nursing & Rehab, which had never reported any cases before this week. Five staff members also tested positive, according to the long-term care facility, an affiliate of Pennsylvania-based Genesis HealthCare.
“We are working round the clock to keep our patients and residents healthy and as safe as possible,” Chief Medical Officer Dr. Richard Feifer said. “We are doing everything in our power – and everything medical experts know as of at this time – to protect our patients, residents and employees.”
Nonetheless, the decline in new nursing home cases overall could signal a broader shift in how the coronavirus is spreading in Rhode Island, since it comes at the same time health officials are seeing notable increases in other age groups, namely young adults, teenagers and children.
A Target 12 analysis of demographic data over the last two weeks shows health officials reported 282 new cases among Rhode Islanders between 20 and 30 years old, which is the largest increase of new cases across all age groups and 10% more than before.
Similarly, the state identified 78 new cases among children younger than 10 years old, representing a 16% increase over those two weeks. For Rhode Islanders between the ages of 10 and 20 years old, the 129 new cases during that time represented a 13% increase.
Rhode Islanders under 20 years old still make up a smaller share of the total cases identified since the pandemic started, but no other age group saw an increase of more than 8% over the last two weeks, with the lowest rates among people ages 70 and up.
The growth of new cases among younger Rhode Islanders also comes in the back half of a summer when children and teenagers have been allowed to gather in larger groups and at camps.
Wendelken said health officials have seen some cases in “structured settings” — such as daycares — but children most often contract the disease from family members. However, he underscored that it’s more challenging to identify how infections spread among children because they often don’t show symptoms.
“With adults, we sometimes have a group of partygoers, for example, who all become symptomatic. It’s easy to identify that as a place of transmission,” Wendelken said. “Children are often not symptomatic, so we’re less often able to trace multiple [COVID-positive] children back to a common exposure, like a birthday party for example.”
For younger adults, health officials say the reason why the numbers are growing appears to be clearer. “We’re partying too much,” Gov. Gina Raimondo said during a recent news conference.
Raimondo has repeatedly called out younger adults for meeting up in large groups, spurring her to scale back the limits on social gatherings to 15 people and to order the closure of bars and bar areas by 11 p.m. each night.
Fraser said he’s encouraged that nursing homes are in a better place now than they were earlier in the pandemic, but he’s nonetheless concerned about the long-term effects the pandemic could have on the industry.
With the number of residents in nursing home declining – some facilities are reporting decreases as high as 30% to 40% – Fraser said it’s unclear how they will remain financially viable long-term.
Nursing home workers, meanwhile, have been calling on the facilities and the legislature to provide them with better pay, mandated staffing levels and improved health insurance.
Two weeks ago, SEIU District 1199 members in five nursing homes threatened to strike, but eventually postponed after Raimondo sent a letter to the group pledging “to find a solution to Rhode Island’s chronic nursing home staffing crisis.” However, the General Assembly declined to pass a bill on mandatory staffing levels that drew fierce pushback from the industry.
Perhaps most importantly, Fraser said, the industry needs to dispel any fears among the broader public that nursing homes are dangerous places to recover, live or send family members.
“Nursing homes are in fact a safe place for your loved ones to be,” Fraser said. “It’s not an automatic death sentence when anyone gets COVID-19, and I think that’s important to remember.”