Articles Posted in Infections

declinenhomedeathsnytfeb21-300x189Just as good news expands about vaccines and declining coronavirus cases and deaths in the nation’s nursing homes and other long-term care facilities, grim information also is developing on how the facilities’ ownership, particularly by wealthy investors, can be lethal to residents.

The positive effects of early efforts to get vulnerable long-term care residents and staff vaccinated can be seen in the accompanying graphic (courtesy of the New York Times). The newspaper reported this:

“Throughout the pandemic, there has been perhaps nowhere more dangerous than a nursing home. The coronavirus has raced through some 31,000 long-term care facilities in the United States, killing more than 163,000 residents and employees and accounting for more than a third of all virus deaths since the late spring. But for the first time since the American outbreak began roughly a year ago — at a nursing care center in Kirkland, Wash. — the threat inside nursing homes may have finally reached a turning point. Since the arrival of vaccines, which were prioritized to long-term care facilities starting in late December, new cases and deaths in nursing homes, a large subset of long-term care facilities, have fallen steeply, outpacing national declines, according to a New York Times analysis of federal data. The turnaround is an encouraging sign for vaccine effectiveness and offers an early glimpse at what may be in store for the rest of the country, as more and more people get vaccinated.

cdccoviddata22721-300x156As patients who have suffered through catastrophic injury or illness know, the recovery process can be a tough slog. Good days. And bad. Positive signs. Negative ones, too. This is the difficult up-and-down the nation is enduring as it seeks to conquer the coronavirus pandemic.

Cases, hospitalizations, and deaths from the disease plunged in recent weeks.

But the trend lines, unacceptably high even after their decline, have plateaued (see chart from the federal Centers for Disease Control and Prevention) — and public health experts fear they will rise anew.

chartjhavax-300x189The national campaign to quash the coronavirus pandemic with what appears to be a highly safe and effective means — new vaccines — has hit more chop as the Biden Administration pushes to increase supplies, sites, and credible public information about the shots.

While the White House has worked with makers to boost the complex production of vaccines  and officials are ferreting out unused stashes, demand still exceeds supplies, and rotten weather in the central part of the country disrupted deliveries of millions of shots, causing coast-to-coast cancellations of appointments for patients hoping to get shots. This snag affected the region around Washington, D.C.

The White House has said the supply chains will be restored, pronto.

cmsjan2021nhomedeaths-300x156The campaign to vaccinate millions of residents and staff in the nation’s thousands of nursing homes and other long-term care facilities against the coronavirus is gaining momentum and showing early, positive effects.

At the same time, however, information is emerging on shabby treatment of the vulnerable, including their exposure to illness exported into their facilities from hospitals, explaining the increasing number of civil lawsuits that owners and operators face.

Good news has been so rare with the pandemic that it may be worth considering first the coast-to-coast drive for long-term care facility vaccinations.

After months of giving chaotic and counter-factual guidance — or none at all — on the coronavirus pandemic, the federal government now under President Biden has weighed in on vital concerns: individuals redoubling their self-protection, notably by wearing better or two face masks, and safely reopening schools for younger kids.

The new counsel from the federal Centers for Disease Control and Prevention may rile parts of the public, notably teachers’ unions and those who have fought health restrictions with cavalier and extreme claims that they somehow infringe on their personal rights.

covidkillerfactors-300x130Roughly a tenth of adult Americans (~37 million people) have gotten coronavirus vaccinations, as the Biden Administration pushes to increase vaccine supplies and shot sites, while also boosting disease testing capacity and availability of personal protective equipment (PPE) for health workers.

The battle against Covid-19 may seem still to be a slog, with vaccine demand exceeding supply and frustration high as to why the nation has not made greater progress in quashing the pandemic and returning to normality.

As expected, Republicans in Congress have declined to join the new president and his administration in the Democratic plan to fast track and go big with a pandemic response — especially with a $1.9 trillion relief plan that will follow hard on the heels of a $900 million package that was stalled for months by the GOP but finally approved in December.

candidacdcauris-300x135Patients long have dreaded the possibility that — when already seriously ill or hurt — they also would be hit with debilitating or deadly hospital- or health care-associated infections, aka HAIs. The most nightmarish of these cases involve bacteria or fungi difficult to subdue, even with powerful treatments.

Now, with care institutions overwhelmed by coronavirus pandemic cases, drug-resistant HAIs are increasing — and in worrisome fashion because they are so difficult on their own for patients, doctors, and hospitals to deal with, the New York Times reported:

“’Seeing the world as a one-pathogen world is really problematic,’ said Dr. Susan S. Huang, an infectious disease specialist at the University of California at Irvine Medical School, noting that the nearly singular focus on the pandemic appears to have led to more spread of drug-resistant infection. ‘We have every reason to believe the problem has gotten worse.’ A few data points reinforce her fears, including isolated outbreaks of various drug-resistant infections in Florida, New Jersey, and California, as well as in India, Italy, Peru, and France. Overall figures have been hard to track because many nursing homes and hospitals simply stopped screening for the germs as resources were diverted to Covid-19. When even modest screening picked up again early in the summer, the results suggested that certain drug-resistant organisms had taken root and spread. Particularly troublesome have been growing case counts of a fungus called Candida auris [shown in CDC photo, above], which authorities had tried to fight before the pandemic with increased screening, isolation of infected patients and better hygiene.”

coronavirusvaxallocationfmgao-300x167As coronavirus vaccine supplies  keep far exceeding demand, and as the new administration races to acquire and distribute more doses, as well as to kick start  plodding vaccination campaigns across the country, it may be a challenge not to ask the people who oversaw battling the pandemic before: What the heck were you thinking?

More on that in a second.

As of Jan. 29, the federal Centers for Disease Control and Prevention reported that ~49 million vaccine doses had been shipped and ~28 million were administered, with ~23 million patients now having received at least one of two shots required.

altarumfig-300x176The Biden Administration faces major challenges as it seeks to tame the coronavirus pandemic’s terrible toll on nursing homes and other long-term care facilities. The roll-out of vaccines for residents and staff plods along, while a big concern may be rising as facility staffing keeps eroding.

The New York Times reported that Walgreens and CVS, the chain pharmacies that the Trump Administration chose to partner with with to deliver vaccine shots to long-term care facilities, have vaccinated 1 million and 1.6 million residents and staff, respectively.

Both companies say the vaccination rollout has been rockier and tougher than expected, with issues in getting required consent for shots for the elderly, sick, and injured, as well hesitancy among staff. Vaccine supplies have been less predictable than would be optimal, though the pharmacies are not reporting shortfalls. Rina Shah, a group vice president at Walgreens, told the New York Times that the logistics and scheduling of vaccinations, with multiple visits at facilities, has required a “monumental effort.”

bidenPresident Biden kicked off his term by swiftly issuing a series of executive orders and sharing an actual plan to combat the unchecked, raging coronavirus pandemic — which he warned will get worse before it gets better and may kill as many as 600,000 Americans in grim days ahead.

Biden put the federal government squarely in the Covid-19 battle, promising to work with states and local governments but not, as his predecessor had, to shove huge roles and responsibilities on a host of others without talking with or helping them thereafter.

He said his strategies and tactics would rely on science and the best experts available, not on personal and political cronies or personalities popping up on TV broadcasts or extremist online sites.

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