Covid in the nursing homes: the US experience

Abstract

The death toll in nursing homes accounted for almost 30 per cent of total Covid-19 deaths in the US during 2020. We examine the course of the pandemic in nursing homes focusing especially on whether nursing homes could have been better shielded. Across all nursing homes the key predictor of infections and deaths was community spread, i.e. a factor outside of the control of nursing homes. We find that higher-quality nursing homes, as measured by the CMS Five-Star Rating system, were not better able to protect their residents. Policy failures from the CDC and FDA, especially in the early stages of the pandemic, created extended waiting times for Covid-19 tests and slowed attempts to isolate infectious residents. But once infections were widespread, testing would have had to have been much greater to have had an appreciable effect on nursing home deaths. We find, however, that starting vaccinations just 5 weeks earlier could have saved in the order of 14,000 lives and starting them ten weeks earlier could have saved 40,000 lives.

Covid-19 Vaccines As a Condition of Employment: Impact on Uptake, Staffing, and Mortality in Elderly Care Homes

“…In contrast, Bjoerkheim and Tabarrok (2022) find no association between nursing home quality and Covid-related deaths.…”

“…Deaths among elderly care home residents have been a significant contributor to Covid-related mortality in many countries (see, for example, Chen, Chevalier and Long, 2021;Bjoerkheim and Tabarrok, 2022). The primary aim of the mandate was to reduce infection outbreaks and subsequent serious illness and death among elderly residents by lowering the likelihood of transmission from infected care workers.…”

Quantifying the effect of vaccination on transmission in modelling studies

“… 3 Third, the COVID-19 pandemic has shown us that highly infectious individuals can cause disproportionate morbidity and mortality in environments with vulnerable people, such as nursing homes and hospitals. 4 …”