Vaccinations can’t come too soon for hard-hit Nebraska nursing homes

Nebraska – When Adrian Pospisil learned that COVID-19 vaccinations would soon be coming to his nursing home, he immediately jumped to the front of the line.

“Put me on the list,” the 73-year-old resident of the Douglas County Health Center told one of his caregivers. “I’ll be the first.”

The retired machinist said he’s more than ready to be freed from the deadly virus that has kept him largely confined to his room.

No movies or other group activities.

No Sunday worship or Wednesday rosary service.

No visits from his brother or outings to Pospisil’s favorite dining spots — Arby’s and the diner at Hy-Vee supermarket.

And despite all the measures taken by staff to protect the county-run nursing home’s vulnerable residents, the care center has seen two fatal COVID-19 outbreaks — the most recent coming during a statewide surge of virus cases this fall that at its peak was killing a dozen Nebraska nursing home residents a day.

Throughout the wearying coronavirus pandemic, no one has paid a higher price than residents of long-term care facilities.

That’s why those residents and the workers who help care for them have been given high priority as Gov. Pete Ricketts and health officials allocate the state’s limited supply of lifesaving vaccines. The big rollout of vaccines for care facilities across Nebraska is set to begin Monday.

“This vaccine represents our way out,” said Heath Boddy, president of the Nebraska Health Care Association, which represents the state’s long-term care facilities. “We know the vulnerability of the population.”

Indeed, nursing home residents have accounted for roughly half of all Nebraska deaths linked to COVID-19. Federal data suggests that more than 600 Nebraska nursing home residents had died as of earlier this month.

Iowa has seen at least 1,500 nursing home deaths, and there have been more than 80,000 nationally. And those figures don’t include deaths in other long-term care settings for the elderly, such as assisted living.

Even residents who have avoided the contagious virus have faced months of confinement, and health officials say that has been detrimental to their health, quality of life and feelings of well-being. Both residents and their families have been longing for the day when they can hug each other again.

“Long-term care residents are bearing the brunt of this disease right now,” said Todd Stubbendieck, state director of AARP Nebraska.

Given that there are some 20,000 long-term care residents in Nebraska and another 28,000 people who care for them, the task of vaccinating them all is Herculean.

The state and federal government are working with three pharmacy partners to get the vaccines out to roughly 200 nursing homes and 300 assisted living facilities in every corner of the state. The process will take weeks — but it also offers much hope for residents and their loved ones.

While state officials have provided limited information on COVID-19 outbreaks in the state’s long-term care centers, The World-Herald has been tracking outbreak data reported to federal regulators by the state’s federally licensed nursing homes.

Those figures paint a grim picture of what happened within the homes as the virus surged across Nebraska this fall, giving Nebraska some of the highest infection rates in the nation and threatening to overwhelm the state’s hospitals.

The state went from averaging about one nursing home death per day in September to a dozen a day by Thanksgiving. In a single week in late November, 83 nursing home residents died.

And despite the belief among many in rural Nebraska that the virus is largely a city problem, nursing home death rates have been far higher outside Nebraska’s two largest cities than within them.

The pandemic has shown that when COVID-19 cases surge within Nebraska’s cities and towns, the virus frequently makes its way into nursing homes. Most often, it’s brought inside by a staff member not yet showing symptoms who contracted the virus within the community.

Because of that, experts say, wearing masks and practicing social distancing to limit community spread continues to have a direct impact on the fate of nursing home residents.

Too many people have mistakenly believed that we could somehow just wall off vulnerable citizens from the virus, said Dr. James Lawler, a pandemic expert with the University of Nebraska Medical Center. The truth is, until widespread vaccinations can stop virus spread, the only way to protect those most at risk is for everyone to do the right thing, he said.

“It’s impossible to protect certain subsets of the population from transmission,” said Lawler, a director in UNMC’s Global Center for Health Security. “That’s been one of the real unfortunate myths that was propagated. And it has had catastrophic consequences.”

It has been a long 10 months for residents of the Douglas County Health Center, the nursing home in the former Douglas County Hospital building at 42nd and Woolworth.

In March when the first COVID cases were being reported in Nebraska, in-person visitation was cut off, group dining in the cafeteria and group activities like bingo and church services were shut down, and outings ceased — much to the disappointment of residents and their families.

“I had residents tell me they’d rather have COVID than not see their grandkids,” said Erin Nelson, administrator of the facility.

Despite such precautions, the Douglas County Health Center became one of the first care facilities in the state to fall victim to an outbreak.

An employee brought the virus to work one day in March. At that time, so early in the pandemic, mask-wearing among staff was not universal.

Nor were there many protocols for containing outbreaks. Care workers learned on the fly as part of the home was suddenly converted into a biocontainment unit, with workers donning full protective equipment, including masks, shields, gowns and gloves.

By the time the outbreak ran its course, 37 staff members and residents in the 254-bed facility had tested positive, and six residents died.

The outbreak was heartbreaking for both workers and residents, who grow close to each other in their daily interactions. Some of the residents have lived there 10 years or more. Their caregivers often become their best friends.

“For those that don’t have family, we become that for them,” Nelson said. “It was very, very devastating and scary all at the same time.”

Nebraska’s spring virus surge ultimately passed. Care facilities began to loosen some restrictions, with the Douglas County center allowing family visits outside on the grounds.

“Some (residents) danced, some cried, some kissed the ground,” Nelson said. “They never thought they would see the outside again.”

But months later, the virus was again surging, stronger than ever. By mid-November, weekly cases in Nebraska were five times the peak levels seen in the spring. And nursing homes across the state were devastated like never before.

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