Minnesota’s long-term care facilities see COVID-19 rates drop after vaccines

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Just after Christmas, residents of the Gardens, an Episcopal Homes nursing home in St. Paul, were among the first Minnesotans to be vaccinated against the COVID-19 virus.

It’s been a tough year for residents, said site administrator Keanan Franco. Indoor visits from family and friends had mostly been off-limits, except for about a week in September when cases in the facility and surrounding community were low enough to allow them.

With the opportunity to be vaccinated, there was much excitement among both residents and staff at the prospect of things getting back to something like normal.

Now, two months into the state’s vaccination drive, there’s evidence that the shots are working to reduce cases in senior residences like the Gardens. That comes as a relief to residents, many of whom have had limited in-person contact with family and friends for nearly a year.

“We just started doing visitation [indoors] again in the last few weeks. Our elders have been able to reunite with families, obviously with masks on,” Franco said last week. “We have a big open air space on the first floor. Our elders [are] just excited to get off of their floor and to see their families and to reunite with people they haven’t seen in so long except through a monitor or TV screen.”

Cases dropping off

Officials have been cautious to declare victory on behalf of the vaccination efforts in long-term care facilities for a couple reasons: first, while the number of COVID-19 cases in long-term care facilities has been declining, so too has the number of cases in the state. Minnesota’s most recent seven-day positivity average hit 3.7 percent, among the lowest rates since June.

Second, vaccines don’t boost immunity immediately. Nursing home staff and residents were among the very first Minnesota residents to be vaccinated, starting in late December. Three to four weeks later, depending on the vaccine, they received their booster shots, after which it takes an estimated two weeks for the vaccine regimen to be fully effective. That means the first group to be vaccinated would be expected to have the vaccine’s full protection around early February.

But in recent weeks, the data have started to more clearly show the effect of the vaccines.

“The commissioner and I, as cautious as we are, can say that we see a positive trend in that area,” Kris Ehresmann, the Minnesota Department of Health’s Infectious Disease Director, said in a press call Monday.

Last week, Minnesota announced it had seen just 15 new cases of COVID-19 in nursing homes in the prior week of data — the lowest number seen since last March.

“The data are very encouraging in terms of a significant reduction in the number of cases that we are seeing in our long-term care facilities,” Ehresmann said.

Another sign the vaccines seem to be working can be found in the breakdown in cases in skilled nursing versus assisted living.

Throughout the pandemic, the number of new COVID-19 cases in a given week has been higher in skilled nursing facilities — nursing homes — than it has in assisted living. That’s likely because nursing home residents are more often in contact with staff and other residents than assisted living residents.

In recent weeks, data from MDH show fewer cases in skilled care (nursing homes) than assisted living for the first time, with both numbers declining, Ehresmann told a Minnesota Senate committee last week.

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That’s significant because while both nursing home and assisted living residents and staff were in vaccine priority group 1a, among the very first to get vaccinated, nursing homes were offered first priority because of residents’ vulnerability.

Long-term care facilities, including skilled nursing and assisted living, each get three opportunities for residents and staff to get vaccinated. Currently, all nursing homes have had at least their first vaccine clinic, while the vast majority of assisted living facilities have had at least their first clinic and all will have had them by the end of February, Ehresmann said Monday.

As that happens, Ehresmann said she expects to see cases continue to decline even more dramatically.

Minnesota’s not the only place starting to see the effects of vaccines. A Kaiser Family Foundation analysis of national data released this week found that nursing home COVID-19 deaths have declined by 66 percent since residents began to be vaccinated, compared to a 61 percent increase in COVID-19 deaths among non-nursing home populations in the same time period.

Not back to normal yet

Vaccines got an enthusiastic response among skilled nursing residents at Catholic Eldercare in Northeast Minneapolis.

“They were basically lining up. They’re ready,” said Marie Barta, the director of operations for skilled care.

The facility was hit hard by the COVID-19 pandemic in April of last year, and its skilled nursing site has been closed to indoor visitors since March 2020.

“There’s been separation between families and residents, but we’ve managed to be creative within the regulations and guidelines to still have that connection, whether through phone or video or essential caregivers, compassionate caregivers,” Barta said. Over the summer, Catholic Eldercare hosted many outdoor visits in a green space set up with visiting stations.

Vaccines are just one piece of being able to open to visitors again, Barta said. It’s also critical that the site continues infection control measures and that the number of cases in the community outside the facility remain low.

Still, with the vaccine comes hope that the site will be able to welcome family members indoors for the first time in nearly a year. And unlike two months ago, Barta said she can see it happening sooner than later.

While the outlook is vastly improving as elders get vaccinated, Patti Cullen, the president and CEO of Care Providers of Minnesota, said families still need to keep taking precautions to keep their loved ones in long-term care healthy.

“We still have to deal with the issue that people think a vaccine means we’re back to normal. I keep telling folks we are never going back to normal. Let’s embrace masks as a new accessory because we’re a long time time away from being able to hug without masks, especially in our communities,” Cullen said.

At Jones-Harrison, a senior residence in Minneapolis, the atmosphere surrounding a vaccination clinic earlier in February was that of a party, said Peter Grose, a resident.

Residents were organized into groups and talked and joked with one another as each person was called up to be vaccinated.

“When they got through, the general feeling was, well, this has been fun, let’s do it again!” he said.

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