Repeat Business – COVID-19 & the Elderly

 

In the earliest breakout phases of our pandemic, the disease raged through nursing homes like a California wildfire. The mortality rates among the elderly were staggering. Nursing homes were often staffed by people who simply were not trained in containment, often surrounded by uncaring routines, and the elderly were basically trapped and helpless. 

According to the COVID Tracking Project, about 8% of people who live(d) in US long-term-care facilities have died of COVID-19—nearly 1 in 12. For nursing homes alone, the figure is nearly 1 in 10. For those with severe COVID symptoms, those who were placed on ventilators (always sedated), the survival rates ranged from 25% to 70% (according to Physician’s Weekly) with the lowest numbers accorded to the elderly (especially those who had been living in nursing homes). Many assumed that if a nursing home infected victim were severe enough to be placed on a ventilator, they simply were not expected to survive. That assumption was seldom wrong.

States varied in their statistics on such deaths. Infamously, former NY Governor Andrew Cuomo deeply under-reported nursing home deaths, and states like Florida masked COVID mortality statistics by using death certificates that often only listed the last symptom as the cause of death – like pneumonia – of truly COVID-caused deaths. Even to this day, Florida Governor Ron DeSantis maintains that the negative COVID statistics in Florida are due to over-testing… failing to explain why Florida hospitals are now well over capacity with morgues filled with unvaccinated COVID victims.

But what we did not know, what we could not know without the passage of time and constant tracking, was that the elderly that do survive a bout with COVID are also the most likely to become reinfected. The Journal of the Yale School of Public Health (August 26th) summarizes: “COVID-19 took its largest toll on residents of U.S. nursing homes. Prior to the vaccine roll-out, many states reported that over a third of all cases and deaths occurred amongst this vulnerable population… New research led by the Yale School of Public Health in collaboration with the Connecticut Department of Public Health (CT DPH) found evidence that helps explain why: Residents in long-term care facilities had a significantly higher rate of reinfection than people in the general population.

“Published in the journal The Lancet Regional Health – Americas [August 21st], the study analyzed nine months of testing data, just prior to the roll-out of vaccines in long-term care facilities, a period that allowed researchers to look at test results in the setting of natural exposure to the virus… They identified that 2.6% of residents in Connecticut’s 212 nursing homes had one or more repeat positive SARS-CoV-2 PCR tests occurring as early as 90 days after an initial positive test. This percentage was significantly higher than other demographics, such as younger adults, or community-dwelling elderly.

“Even more concerning, 12.6% of the elderly with a second positive test after 90 days died shortly after that repeat positive test. While genetic sequencing was not available, several lines of evidence supported that re-infection may have been responsible for the repeat positive tests, including the fact that 80% of those elderly had an intervening negative test.

“‘While nursing home residents represent some of the most elderly and frail individuals in our community, we were still quite surprised at the patterns of test results and the outcomes. This was an early clue as to the less robust and waning immunity that may be seen in this vulnerable population following natural SARS-CoV-2 infection,’” said Sunil Parikh, associate professor and the study’s lead author.” The Lancet article questioned whether the increasing frequency of testing might be responsible for the results, but found that the numbers about the elderly, particularly among nursing home residents, could not be ignored: “Data on the rates of repeat test positivity in nursing home settings is limited to a small number of outbreaks but suggest that the frequency may be higher than in the general population.”

For residents in red states where employers and even local public-school districts are not legally able to require vaccinations or even masks, we have developed massive petri dishes for COVID variants to form, spread and prosper. The current Delta variant surge just may be the tip of the iceberg as new and possibly more virulent strains of the virus are being tracked all over the world… and even here in the United States. Given the right vaccine-resistant variant, and this entire pandemic could just experience a complete do-over.

With red state vaccination statistics substantially lower than what we are seeing in blue states, the politization of medical treatment and prevention has generated horrific new infection, mortality and hospitalization rates in those politically skeptical regions. And people travel! As a result, reinfection is becoming a likely vision for the coming years. Horse deworming treatments among vaccine skeptics tell you how desperately wrong the pattern of disinformation has become.

I’m Peter Dekom, and the ability to ignore statistics, hard medical facts and insist on a non-existent right to move freely in society without masks or vaccines guarantees that COVID is here for the foreseeable future and that our economy will also sputter in its attempts at recovery.