Nursing Homes Unprepared for Ongoing Deadly COVID Pandemic

Interview with Dr. Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center, Brown University's School of Public Health, conducted by Scott Harris

The coronavirus pandemic now in its third year, has killed over 1 million Americans, with the World Health Organization estimating that the global death toll is more than 6 million. Among all wealthy nations, the U.S. has the highest Covid-19 deaths per capita.

With holiday family gatherings and an increase in cold-weather indoor activity, the spread of COVID is on the rise across the U.S. According to the Kaiser Family Foundation, people 65 and older accounted for 75 percent of all American Covid deaths since the start of the pandemic in 2020. Today, Americans 65 and over account for 90 percent of new Covid deaths, an especially large share given that 94 percent of American seniors are vaccinated.

Nursing home deaths have remained high while older Americans’ rates of receiving Covid boosters have been lower than expected. As people have grown weary of the pandemic, mask mandates, social distancing and testing have declined. Federal funding for testing and Covid treatments have also fallen away.  Between The Lines’ Scott Harris spoke with Dr. Jennifer Nuzzo, professor of epidemiology and director of the Pandemic Center at Brown University’s School of Public Health. Here she talks about her concern regarding the high rate of COVID nursing home deaths and the low rate of the elderly population receiving the latest omicron bivalent vaccines, which expose inadequacies of the U.S. public health system. 

DR. JENNIFER NUZZO: So the worry that we have now is that while people over the age of 65 initially had good uptake of the vaccine, for many people, it’s been a really long time since they’ve last gotten a dose of that vaccine. And so we’re quite worried about the low uptake of boosters among people who remain the highest risk for developing severe illness were they to be infected.

And again, that’s the elderly. You know, right now, the deaths that are occurring in the country are by and large not just over the age of 65, but over the age of 75. So it really speaks to the importance of older folks remaining up to date with their vaccinations. And unfortunately, we are seeing not as much use of boosters in these age groups as we’d like to see. But in particular, really, really worried about older folks who are living in congregate settings like nursing homes, where the Kaiser Family Foundation just put out data showing that fewer than half of residents in nursing homes are up to date on their vaccinations.

So that really creates a lot of vulnerabilities in these settings that is unnecessary with an additional dose of vaccine, which can really bring down the risk to patients in those settings.

SCOTT HARRIS: Dr. Nuzzo, earlier this year, President Biden pronounced the pandemic is over or almost over. And I know there was a lot of frustration in the medical community with that pronouncement. Why do we have local, state and our federal public health system not focusing more attention on the elderly living in nursing homes who are so vulnerable to COVID and even other infections? Why isn’t there a concerted effort to get these folks who, most of them, would be fine with getting another vaccine? They already took a couple or three. Why isn’t there more of an emphasis on getting protection for these folks?

DR. JENNIFER NUZZO: I, you know, was disappointed earlier on that there wasn’t a clearer message about the saliency of making sure, above all, people who are the highest risk for severe illness were they to be infected, to make sure that they above all are the ones that get boosted.

But now, you know, I think there has been a changing message. And I’ve certainly been hearing more of an emphasis on making sure if you’re above the age of 65, make sure you get boosted. Make sure if you develop symptoms, you get tested. And if you test positive, make sure you get a prescription of Paxlovid. Those two things boosted and use of Paxlovid if you’re at high risk, those two things combined would dramatically bring down the deaths that are occurring due to COVID.

And unfortunately, there’s a real, I think, education gap not just among patients, but also providers about the importance of that. And so I think there’s just been some missed opportunities to educate along the way and now we’re sort of making up for it. I wish we were doing it a bit earlier when we weren’t heading into what possibly is a rising COVID season.

SCOTT HARRIS: There’s been an erosion of public health precautions being taken across the country such as masking, COVID boosters and vaccinations as you as you’ve been talking about. Social distancing and testing. As far as I understand it, Congress has even hesitated to provide additional funding to provide the money for testing. I guess there’s subsidies for Paxlovid that will soon be withdrawn. What would you like to see Congress do in terms of addressing this ongoing pandemic that has not ended yet and is still a major threat?

DR. JENNIFER NUZZO: Yeah. So first of all, I would love for there to be clear and unequivocal messaging from our leaders about the importance of getting boosted, the importance of continuing to get tested for COVID so that if you’re infected and you don’t spread it to others and that you can access Paxlovid if you are in the category of patients that would benefit from it.

That kind of messaging, I think, has to happen. Unfortunately, when we have a Congress that’s not willing to pass additional funding and, you know, pronouncements that the pandemic is over, that really muddies the message a bit. But secondly, we have to make sure people can continue to access testing, that they can go and get vaccinated without worrying about costs and that they can access treatments again, without worrying about costs.

And one of my greatest fears is that if we make it such that these tools are only accessible by people with insurance or people with means, we’re basically concentrating the harms of this pandemic in exactly the ways that it has happened over time. We’ve seen quite clearly that income has been an important factor in who can protect themselves and who can’t.

So we can’t continue to reinforce those disparities. We have to make sure people can access these life-saving tools without worry about cost and without other barriers.

Listen to Scott Harris’ in-depth interview with Dr. Jennifer Nuzzo (14:58) and see more articles and opinion pieces in the Related Links section of this page.

For the best listening experience and to never miss an episode, subscribe to Between The Lines on your favorite podcast app or platform: Apple PodcastsSpotifyStitcherGoogle PodcastsAmazon MusicTunein + AlexaCastboxOvercastPodfriendiHeartRadioCastroPocket Casts,  RSS Feed




Subscribe to our Weekly Summary