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Virus spread down sharply in Mass. nursing homes

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The positive COVID-19 test rate in long-term care facilities remains above the state average, and a public health official said Wednesday that the gap is closing.

Katherine Fillo, the Department of Public Health's director of clinical quality improvement, gave an update to the Public Health Council on the state's response to COVID-19 in nursing homes.

Most of the COVID-19 deaths in Massachusetts have been in long-term care facilities. The spread of the disease in nursing homes and similar settings has prompted state officials to take steps including providing nursing homes with additional funding, requiring testing for residents and staff and increasing infection-control efforts. A new law also required the reporting of additional data on COVID-19 in elder care facilities.

The rate of positive tests, new daily COVID-19 cases and daily deaths in long-term care facilities are all now showing declines from earlier in the pandemic, according to Fillo's presentation.

The seven-day rolling average of new daily cases among residents and staff of skilled nursing facilities and rest homes was 31 on June 30, down from 212 on May 30.

The seven-day average of new daily COVID deaths in skilled nursing facilities and rest homes fell from 92 on May 10 to 24 on June 30, and has been in the teens and 20s throughout late June. Before the arrival of COVID-19, the average number of nursing facility deaths per day was 20, Fillo said.

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Statewide, the seven-day weighted average of positive test rates has been hovering at or below 2 percent since June 18.

The seven-day average in long-term care facilities was 5 percent as of June 28. That's down from 16 percent on May 24, when the statewide rate was 8 percent. The long-term care positive rate was above 30 percent in late April.

"That gap is closing and is getting very close to being closed," Fillo said. "I think [that is] positive news and speaks to some of the work that's gone on and speaks to some of the proactive testing efforts."

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COVID-19 has dealt a devastating blow to nursing homes in Massachusetts and across the country. As of Wednesday, 23,612 of the 110,602 confirmed and probable COVID-19 cases in Massachusetts — more than one in five — were among residents or health care workers at long-term care facilities. A total of 5,220 COVID-19 deaths have been logged in long-term care facilities, representing about 63 percent of the total fatality count since the onset of the pandemic.

In the Berkshires, Williamstown Commons had a total of 83 positive cases and 24 deaths of residents from COVID-19. Sixty-nine residents recovered, and last month the facility announced it was free of the virus. Four deaths were reported at Fairview Commons in Great Barrington.

Public Health Council member Dr. Edward Bernstein asked Fillo what "take-home lessons" the department has learned since the COVID-19 surge.

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Fillo said she believes the department's frequent and at times in-person support has helped make sure infection-control practices are implemented.

"Sometimes from a department perspective, we've really been in the role as the regulator, and while we certainly have continued to play that role, I think this has been a time where we have to play a much more supportive role where we're really a partner working through issues together with nursing homes and rest homes," she said.

Fillo said staffing was an issue at nursing homes before the pandemic and "remains a significant concern." She highlighted an online portal the state launched to link long-term care facilities that need staff with health care workers who are seeking jobs.

She said it provides nursing homes with a "targeted way" to recruit, hire and train staff and has been particularly helpful in geographically isolated regions of the state.

Advocates have been sounding the alarm over the financial and workforce challenges facing nursing homes since before COVID-19 arrived in Massachusetts. Backers of a proposed ballot question to increase funding by updating the rates state government pays nursing homes did not meet last week's signature-filing deadline and are now planning another push to bring their proposal before voters in 2022.

"As COVID-19 inhibited direct contact with Massachusetts voters, it also required that the skilled nursing community focus all its attention and energy on caring for residents and frontline personnel," the Massachusetts Senior Coalition said in a statement. "Our thoughts over the past month have been focused on our loved ones and the thousands of dedicated individuals that provide care to them around the clock while at risk to their own personal safety. There is no doubt that this outcome was affected by the unique and difficult circumstances under which we were forced to collect signatures."


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