There are more outbreaks in Colorado's long-term care facilities now than at any previous point in the pandemic, state data shows, as the omicron variant causes unprecedented levels of COVID-19 spread.
There are 323 outbreaks in the state's assisted-living and skilled nursing facilities, up from 210 the week before, according to state data released Wednesday. It's more than the number of outbreaks in fall 2020 or 2021, the surges that - before omicron - were the state's largest. Some of those outbreaks pre-date omicron by months, but the majority were reported in December and January.
In all, 527 residents and 895 staff members have been infected in 162 active assisted-living outbreaks; both of those case numbers roughly doubled in the span of a week. Nursing homes experienced similar growth: The number of outbreaks jumped from 91 on Jan. 5 to 161 on Wednesday; infections among residents more than doubled, from 342 to 696, as did cases among staff, from 710 to 1,534.
The good news is that the outcomes for infected residents and staff are better than in previous waves, said Doug Farmer, the head of the Colorado Health Care Association, a nursing home trade group: Fewer are dying or ending up in the hospitals. In those 161 nursing home outbreaks, there have been 10 deaths. In comparison, in late December 2020, there were 479 deaths associated with 138 nursing home outbreaks. Deaths in assisted-living residences are similarly low now compared to the previous peak.
There were also more infections in those December 2020 outbreaks, previous state data shows. Farmer credited high vaccination rates among both staff and residents as helping keep the severity of disease in check; long-term care staff are required by the state to be fully vaccinated against COVID-19, unless they've received a medical or religious waiver. Omicron has also shown to cause less severe disease than previous strains of the virus.
A message sent to the state Department of Public Health and Environment on Thursday seeking comment on the outbreaks was not returned.
As has been the case across American society amid the omicron surge, the rate of spread has exacerbated existing staffing shortages in long-term care facilities, Farmer said. Those problems pre-dated the pandemic to an extent, he said, but burnout and exhaustion among long-term care staff have thinned those ranks further, as has happened across health care. Now, omicron's rampant statewide spread is sending workers into quarantine.
"It’s the most significant challenge we face right now," Farmer said. "Staffing is the most challenging it has been throughout the pandemic or anytime prior to the pandemic. Part of is it due to outbreaks, and when you have outbreaks and people test positive, they have to be kept out of the workforce for a period of time."
He said nursing homes have about 2,000 fewer beds available now versus what was standard pre-pandemic. That translates to a loss of roughly $200 million in revenue and less room for people who qualify for nursing care. It further strains the entire health system, he continued: Hospitals, also facing significant strain because of staffing, often send patients to long-term care facilities as step-down beds. When those facilities can't take any more, hospitals become more backed up.
Farmer said the state have sent 200 to long-term care facilities over the past month, as the delta waved ebbed and omicron swelled to take its place. But many of those workers have yet to enter the workforce because they're still working through background checks and licensure requirements.
Despite omicron's dominant presence, the federal Centers for Medicare and Medicaid Services - which regulate nursing homes - is still requiring facilities to allow for in-person visitation, without checking visitors' vaccination or if they've recently tested negative. Farmer said it's impossible to quantify what impact that policy is having on spread in those facilities, but "it has to be having an impact."
"While we're doing everything in our power to vaccinate and get booster shots into the arms of residents and staff members, visitors are still allowed to come and go as they please without any of those restrictions," he said. "That’s an obvious hole in the net."