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The spread of the COVID-19 vaccine is painfully slow for old people’s homes

During the COVID-19 pandemic, no group suffered more than the staff and residents of nursing homes, where high concentrations of elderly people with serious health problems created the perfect place to kill the virus.

Yet efforts to vaccinate people in these homes are developing at a disappointingly slow pace, according to experts across the country.

As of Friday, only about 17% of the more than 4 million doses of vaccine distributed in long-term care facilities had been injected, according to the Centers for Disease Control and Prevention.

“Obviously no one cares if the elderly die,”

; said Dr. Michael Wasserman, a former California president. of long-term care medicine, which represents doctors, nurses and others working in nursing homes. “We could vaccinate all these places quickly if we took the right approach.”

Wasserman accuses the federal government of failing to develop a streamlined plan and directly controls the delivery of the vaccine.

Instead, the decisive decisions on who will take the first photos are left to state and local authorities, and the work of actually administering the photos is left to large national pharmacy chains – CVS and Walgreens – that do not have the same relationship with nursing homes as specialist pharmacies. which already serve the industry.

The slow spread is “certainly a cause for concern,” said David Grabowski, a professor of health policy at Harvard Medical School. “I think like many other parts of the pandemic, the federal response has been too slow.”

Among the obstacles is bureaucracy: the huge amount of work required to fill out forms and upload data to ensure that consent is obtained and that each dose is tracked.

“It’s just crazy,” said Jeff Sprinkle, administrator of the Lake Minnetonka Care Center, home to about 20 people in Deephaven, Min. When a crew arrived at the end of December to control the shots, they had six more people with them than could safely fit in the small rest room used for vaccinations, given the requirements of social distance. And three of those people were there just to “enter information into their database,” Sprinkle said.

It took 7 hours for the team to vaccinate everyone, a task that could be performed by a nurse at the same time without all the paperwork, Sprinkle said.

And because the vaccines are available in portions, there are about eight doses left after all those who qualified for the first round of vaccines have been vaccinated.

“I planned for my family to be vaccinated, to give it to my wife, but I imagined that if we found out the news, it would make us blaspheme,” Sprinkle said. Instead, the doses went to waste.

Another obstacle is the surprising degree of hesitation among nursing home staff to get the vaccine. A survey last month by the Kaiser Family Foundation found that 29% of health workers across the country are “hesitant about the vaccine”, a figure slightly higher than the percentage of the general population, 27%.

“We have not treated the staff very well in this pandemic,” Grabowski said.

Approximately 40% of COVID-19 deaths nationwide were among residents and staff of long-term care facilities, but workers there were chronically short of masks, gloves, and dresses needed to protect them from the virus, and most have been denied payment for danger, even though they have done some of the most dangerous work.

“I think they are quite skeptical now,” Grabowski said. I understand why they may not bother to move forward.

Another factor slowing the spread is the number of active cases in old people’s homes, which is constantly increasing along with the increase in cases after the general public after the holidays.

“If you have a nursing home with 100 residents and 20 had COVID last week, they may choose not to have the vaccine,” said Dr. Christian Bergman, an academic geriatrician at the University of Virginia in the British Community. “You could not observe any adverse events and they would probably be protected for 90 days, so we do not give them to these people.”

Rescue vaccines didn’t start in Virginia until Dec. 28, Bergman said, and then the shots stopped abruptly on New Year’s Eve and New Year’s Eve, slowing things down from the start.

Despite the problems, most homes in the state hope to receive their first doses by mid-January. “It will help a lot to stop the spread,” Bergman said.

So far, it is difficult to obtain data documenting the progress of vaccination efforts in nursing homes in California. State and Los Angeles County health officials did not respond to requests for numbers on Friday afternoon.

But interviews with local industry experts show that things are not going much faster in California than elsewhere in the country.

Rafaela Mayer, vice president of operations at a pharmacy for qualified nurses specializing in home care for the elderly in California, said there were problems up and down the state.

So far, her company has not been used to administer the vaccines, but many of her clients have said they do not plan to receive their first doses by the end of January. In Los Angeles County, where public health officials abandoned the CVS and Walgreens program to deal directly with vaccinations, homes saw the opposite problem.

“Many of our nursing homes in Los Angeles County have hundreds of extra doses,” Mayer said. Once opened, these vaccines have a limited shelf life and nursing homes do not know what to do with them.

“I talk to Los Angeles County every week; they have no answers. When talking to [state health officials]”They don’t know either,” Meyer said.

Most homes with extra doses are qualified nurses, places for people who need the highest level of medical care.

They have been a top priority for vaccines, along with hospital staff on the front lines, because of the devastating casualties the virus has taken there.

One way to use their extra doses, Wasserman said, would be to share them with life support facilities whose residents are just as old and often almost as sick, but are not included in the first vaccination group.

“They are on fire with new cases right now,” Wasserman said. He worries that frustration with the delays will lead to pressure to spread the vaccine to the general public before states and local authorities even vaccinate people in assisted housing.

“And then who is pushed into the back of the bus?” Older people and poor colored women who take care of them, ”Wasserman said.

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