The United States has reported 102,294 deaths from Covid 19 on 5/29/2020. Each day that passes, more is learned of the virus and how it exactly impacts our society.
A very surprising fact became apparent this week, that was not previously noticed or highlighted..
42% of covid 19 patients were in nursing home or assisted living facilities. This is an incredible statistic, as the number of patients in these places only account for 0.6% of the total US population.
Nursing homes are residential facilities for those needing 24/7 on-site medical supervision; assisted living facilities are for those not needing 24/7 medical supervision. An estimated 2.1 million people live in nursing homes and the vast majority (>90%) are over the age of 65.
This finding has many important implications. First although it has been known for some time that the most at risk group was over 65 with some pre existing conditions, it turns out that being in a nursing home is a significant risk factor. This means the fatality risk of not being in a nursing home is lower. Less than 1% of the population accounts for 42% of all covid 19 deaths.
Because nursing homes are remain ‘hot spots’ for covid deaths and cases, it may be difficult for some states or area to achieve mandates such as no covid deaths for a number of days. The deaths may be limited to within specific nursing homes and not a reflection of areas outside the nursing home.
In addition to maintaining social distancing and handwashing, it remains prudent ot wear a mask if you are around others and most important, elderly in nursing homes and restricted spaces should receive extra care and attention to avoid infection.
In the US, two states, New York and New Jersey and nursing homes have contributed to well over 50% of the covid deaths. This raises the question regarding the overall effectiveness of general business shutdowns and stay-at-home policies. Only additional data and study will be able to sort this all out.
There are an estimate 49 million people in the US over the age of 65. Over 80% of the US covid 19 deaths are from people over the age of 65. This would correspond to 81,000 deaths. This corresponds to a fatality of .2%/million people over 65.
However, the fatality rate of being in a nursing home is 6.76% or 30x higher than not being in a nursing home.
The following presents the percentage of deaths that occurred in nursing homes for all 50 states. The highest fatility rate was in Minnesota where an incredible 81% of covid deaths occurred in nursing homes and the lowest being NY with 20%. Interestingly, NY has a low percentage of covid 19 deaths in nursing homes because the number of deaths in NY outside of nursing homes is also the highest in the nation. This will be discussed in further detail below.
Looking at this another way, nn the basis of covid 19 nursing deaths/million people, New Jersey has the highest with 954 deaths/million and Wyoming is the lowest with 7. This can be seen in the map below.
Some comments on some key individual states.
Nursing home and assisted living covid 19 deaths account for almost 40% of the 2400 of the states covid deaths. There are an estimated 155,000 people living in Florida nursing homes. This is .07% of the population of Florida accounting for 40% of the deaths.
49% of all Covid 19 deaths in California occurred in nursing homes or assisted living facilities. 387 nursing homes have reported deaths with many of them clustered around Los Angeles.
The highest nursing home death toll in the state remains at Redwood Springs Healthcare Center in Tulare County, where 28 residents have died.
In Minnesota, 80% of the covid 19 deaths have occurred in nursing homes and assisted living facilities. The number of residents in these institutions are less than 1% of the population of Minnesota.
On May 10, there were an estimated 5300 covid 19 deaths in New York nursing homes and assisted living facilities. This is almost 3x more than the deaths in the entire state of Florida. However, so many have died outside of nursing homes (highest in the country), that the percentage of covid 19 in NY nursing homes is one of the lowest in the country.
The U.S. is not an outlier in terms of its nursing home-related COVID-19 fatalities. A study by researchers at the International Long Term Care Policy Network of fatalities in Austria, Australia, Belgium, Canada, Denmark, France, Germany, Hong Kong, Hungary, Ireland, Israel, Norway, Portugal, Singapore, South Korea, Spain, Sweden, and the United Kingdom found that 40.8 percent of reported COVID-19 fatalities took place in nursing homes.
Final note: I am NOT trying to downplay the seriousness of Covid 19. Each death tragic. However, these discussions are hoped to provide information about the numbers and comments you receive by other means in some context. Also, it is hoped that this information will lead to better policies, decisions and improved health of our country.