Aging Well

NC takes conservative approach to outbreaks in congregate care settings

While the number of outbreaks in North Carolina Nursing Homes and Residential Care Facilities at the moment can seem alarming, it's important to look more deeply at the details.

Posted Updated
Dr. Susan Kansagra
By
Liisa Ogburn
According to the latest NC DHHS weekly report, updated every Tuesday at 4 pm, there are currently COVID-19 outbreaks in 259 Nursing Homes and 129 in Residential Care Facilities (which include Assisted Living, Memory Care and Family Care Homes) in North Carolina.

While these numbers may understandably alarm many, it is critical to understand a major difference between the extensive outbreaks we saw during the early stages of the pandemic and how they differ with current ones.

In a recent interview, Dr. Susan Kansagra, Section Chief for the Chronic Disease and Injury Section and Acting Senior Deputy Director for NCDHHS’ Division of Public Health, pointed to how conservatively North Carolina defines and treats an outbreak in a congregate living setting. "The threshold is very low. An outbreak is considered two or more positive tests. If there are two cases, the facility is considered in outbreak status for 28 days. If there is a new case on Day 27, then the clock restarts."

Dr. Kansagra added, "One thing we are seeing that is very positive is that there are very few case numbers associated with many of those outbreaks, many just have two to three cases. They are not widespread outbreaks that we were seeing earlier and that really is a testament to the effectiveness of the vaccine."

According to Medicare & Medicare Services data, 82% of residents in North Carolina facilities are fully vaccinated. Staff vaccination rates are much lower at 57%.

The high community transmission rates of the highly contagious Delta variant have undoubtedly played a huge role in these outbreaks after a relatively quiet period.

While President Biden recently announced a mandate for all health workers to be vaccinated, including those working in congregate care settings that receive Medicare and Medicaid reimbursement, there is currently no set deadline. Centers for Medicaid and Medicare Services will be issuing rules in October on this. That said, many facilities are setting their own deadlines for employees.

To encourage and increase the number of staff in congregate care getting vaccinated, Dr. Kansagra said the NC DHHS is spending significant time trying to educate, answer questions and dispel myths by setting up open calls with the facility staff and providing webinars. They are also ensuring that each facility has a vaccination partner, who can provide vaccines on-site.

Dr. Kansagra emphasized that, for staff in healthcare settings and for anyone, it is so much easier to get vaccinated now than it was earlier in the year. North Carolina has over 3500 vaccination sites.

"Getting vaccinated is really our strongest tool against further spread and severe disease," Dr. Kansagra said. "Unvaccinated individuals are about five times as likely to get Covid-19 than vaccinated individuals. Unvaccinated individuals are about 15 times more likely to get severe disease or be hospitalized than vaccinated individuals."

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