Drop in COVID Cases Seen in Nursing Homes as U.S. Vaccine Effort Makes Headway

MONDAY, Feb.1, 2021 (HealthDay News) -- As America's vaccination campaign begins to gain momentum, a promising sign has emerged: Federal data shows that coronavirus cases in nursing homes have declined over the past four weeks.

The country recorded 17,584 cases in nursing homes during the week ending Jan. 17, The New York Times reported. A month earlier, during the week ending Dec. 20, more than 32,500 cases were reported.

To some extent, the development reflects a downward trend in new cases across the country, health experts said. Coronavirus cases in nursing homes are driven by infections in the rest of the community, Dr. Ashish Jha, dean of the Brown University School of Public Health, told the Times.

But the drop in cases in nursing homes is more pronounced than it is nationally, and it also began earlier, Jha noted. Since the rollout began, nursing home residents and staff have been prioritized as among the first groups to get the vaccine.

"That combination really does make me think this is not just broad national patterns, but that vaccines probably are playing a role," Dr. Jha said. "I'm optimistic, this is good."

As of Saturday, more than 3.5 million shots have now been administered in long-term care facilities, according to the U.S. Centers for Disease Control and Prevention.

Still, a slower than hoped rollout in nursing homes has been deeply frustrating, Jha added. Efforts to efficiently give shots to all nursing home residents should be a top priority. "Once that's in, then we should feel really confident that these declines will continue and we will not see a spike back up, even if we see one in the national picture," Jha said.

Nursing homes have been devastated by the coronavirus. Although only 5 percent of the country's cases have occurred in long-term care facilities, deaths related to COVID-19 in these settings have accounted for about 36 percent of deaths from the virus in the country, the Times reported.

That makes it all the more promising that reports of new cases among residents in nursing homes run by New York's health facilities association — which includes 425 skilled nursing homes and assisted living facilities — have been steadily declining since the first and second week of January, Stephen Hanse, president and CEO of the association, told the Times.

"Throughout the state, providers really saw the cases reducing, residents stabilizing," he said, adding that it's too early to tell if the drop is directly linked to the number of vaccine doses being administered. At least 80 percent of residents have now received their second dose of the vaccine, Hanse said. Nursing home administrators and directors "really see the vaccine as the light at the end of the tunnel," he told the Times.

J&J, Novavax COVID vaccines work, but less so against South African variant

Two widely anticipated new COVID-19 vaccines -- from Johnson & Johnson and Novavax -- appear to halt infections in places where more contagious variants are circulating, new trials show.

But there was one key exception: Each loses a significant amount of its protective power when used where the new South African variant is circulating.

The news is ominous, since three U.S. cases of infection with the South African variant have now been reported in two U.S. states.

For the Johnson & Johnson one-dose vaccine, the efficacy rate fell from a robust 72 percent in the United States arm of the trial to 57 percent in the trial conducted in South Africa, where the highly contagious variant is driving most cases.

Still, Dr. Paul Stoffels, chief scientific officer at Johnson & Johnson, said the company plans to proceed with applying for emergency use approval in the United States. "This is the pandemic vaccine that can make a difference with a single dose," he told the Times.

Novavax's vaccine trial in Britain was far more successful than its South African trial: The company said that its initial analysis in the U.K. showed that out of 62 participants who developed the illness, 56 had received a placebo and 6 had gotten the vaccine. The more infectious British variant was found to have caused about 50 percent of the cases in that trial, Novavax said.

However, Novavax's smaller trial in South Africa also found the vaccine to only have a 49.4 percent efficacy overall. The company reported that about 6 percent of the trial's participants were positive for HIV, and for those who were not HIV-positive, the vaccine had a 60 percent efficacy.

The Novavax trials revealed another troubling fact: A third of the participants in its South African trial appeared to have already been infected with the original coronavirus and some of those people became infected again, suggesting natural immunity might not fully guard against the newly emerged South African variant.

South African COVID variant surfaces in Maryland, South Carolina

A Baltimore resident and two South Carolina residents, none of whom who had traveled recently, have been infected with the highly contagious South African coronavirus variant, health officials have reported.

The variant is perhaps the most worrisome to public health experts, because it seems to have some ability to evade COVID-19 antibody treatments or vaccines.

These are the first cases in the United States involving the new B.1.351 variant, and the patients' lack of travel or a connection to one another suggests the variant is already spreading in communities, experts said.

"We strongly encourage Marylanders to practice extra caution to limit the additional risk of transmission associated with this variant," Maryland Gov. Larry Hogan said Saturday, the Washington Post reported. "Please continue to practice standard public health and safety measures, including mask wearing, regular hand washing, and physical distancing."

The tone was similar in South Carolina.

"The arrival of the SARS-CoV-2 [South African] variant in our state is an important reminder to all South Carolinians that the fight against this deadly virus is far from over," Dr. Brannon Traxler, interim public health director of the South Carolina Department of Health and Environmental Control, said in a statement. "While more COVID-19 vaccines are on the way, supplies are still limited. Every one of us must recommit to the fight by recognizing that we are all on the front lines now. We are all in this together."

State officials did not release the names of the people infected, saying only that one is from the Low Country, along the South Carolina coastline, and one is from the northeastern corner of the state.

The B.1.351 variant, first identified in South Africa in December, is considered by scientists to be even more worrisome than the more widely publicized British variant. And last week, a more infectious Brazilian variant was diagnosed in a Minnesota resident who had recently traveled to Brazil.

Public health experts had feared that the variants were already in the United States, undetected until now because of limited surveillance.

The B.1.351 variant contains a key mutation that appears to allow the virus to elude the full power of antibody treatments and vaccines. At least one antibody therapy will not work against the new variant, and lab studies recently found the mutation in the variant diminishes the ability of vaccine-induced antibodies to neutralize the virus. Meanwhile, vaccine makers are already racing to make new vaccines and "booster" shots to handle the new mutations.

There are now a total of 467 variant cases reported in 32 U.S. states, according to the CDC.

The emergence of coronavirus variants has made the campaign to vaccinate all Americans even more urgent. As of Monday, more than 31.1 million Americans have been vaccinated, while nearly 50 million doses have been distributed, according to the CDC. More than 5.6 million people have received their second shot.

A global scourge

By Monday, the U.S. coronavirus case count passed 26.2 million while the death toll passed 441,000, according to a Times tally. On Monday, the top five states for coronavirus infections were: California with more than 3.3 million cases; Texas with nearly 2.4 million cases; Florida with over 1.7 million cases; New York with more than 1.4 million cases; and Illinois with over 1.1 million cases.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

In India, the coronavirus case count was over 10.7 million by Friday, a Johns Hopkins University tally showed. Brazil had over 9.2 million cases and more than 224,500 deaths as of Friday, the Hopkins tally showed.

Worldwide, the number of reported infections passed 103 million on Friday, with nearly 2.2 million deaths recorded, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

SOURCES: The New York Times; Washington Post