25% of U.S. covid-19 deaths in nursing homes

Visitors admire the Sistine Chapel on Monday as the Vatican Museums reopen after a three-month shutdown to help slow the spread of the coronavirus. More photos at arkansasonline.com/62virus/. (AP/Alessandra Tarantino)
Visitors admire the Sistine Chapel on Monday as the Vatican Museums reopen after a three-month shutdown to help slow the spread of the coronavirus. More photos at arkansasonline.com/62virus/. (AP/Alessandra Tarantino)

WASHINGTON -- At least a quarter of the covid-19 deaths in the United States were among nursing home residents, a new report said, a disclosure that came as coronavirus restrictions eased Monday even as U.S. protests against police brutality sparked fears of new outbreaks.

The scope of the devastation in the nation's nursing homes became clearer in a report prepared for governors that said nearly 26,000 nursing home residents have died from covid-19 -- a number that is partial and likely to go higher.

The Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention reported 60,000 cases of coronavirus illness among nursing home residents, according to a copy of a letter addressed to the governors and an accompanying chart provided to The Associated Press.

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The data was based on reports received from about 80% of the nation's 15,400 nursing homes as of May 24. But some states with high rates of nursing home deaths appeared to have low levels of response to the survey, intended as a first step toward developing policy changes.

"This data, and anecdotal reports across the country, clearly show that nursing homes have been devastated by the virus," wrote CDC Director Robert Redfield and CMS Administrator Seema Verma.

The U.S. has seen more than 105,000 deaths and more than 1.8 million infections in the pandemic, both counts the highest in the world.

And although the first wave of the pandemic may be easing in much of the U.S., that doesn't mean nursing homes are in any less danger. Experts say that in a virus rebound they could again become the stage for tragic scenes of death and despair, as well as a risk for the broader community.

"What is going on in a nursing home can be a barometer for where the virus is," said Tamara Konetzka, a research professor at the University of Chicago, who specializes in long-term care issues.

PROTESTS POSE RISK

Meanwhile, ongoing protests sparked by the death of George Floyd, a black man who died after a white Minneapolis police officer pinned a knee to his neck -- and law enforcement's response to them -- are threatening to upend efforts by health officials to track and contain the spread of coronavirus just as those efforts were finally getting underway.

Over the past week, protests have involved thousands of people gathered tightly together in large crowds in more than 20 cities nationwide.

It's unclear if the protests themselves will trigger big new outbreaks. The protests were outside, where infections don't spread as readily as indoors. Also, many of the protesters were wearing masks, and much of the contact was likely less-hazardous "transient" moments of people moving around, passing each other, said Dr. William Schaffner, an infectious diseases expert at Vanderbilt University.

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Still, experts worry that public efforts to contain the disease in the future could be undermined.

In Los Angeles, the mayor announced Saturday that covid-19 testing centers were being closed because of safety concerns related to violent protests. Testing in Minneapolis will be affected because some of the clinics that provide the service have been damaged in the protests, said a city government spokesperson.

Reduced testing could "be giving the virus another head start," Schaffner said.

And contact tracing, which is only just getting going in several states, is an even bigger concern. It involves people who work for or with health departments asking intimate questions about where a person has been and who they've been talking to -- and getting full, truthful answers.

"In this current environment which has enhanced or brought forth a mistrust of governmental authority, it might make them disinclined to speak with anyone in government," Schaffner said.

New York Gov. Andrew Cuomo expressed concern the protests in New York City could imperil the long, hard fight to contain the pandemic in a worldwide hot spot.

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"You turn on the TV and you see these mass gatherings that could potentially be infecting hundreds and hundreds of people after everything that we have done," Cuomo said. "We have to take a minute and ask ourselves: 'What are we doing here?"

OPENINGS INCLUDE FLORIDA KEYS

The Florida Keys welcomed visitors for the first time in two months, the Colosseum opened its ancient doors in Rome, ferries restarted in Bangladesh and golfers played in Greece. But as tourist destinations worldwide reopened for business, new rules were in place to guard against the virus's spread.

"Bring facial coverings, gloves, hand sanitizer, reef-safe sunscreen and personal essential medicines. If you're feeling unwell, please stay home," the Monroe County Tourist Development Council, which includes the tourist-dependent Keys, said on its website.

Electronic signs warned travelers to two of the world's largest casinos about covid-19 on the first day they partially reopened over Connecticut Gov. Ned Lamont's objections. "Avoid Large Crowds, Don't Gamble With COVID," flashed the signs near Foxwoods Resort Casino and Mohegan Sun as cars -- many with Massachusetts, Rhode Island and New York license plates -- passed by.

Roadblocks were taken down shortly after midnight near Key Largo, the northernmost island in the Florida chain, where almost half of all workers are employed by hotels, bars and other hospitality industries, and many of the rest are involved in commercial and sport fishing.

But even as the Keys reopened, Miami-Dade County kept its beaches closed because of protests in South Florida.

Countries around the Mediterranean Sea also tentatively kicked off a summer season in which tourists could bask in their beaches with distancing measures in place.

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"We are reopening a symbol. A symbol of Rome, a symbol for Italy," said Alfonsina Russo, director of the Colosseum's archaeological park. "[We are] restarting in a positive way, with a different pace, with a more sustainable tourism."

Greece lifted lockdown measures for hotels, campsites, open-air cinemas, golf courses and public swimming pools, while beaches and museums reopened in Turkey and bars, restaurants, cinemas and museums came back to life in the Netherlands.

A long line of masked visitors snaked outside the Vatican Museums, which include the Sistine Chapel, as they reopened for the first time in three months.

The museums' famous key holder -- who holds the keys to all the galleries on a big ring on his wrist -- opened the gate in a sign both symbolic and literal that the museums were back in business. Still, strict crowd control measures were in place: Visitors needed reservations, their temperatures were taken before entering and masks were mandatory.

The Dutch relaxation of coronavirus rules took place on a major holiday with the sun blazing, raising fears of overcrowding in popular beach resorts. The new rules allowed bars and restaurants to serve up to 30 people inside if they maintained social distancing, but there was no standing at bars and reservations were necessary.

Britain, which has the world's second-worst death toll, eased restrictions despite warnings from health officials that the risk of spreading covid-19 was still too great. Some elementary school classes reopened and people could have contact with family and friends, but only outdoors and with social distancing.

Spain on Monday reported no deaths in a 24-hour period for the first time since March. The development is "very, very encouraging," emergency health response chief Fernando Simon said.

The country's death toll now stands at 27,127, with almost 240,000 confirmed cases.

Around 6.25 million infections have been reported worldwide, with more than 374,000 people dying, according to a tally by Johns Hopkins University. The true death toll is believed to be significantly higher, since many died without ever being tested.

CITIES DIVERGE

In the weeks since America began reopening on a large scale, the coronavirus has persisted on a stubborn but uneven path, with meaningful progress in some cities and alarming new outbreaks in others.

Around Chicago, Wednesday was one of the most lethal days of the pandemic, with more than 100 deaths. Among them were a woman in her 30s and four men past their 90th birthdays.

In the Boston area, where an alarming crisis of a month ago has given way to cautious optimism, businesses were reopening and new cases numbered in the dozens, no longer the hundreds.

The Midwest is still troubled by persistent outbreaks. Hospitalizations are on the rise in Wisconsin, an unnerving development after that state's Supreme Court abruptly overturned a stay-at-home order in May. New cases are consistently high in Minnesota, particularly around the Twin Cities, where health officials have warned that escalating protests could increase the infection risk.

Jan Malcolm, Minnesota's health commissioner, said in a statement that "we are one of the communities most vulnerable to rapid increases in the spread of the virus, given where we are in the course of the epidemic."

But in the Northeast, the outlook has seesawed in the other direction. A glimpse of that region on the same day seemed hopeful.

In New Jersey and Connecticut, case numbers have plunged considerably in recent days. In New York, where more than 1,000 deaths were announced on some of the worst April days, that number is now often below 100. And in Massachusetts, Gov. Charlie Baker has given houses of worship and many businesses permission to open again.

As the pandemic progresses, parts of the country may eventually need to reimpose restrictions, said Dr. Tom Inglesby, director of the Center for Health Security at Johns Hopkins University.

"The country is divided in terms of its overall trajectory," Inglesby said. "This virus is persistent. It hasn't changed."

Information for this article was contributed by Ricardo Alonso-Zaldivar, Candice Choi, Curt Anderson, Mike Stobbe, Brady McCombs and staff members of The Associated Press; and by Julie Bosman and Mitch Smith of The New York Times.

A Section on 06/02/2020

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