Study: Nearly 69K COVID-19 cases, 17K deaths at nursing homes went uncounted

Nursing homes across the country, including the California home pictured last year as a patient was moved out of the facility, were known epicenters for COVID-19 outbreaks last year -- but researchers say that cases and deaths from senior homes were widely under-reported. Photo by Terry Schmitt/UPI

Sept. 10 (UPI) — Nearly 69,000 additional COVID-19 cases and 17,000 more deaths occurred at nursing homes in the United States in 2020 than were reported, an analysis published Thursday by JAMA Network Open found.

This means that at least 40% of COVID-19 cases and deaths went unreported — at least initially — at these facilities across the country, the data showed.

These figures equate to about 12% of total reported cases and 14% of total reported deaths in nursing homes nationally, the researchers said.

They said the differences are attributable, at least in part, to the federal government not asking nursing homes to report COVID-19 cases and deaths until the end of May, or about three months after the first infections were reported.

“It’s pretty inexcusable that the federal government didn’t start counting cases and deaths in these facilities until the end of May,” study co-author Karen Shen told UPI in a phone interview.

“For their families and loved ones, we wanted these people to be counted,” said Shen, a doctoral candidate in economics at Harvard University in Cambridge, Mass.

In addition to the JAMA Network Open article, Shen and her colleagues have made their findings on nursing home infections and deaths publicly available.

Since the start of the pandemic, nearly 676,000 COVID-19 cases occurred among nursing home residents, with more than 134,000 deaths, according to the Centers for Medicare and Medicaid Services.

However, these figures are based on facility reports to the Centers for Disease Control and Prevention’s National Healthcare Safety Network, which has been tracking the impact of the pandemic on nursing homes and other long-term care facilities.

Nursing homes have been epicenters for COVID-19 outbreaks from the early days of the pandemic, but delays in reporting numbers — homes were not required to report cases and deaths until May 2020 — continue to cloud the real toll the coronavirus had on these facilities, the Harvard researchers said.

Still, the Life Care Center in Kirkland, Wash., the site of the first known nursing home outbreak in the United States, reported zero cases, despite a March 2020 CDC investigation identifying 81 infections and 23 deaths among residents.

In addition, state officials in New York are alleged to have intentionally under-reported COVID-19 cases and deaths in nursing homes in 2020.

For this study, the researchers analyzed COVID-19 case and death data from more than 15,000 nursing homes across the country through the end of last year.

They compared figures from 20 states that required reporting from the start of the pandemic to the CDC’s National Healthcare Safety Network data for these states.

Based on the differences in these numbers, researchers then estimated the true number of nursing home cases and deaths for the 30 states that did not require reporting before late May of last year.

After crunching the numbers, Shen and her colleagues estimated that, nationally, nursing homes under-reported infections by about 44%, on average, and deaths by about 40%, on average.

However, the true scope of the pandemic may be even greater, given that there is evidence that cases and deaths may have been under-reported even in states that began collecting data in March 2020, including New York, according to Shen.

“We felt it was important to get these numbers from early in the pandemic out there, before we forget about them,” Shen said.

“Right now, individual states are collecting data in different ways, and we may not be getting an accurate picture — and that needs to change,” she said.


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