Nikki Swearingen arrived to Heartland Health Care Center in Jacksonville with a cake in tow. Seventy-one candles adorned its frosty surface, and Swearingen, at 38, felt elated.
It was early April, and after surviving a bout of COVID-19 and a year in isolation, her mother was celebrating a another birthday.
“I thought it was hysterical to put 71 candles on a cake and see if she could blow them all out,” Swearingen said.
An entourage of family members was coming, too, their first visit inside since the pandemic began.
But then staff informed her the facility had an outbreak, she said. The cake was tossed, and the family instead did a limited visit — two guests at a time — on the patio. “I was devastated when they took that cake away from me,” Swearingen said. “They wouldn’t tell me if it was a staff member or a resident, or their percentage of how many staff are vaccinated. I feel like they’re keeping our parents hostage.”
Coronavirus infections among people living in nursing homes are on the rise in Florida, despite widespread vaccine availability. Almost 20 percent of Florida’s nursing homes had new confirmed resident cases in the last month — nearly double the national average, which sits at 10 percent – according to a new report from AARP.
Residents of longterm care facilities, who tend to be older and live alongside others in relatively small spaces, are particularly vulnerable to the virus — accounting for over a third of Florida’s overall COVID-19 deaths.
As much of the world reopens, seniors living inside these facilities remain at risk, and even those who are vaccinated must bear the brunt of outbreaks in the form of lost visits. “The chronic problems we’ve had in these facilities, including with infection control, still remain,” said Jamie Champion, spokesperson for AARP. “The fact that people are still dying means the focus needs to be on vaccination — and that doesn’t just extend to the residents of these facilities, but also the staff.”
The new report cites the most recently available data from the Centers for Medicare & Medicaid Services, which is self-reported from nursing homes and describes the monthlong period between April 16 and May 16. The rate of new infections among people living in Florida nursing homes is up 5 percent from the previous four-week period.
People living in nursing homes and other longterm care facilities are never fully isolated from the larger community — staff enter and exit daily.
The Sunshine State currently ranks third worst in the country for staff vaccinations at nursing facilities, according to federal Medicare agency data, lagging behind all other states except Wyoming and Mississippi.
Less than half — approximately 42 percent — of Florida’s nursing home staff have been inoculated. In contrast, 70 percent of the state’s nursing home residents have received at least one dose of the vaccine.
“Florida had been low on staff vaccinations in particular for so long,” Champion said. “When you look at what we would consider our peer states like California, New York and Texas, we are behind.”
Distrust of the medical system due to a long, well-documented history of mistreatment of people of color — particularly in initiatives involving the federal government — may play a role. People of color are overrepresented in the United States’ longterm care workforce — and in the South, Black people in particular play an outsize role in caring for the elderly and disabled people.
Where racial data is known, just 9 percent of Florida’s vaccinations have gone to Black residents as of last week, despite accounting for 17 percent of the state’s overall population.
“I think education is the big piece — educating people on how we’re not trying to take DNA to use it against you in a crime or anything else,” said Derrick Gilmore, a certified nurse assistant at a Tampa nursing home and a member of the state’s largest health care union. “It’s always been that people of color do not like experimental stuff. We just don’t want it. However, the vaccine is not that way. I preach it all day — take the shot.”
Roughly half of all reporting Florida nursing homes experienced new staff infections in the last month.
And when nursing homes open their doors to visitors — a source of joy for seniors and family members alike and a long-awaited sign that the pandemic may finally be subsiding — unvaccinated people may carry the virus in as well.
“Are families going back into nursing homes, is there a vaccine requirement, and are they accepting visitors that may or may not be vaccinated?” Champion said. “Those are all questions that need to be asked, because that also presents a risk.”
Approximately 22 percent of Florida nursing homes are experiencing staff shortages, according to AARP data, a proportion that has remained stable since the previous month.