For the first time, most COVID deaths in Charlotte aren't in nursing homes

Mar. 5—A nursing home in Mint Hill is on the verge of closing down its COVID-19 treatment unit — less than three months after the first vaccine shots protected residents there from contracting the deadly virus and stymied asymptomatic transmission among health care workers.

At Clear Creek Nursing and Rehabilitation Center, 75 beds are reserved for coronavirus patients. As of this week, only seven are still occupied, said medical director Dr. William Long. When the unit is shuttered, probably 20 to 25 beds will be set aside, just in case there is another resurgence.

As recently as January, the three local long-term care facilities that Long oversees were ravaged by hundreds of new coronavirus infections.

"It has dropped like a rock," Long told the Observer Thursday. "Today, I have none — zero."

Vaccinations provided an extraordinary sense of relief for Long and all his fellow doctors, along with nurses, certified nursing assistants and other long-term care staff. They still need to get tested for COVID-19 twice a week, don personal protective equipment and adhere to strict coronavirus safeguards.

Yet Long's team no longer reports to work fearing they could be exposed to the virus at any minute or unknowingly infect elderly residents, unleashing a torrent of cases and fatalities.

"It's like someone is taking a weight off your shoulder," he said.

Since vaccinations began, the virus has claimed drastically fewer lives in nursing homes in and around Charlotte. The facilities are benefiting from a bubble of sorts. General herd immunity, health experts say, requires between 65% to 85% of a population getting vaccinated.

Looking at Mecklenburg's public health data, a stark reversal of a grim pattern emerged late last year and took a firmer hold in January: For the first time, the majority of people dying from coronavirus in the county were not nursing home or long-term care residents.

More than half of almost all coronavirus-related deaths in Mecklenburg are now tied to the broader community, the latest data show.

"I think it's a combination of two things," said Dr. David Weber, an epidemiology professor at the UNC Gillings School of Global Public Health and associate chief medical officer at UNC Health.

"Many people in the nursing homes have already had COVID, and the most vulnerable have likely already died."

There's "quite a bit of natural immunity" in nursing homes, a phenomenon amplified by the emergency use of Pfizer and Moderna shots starting around Christmas and New Year's, Weber said.

Vaccines saving lives in nursing homes

The most recent data from the health department shows an average of three deaths recorded daily among those who had coronavirus illnesses. That's far fewer fatalities than throughout most of January, when the average was two to three times that.

As of Wednesday, 57.4% of 877 virus-related deaths in Mecklenburg were in the general population, compared to 42.6% in long-term care facilities.

That's particularly significant when considering:

— The numbers were essentially flipped last fall. For most of the pandemic, nursing home deaths made up 50% or more of all COVID-19 fatalities.

— In January, when the county recorded its deadliest month of the pandemic, nursing home deaths were already slowing down. By late-January, the percent of cumulative fatalities not related to nursing homes rose to around 54%.

Vaccine success

Local and state health data does not yet outline how many doses were administered at long-term care facilities through a federal partnership with Walgreens and CVS. Beyond these facilities, nearly 119,000 first doses and more than 77,000 second doses have been administered in Mecklenburg, the North Carolina Department of Health and Human Services reported as of Wednesday.

Mecklenburg Public Health Director Gibbie Harris has repeatedly acknowledged the nursing home blind-spot, as county and hospital leaders try to gauge the success of local vaccination efforts so far.

Anecdotally, it appears most nursing home residents and staff clamored to get their shots, said Hillary Kaylor, a regional ombudsman at the Centralina Area Agency on Aging. Some nursing home owners even mandate their staff get immunized, Kaylor said.

And Long, the nursing home medical director, said likely 97% of the residents and staff at his facilities are inoculated.

The diminished death count, measured by sheer volume, support those estimates:

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In December, there were 59 deaths at long-term care facilities and 50 in the community, Mecklenburg Deputy Public Health Director Raynard Washington told the Observer.

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Amid a holiday-induced surge of infections, the number of community deaths soared to 131 in January. Long-term care facilities, meanwhile, logged 67 deaths.

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In February, only 13 deaths were linked to these facilities — less than 20% of the monthly total, Washington said through a county spokeswoman. Another 65 deaths occurred in the community.

Nursing homes glimpse of future

Many congregate care communities, once ravaged by the virus and closed off to the outside world as the virus circulated rapidly in Charlotte, have been transformed into a microcosm of hope and normalcy. Families can now visit loved ones inside their rooms, a type of interaction that's been fractured by window and plexiglass barriers to keep everyone safe from the virus.

Long said communal dining, albeit with physical distancing protocols, is the next big step for nursing homes. The days of eating isolated — alone in one's room, devoid of much-needed social interaction — should be gone within months, he said.

There are still 28 facilities experiencing active COVID outbreaks in Mecklenburg, but that compares to 63 on Jan. 31.

"I don't think anyone thought it would be that much of a decline," Kaylor said. "People were sort of amazing. It was kind of shocking."

Weber, the UNC epidemiologist, said nursing homes must also stay vigilant to avoid another bout of infections.

That means ensuring new staff like CNAs, who change jobs frequently, are vaccinated. Incoming residents, including those discharged from hospitals, need to be tested multiple times for COVID-19.

But this ripple effect of vaccine progress should persist and eventually trickle into the general population, assuming young adults also receive their shots to drive up herd immunity, health experts and officials agree.

"The reason why we're seeing those numbers go down so significantly is because those are the people that were vaccinated first," County Manager Dena Diorio said of nursing home data this week.

"What you're seeing is the impact and the success of what happens when people get vaccinated."

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