BISMARCK — Jim Steckler doesn't think life in a nursing home will ever go back to normal after the COVID-19 pandemic, but the arrival of vaccines marks a pivotal moment in the fight against the disease that has rocked long-term care facilities across the country.
Steckler, a resident of Woodside Village nursing home in Grand Forks, invoked former British Prime Minister Winston Churchill when speaking about the COVID-19 vaccine, which he is due to receive on Wednesday, Dec. 30.
"This isn't the end, but it might be the end of the beginning," Steckler said.
With more than 13,000 health care workers and first responders already having received their first of two doses of the vaccine, North Dakota's long-term care residents and staff now stand at the front of the line. Vaccinations began in some of the state's facilities on Tuesday, Dec. 29, and more will continue through the first few weeks of January.
State immunization coordinator Molly Howell estimated that 9,100 doses will be carved out of the state's weekly allocations to cover long-term care residents, along with about 13,700 for staff at the facilities. About 40% of long-term care facilities and group homes have decided to let CVS or Thrifty White pharmacists come in and administer vaccines to residents and staff, while the remaining facilities will administer the vaccines on their own or rely on local public health officials or other local pharmacists.
Willingness among residents to receive the vaccine is high, with more than 90% opting in, though staff seem to have less appetite for the jab, said Vanessa Raile, director of emergency planning at the North Dakota Long Term Care Association.
About 94% of Woodside Village residents, including Steckler, have chosen to take the vaccine, spokeswoman Sally Grosgebauer said.
Steckler said he wants the shot because he believes it's safe and effective and the risk COVID-19 poses to the nursing home is so high. The 65-year-old, who has multiple sclerosis and uses a wheelchair, said he feels "hugely fortunate" to have so far avoided the deadly disease, adding that the vaccine will give him peace of mind as well as likely immunity to the virus.
In the bigger picture, Howell and other experts hope vaccinating nursing home residents and staff will significantly curb virus-related deaths and provide relief to the state's hospitals. More than 60% of the 1,276 North Dakotans who have succumbed to COVID-19 were residents of long-term care facilities, according to the state Department of Health.
Long days in lockdown
Officials have often noted during the pandemic that nursing home residents are more vulnerable to COVID-19 outbreaks than any other section of the American public.
Long-term care facilities house large groups of usually older residents who are nearly always at a heightened risk of serious illness from COVID-19 due to underlying health conditions. Furthermore, staff can bring the disease into the facility from the outside world even when they don't know they're infected.
The challenges of securing nursing homes from the virus combined with the widespread community transmission of the virus in North Dakota for much of the pandemic meant it was a matter of when, not if, the disease crept into each facility.
Woodside Village infection preventionist Carra Hindberg said she'll never forget April 28, when her facility got news of its first few confirmed cases. Other than one resident death in the spring, the 138-bed facility has mostly avoided the worst of the pandemic. However, the facility reported to the state Department of Health on Saturday that three residents and six staff members currently have the virus.
Medical director Dr. Chris Henderson said the lack of major COVID-19 outbreaks at Woodside Village is a credit to Hindberg, diligent staff members and the naturally divided floor layout of the building.
But preventing the virus from spreading through the facility has come at a heavy cost to residents.
For most of the last 10 months, Woodside Village has been on virtual lockdown with residents confined to their rooms. That means no church, no bingo, no birthday celebrations, no meals together and no family visitation.
“It’s pretty sad. People had Thanksgiving in their room by themselves,” Henderson said. “There are a lot of people who are sad and bored and lonely.”
The pandemic’s mental toll on residents is “hard to put into words,” Hindberg said.
“They miss their family. They miss interaction,” Hindberg said. “We’ve done the best we can to provide other ways to connect through phone and FaceTime and window visits, but it’s not the same. You can’t hug your loved one. You can’t interact with them as you normally would.”
Steckler said he's better off than some residents because he has the mental faculties to call up family members on his own, but others with dementia have to wait for staff to help coordinate electronic conversations and may not understand why their families aren't coming to see them.
The arrival of the vaccine finally represents a step in the right direction for residents hoping to reconnect with their families, Steckler said.
Henderson said it's still unclear what vaccines mean for reopening visitation and relaxing social distancing rules. The Centers for Medicare & Medicaid Services, the federal agency that oversees skilled nursing homes, has yet to publish any guidance on the issue.
But vaccines have still provided hope and relief to residents and staff at Woodside Village, Hindberg said.
"Now, you’re seeing this burst of energy come out of people,” she added.
The Good Samaritan Society, owned by Sanford Health, has 20 locations in North Dakota, the majority of which are nursing homes and long-term care facilities. Some of the company's nursing homes have been decimated by the pandemic, including one in Bottineau, where 20 of the home’s residents and one staff member have succumbed to the virus.
Vaccinations, which began at some Good Samaritan facilities on Tuesday, present "a way out of this pandemic," said Mike Deuth, the company's regional vice president.
“We’re very excited about the arrival of the vaccine,” Deuth said. “The vaccine really represents, in my mind, it’s the light at the end of the tunnel."
Eventide Jamestown Care Center has suffered 25 COVID-19 deaths since March, but the majority of residents and staff are scheduled to receive their first dose on Thursday, said Doug Panchot, the facility’s executive director.
“Our staff obviously cherish and love our residents,” Panchot said. “(They) want to do what’s best, and by having the vaccine, we’re hoping it will help our residents if there are future outbreaks down the road."
Henderson and Hindberg urged all North Dakotans to wear masks in public, keep distance from others and get the vaccine when their priority group comes up, saying that heeding the measures could help reopen visitation at nursing homes sooner.