Rapid antigen tests are now the standard way for people to determine if they have COVID-19, but studies show they are less sensitive than laboratory tests and can result in a false negative for infection, creating public confusion about about how to use rapid tests.
COVID-related nursing home cases and deaths are on the rise again, according to recently published data on AARP’s COVID-19 dashboard. And while these rates are nowhere near the levels of 2020 or early 2021, it’s still a troublesome sign that new COVID variants are making their way into facilities tasked with caring for vulnerable older adults.
Rates of COVID-19 cases and deaths rose in June for the second month in a row — with resident cases increasing by 27% for the four weeks ending June 19. That means about one in every 35 nursing home residents nationally tested positive. Staff positivity rates increased by 42% in the same period — about one in every 28. It’s not clear, however, whether staff were infected in the community or contracted COVID in the nursing home. Death rates are trending up too — increasing by about 54% in June compared with the previous month, according to AARP’s data, which is culled from Information on COVID-19 reported by nursing homes to the CDC’s National Healthcare Safety Network (NHSN).
Journalists can use this data to closely follow trends in their state, or even drill down to an individual facility level.
“We’ve actually had increasing cases for a couple of months now,” said Ari Houser, AARP senior methods advisor and lead data analyst on their nursing home COVID dashboard. “Preliminary CDC data through July 17 shows the trend continuing upward, so we’re not at the peak yet.”
When the Biden Administration rolled out two COVID-19 rapid tests programs in mid-January, Kaiser Health News reporters Victoria Knight and Hannah Recht were separately researching the initiatives, including one that allowed Americans to get free tests through the U.S. Postal Service. Their reporting included interviewing experts and gathering U.S. Census Bureau data about health equity measures such as home-based internet subscription rates.
The behind-the-scenes reporting illustrates how some stories are rooted in social media serendipity and collaboration. In this “How I Did It,” Knight and Recht explain how the article came together and why the data they compiled suggested that millions of Americans — mainly Black, Hispanic and Native American, and Alaska Native people — could face significant challenges in getting the rapid tests. (The following conversation was edited for clarity and brevity.)
The COVID-19 story of the summer is omicron subvariants.
As of mid-July, two subvariants are “of concern,” according to the CDC: BA.4 and BA.5, which make up about 80% all COVID-19 cases in the U.S. Another variant, though it has yet to reach the status of “concern,” is BA.2.75, which is rapidly spreading in India and could become a threat in the U.S., according to virologists. (Omicron is the SARS-CoV-2 variant that emerged and swept the globe beginning November 2021, causing a big wave in cases, hospitalizations and deaths globally.)
How much the public should worry about these variants is a matter of debate among public health experts. See this July 13 story in Business Insider, quoting four infectious disease experts I have contacted frequently over the past two and half years. Three of the four experts (Amesh Adalja, M.D., Celine Gounder, M.D., Katelyn Jetelina, Ph.D., M.P.H., and Preeti Malani, M.D.) ranked the risks — on a scale of 1 to 10 — of between 0 and 7 depending upon age, health status and geographic location. One wouldn’t rank the risk because the data isn’t clear.
Some researchers, including Eric Topol, M.D., are extremely concerned because the variant is so contagious.
Federal officials intend to give hospitals a break in quality scoring due to pandemic strains, by halting reporting of a measure known as the PSI 90 score. Patient-safety and business groups are fighting this plan, arguing it would erode quality of care.
Journalists may find good stories in looking at this battle over a quality measurement that pits Medicare and hospitals against patient-safety and employer groups.
The American Hospital Association (AHA) and the Federation of American Hospitals supported this proposal, which was one of myriad policy changes included in Medicare’s draft fiscal year 2023 rule on payments for inpatient services. They agree with Medicare officials who said they feared the effects of the pandemic might result in distorted results that might prove unfair to hospitals that served many people at highest risk from COVID-19.
Opposition to PSI 90 proposal
Among the leaders of the opposition to the PSI 90 proposal is nonprofit Leapfrog Group. Founded in 2000 by business organizations, Leapfrog has become a major force in lobbying for greater transparency about the quality and cost of health care.
“Suppressing PSI 90 would be a giant leap backward in patient safety and transparency, literally life-threatening, and an outrageous violation of the trust Americans place in the Medicare program,” wrote Leah Binder, M.A., M.G.A., chief executive officer of Leapfrog Group, in a June 17 comment letter to the Centers for Medicare and Medicaid Services (CMS).