Latest Texas DSH COVID-19 Stats Should Be a Wakeup Call for Vax Hesitant

Latest Texas DSH COVID-19 Stats Should Be a Wakeup Call for Vax Hesitant

New data from the Texas health department released on November 7 proves what health officials have been trying to tell vaccine-hesitant Texans for months: The COVID-19 vaccine dramatically prevents death and is the best tool to prevent transmission of the deadly virus.

“We know that some people want to see actual numbers and that they want to see it for their own community. And so we are hoping that this reaches some of those people who have been hesitant and really just questioning the benefits of the vaccines.”

—Dr. Jennifer A. Shuford, state epidemiologist

Out of nearly 29,000 Texans who have died from COVID-related illnesses since mid-January, only 8% of them were fully vaccinated against the virus, according to a report detailing the Texas Department of State Health Services’ findings.


And more than half of those deaths among vaccinated people were among Texans older than 75, the age group that is most vulnerable to the virus, the study shows.


“We’ve known for a while that vaccines were going to have a protective effect on a large segment of our population,” said Dr. Jennifer A. Shuford, state epidemiologist. “By looking at our own population and seeing what the impact of the vaccines have been on that population, we’re hoping just to be able to reach people here in Texas and show them the difference that being fully vaccinated can make in their lives and for their communities.”

The state health department study covers most of the positive cases and COVID-19 deaths reported in Texas among residents from Jan. 15 to Oct. 1. It’s the first time state officials have been able to statistically measure the true impact of the vaccine on the pandemic in Texas — which has one of the highest death tolls in the nation. The majority of Texans ages 16 and up didn’t become eligible for the vaccine until late March.

Texas TribuneState health officials also found the vaccine greatly reduced the risk of virus transmission, including the highly contagious delta variant that ravaged the state over the summer.

Only 3% of 1.5 million positive COVID-19 tests examined since mid-January occurred in people who were already vaccinated.

State researchers matched electronic lab reports and death certificates with state immunization records and measured cases and deaths since mid-January, a month after the first shots were administered in Texas.

The study was done using data similar to those used by other states that conducted similar studies and methods recommended by the U.S. Centers for Disease Control and Prevention, Shuford said.

And while the outcome was not particularly surprising, Shuford said, officials hope that the new data will increase trust in the benefits of the shot.

“Texas is a unique place; it’s got a lot of diversity, geographic and population-wise,” Shuford said. “We know that some people want to see actual numbers and that they want to see it for their own community. And so we are hoping that this reaches some of those people who have been hesitant and really just questioning the benefits of the vaccines.”

In Texas, it literally requires a disaster — like a pandemic — before the state records precise information about vaccinations. As a result, there is a record for every single COVID-19 vaccine dose of the name and age of the person who received it plus the date it was administered. Normally, vaccination records are shown to schools by parents, but details of all vaccinations are not regularly kept by a state registry in Texas, unlike nearly every other state, because it’s a voluntary system.

However, state officials still don’t have official numbers on how many vaccinated people were hospitalized with COVID-19 because hospitals are not required to report that level of data under state law.

But the state’s largest hospital districts and counties have reported that at least 90% of the hospitalized Texans with the virus were unvaccinated.

The state’s new health data comes as Republican state leaders grapple with local cities and school districts about masking, which has been proven to reduce transmission of the virus, and with federal officials over vaccine mandates.

About 53% of the Texas population is fully vaccinated. More than 70,000 Texans have died from COVID-19 since the pandemic began.


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Mandi Cai contributed to this report.

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Texas Nursing Homes Request $400 Million to Address Staffing Crisis

Texas Nursing Homes Request $400 Million to Address Staffing Crisis

About 40% of Texas nursing home workers are unvaccinated and could face dismissal or quit their jobs under a federal vaccination requirement for the industry..

Texas nursing homes, crippled by a pandemic that ravaged their residents and decimated their workforce, are asking the state for $400 million in federal coronavirus relief to address a staffing crisis in the system that cares for the state’s oldest and most fragile residents.

Adding to the urgency is the fact that 40% of the state’s 100,000 nursing home employees  aren’t vaccinated against COVID-19 and they could face a federal ultimatum to do so later this month.

Industry advocates fear the federal vaccination mandate could mean the potential exodus of tens of thousands of workers from facilities across the state before Halloween.

“We know we are going to lose additional staff when that vaccine mandate comes out,” said Becky Anderson, head of clinical operations for Focused Post Acute Care Partners, which runs 31 nursing homes and employs about 2,500 workers in Texas. “We just have some staff that are very adamant that they will not get the vaccine.’”

The federal rule comes at a time when the industry is already struggling with a shrinking workforce due to burnout, low pay, increased expenses related to the pandemic, and competition from other health care providers, administrators say.

Gov. Greg Abbott has vowed to fight any vaccine mandates in Texas.

According to recent surveys by the Texas Health Care Association and LeadingAge Texas, two nursing home industry groups in Texas, facilities across the state have seen a 12% decrease in their workforce in the last year. At least one-third of survey respondents are turning away new admissions due to staffing shortages, the survey says.

For the facilities, staffing shortages mean higher costs for overtime and an inability to grow or maintain patient population levels. Facility operators are also facing a pressing need for higher salaries and more money for recruiting tools, industry advocates said.

“The environment providers are operating in today isn’t sustainable,” said George Linial, president and CEO of LeadingAge Texas. “Texas cannot continue to kick this can down the road. A strong commitment and investment by lawmakers will pay huge dividends for the people we serve.”

However, it does not appear that help from Texas officials, either with emergency funding or staff, is imminent.

There is no bill filed in the current special session of the Legislature, which ends in just over two weeks, that would funnel any relief funds to nursing homes.

Texas has about $16.7 billion in American Rescue Plan Act money, and about $7.2 billion is marked in legislation to shore up the state’s unemployment fund, which was overloaded last year by record claims.

The funding request by the nursing homes includes $400 million to help recruit and retain workers, and an additional $350 million to pay for new infection-control measures and maintain them permanently for future crises.

For the remaining $8.5 billion available, requests from everyone else outside the nursing home industry amount to nearly eight times that much, budget officials say.

The nursing homes’ effort to get that funding has not gotten very far, sparking industry concerns that nursing homes will start shutting down.

Already, the nursing home workforce crunch is forcing admission caps, which is having a ripple effect on hospitals that are already at capacity with COVID-19 patients. With nowhere to transport patients well enough to leave a hospital but still too ill to go home, hospitals are now often required to house patients longer than they would have if they’d had a nursing home spot available, said Kevin Warren, president and CEO of the Texas Health Care Association.

It has also placed more burdens on families that may not be equipped to care for an aging relative much longer or older Texans whose medical needs are best met in a skilled nursing facility rather than through costly home care, he said.

“I am concerned that without additional funding necessary to recruit and retain current staff and develop opportunities to bring new employees into the profession, we will see continuously increasing access-to-care issues with expanding admission restrictions, closures, small independent owners being forced to sell, and bankruptcies,” Warren said.

Meanwhile, New York state lawmakers are considering sending medically trained National Guard members to fill vacancies in struggling nursing homes. So far, there are no similar plans underway in Texas to use the military branch to supplement staffing in any of the state’s 1,200 nursing homes.

A spokesperson for the Texas Division of Emergency Management, which oversees the state guard, referred questions about potential help for nursing homes to the Texas Department of State Health Services.

A DSHS spokesperson said that nursing homes with staff who are out sick with COVID-19 or that are overwhelmed with COVID patients can ask the state for help, but the facilities aren’t reporting high numbers of active cases.

While Texas has paid for thousands of relief workers this summer to send to hospitals that are struggling with a similar staffing crisis, Abbott has not announced a similar program for nursing homes.

Texas nursing homes were devastated by the coronavirus, which had an especially high death rate among the older population and killed 10% of the state’s nursing home residents in its first year.

In an effort to reduce the deadly impact of the virus, both state and federal governments imposed stringent safety mandates on nursing homes that changed daily, sometimes hourly, at the height of the pandemic last year.

The homes struggled to supply tests and personal protective equipment to staffers at their own expense, and some made extensive modifications to their air filtration systems, their building layouts and their staffing plans to respond to the health crisis.

Meanwhile, the cost to run a Texas nursing home has risen dramatically during the pandemic. Safety protocols and the ongoing staffing problems have meant budgets for Texas nursing homes have risen by 25% in the past 18 months, according to the survey released on Tuesday.

And even more trouble lies ahead. About 75% of Texas nursing homes are operating at a loss, the THCA/LeadingAge survey said.

Staffing challenges

These staffing challenges at nursing homes are not limited to lower-paying or entry level positions. Every one of the 31 facilities run by Focused Care in Texas has openings, and the vacancies go all the way to the top, Anderson said. Three facilities have no administrator, and another handful are without a director of nursing, she said.

Bonuses for referring new employees and extra shifts can help attract and retain staff, but about 90% of nursing home residents use Medicaid or Medicare, which keeps budgets limited and pay for most entry-level positions between $10 and $15 an hour.

There is also a shortage of applicants for work that was already difficult and now that work comes with the extra safety requirements and gear needed to treat a COVID-19-susceptible population. Any new worker finds themself working longer overtime hours because of the hiring shortfalls and all of that contributes to employees quitting within a month or two of being hired, she said. The problem has gotten so bad that the company is updating its orientation program to find a way to better prepare new hires for the difficult environment, Anderson said.

The high turnover, especially among new hires, “is quite alarming,” she said. “It’s always been hard work, but it’s even harder now with everything going on, and just the exhaustion.”

Vaccine woes 

According to the U.S. Centers for Medicare and Medicaid Services, about 65% of nursing home staff are currently vaccinated nationally. A recent rise in cases among nursing home residents, both in Texas and across the country, driven by the highly contagious delta variant, prompted the federal agency to announce in August that all nursing home employees be vaccinated in order for their facilities to continue participating in the Medicare and Medicaid program.

Those rules are expected to come out later this month.

Anderson is casting an anxious eye on that moment, when potentially 40% of her workforce could become ineligible for employment.

About 62% of the staff and 81% of the residents in Focused Care facilities across Texas are vaccinated, Anderson said.

But while the rates of resident vaccinations are fairly high across the system, they range widely among the staff depending on the facility, state numbers show.

Statewide, the vast majority of nursing homes that have fewer than 40% of their staff fully vaccinated are located in rural areas — mainly east Texas, where counties have some of the lowest vaccination rates in the state.

By contrast, most of the nursing homes with more than 90% of staff vaccinated are in the Rio Grande Valley and in El Paso, which have some of the highest vaccination rates in the state.

Warren, the head of the nursing home advocacy group THCA, said that while administrators work every day to convince their staff to get vaccinated, it is a near-impossible task to move them off the belief system that causes them to reject or fear the vaccine even though it’s free and widely available.

Much of it, he said, has to do with where they live.

“There is that relationship between the vaccine rates within the community and within the facility,” Warren said. “When folks in these facilities are working 8, 10, 12 hours a day, on their days off, they’re spending time with their families and friends in the community. So if that same prevalence of concern and distrust of the vaccine is present in that community, it’s only furthering their own hesitation.”

From Online Threats to Physical Assault, Violence Mounts at Texas Hospitals

From Online Threats to Physical Assault, Violence Mounts at Texas Hospitals

“Our staff have been cursed at, screamed at, threatened with bodily harm and even had knives pulled on them…. It is escalating.”

—Jane McCurley, chief nursing executive for Methodist Healthcare System

Texas Methodist Hospital, San Antonio

“Our staff have been cursed at, screamed at, threatened with bodily harm and even had knives pulled on them,” said Jane McCurley, chief nursing executive for Methodist Healthcare System, speaking at a press conference five days after the incident in the children’s ER. “It is escalating. … It’s just a handful at each facility who have been extremely abusive. But there is definitely an increasing number of occurrences every day.”

 

“[We’ve had] people being punched in the chest, having urine thrown on them and inappropriate sexual innuendos or behaviors in front of staff members.

The verbal abuse, the name-calling, racial slurs … we’ve had broken bones, broken noses.”

—Karen Garvey, Parkland Health & Hospital System, Dallas

Parkland Memorial Hospital, Dallas, Texas.

Parkland Health & Hospital System, Dallas.

“Tempers are high”

Serena Bumpus, Texas Nurses Association.

Serena Bumpus, Texas Nurses Assn.

Health workers face online harassment

Texas Tribune