COLUMBUS, N.C. (AP) - Being a mathematician and former Fulbright Scholar, Jay Leavitt trusts the science behind the incoming COVID-19 vaccines from Pfizer and Moderna. He hopes their arrival means he’ll soon see his wife again.
Leavitt, a resident of Polk County in Western North Carolina, hasn’t been with his wife, Virginia, since the pandemic began. Virginia lives on their family farm with two cats, two dogs, and two horses, while Jay, who is 85 and paraplegic, receives treatment in a long-term acute care facility about an hour away in Easley, South Carolina.
After a career in academia, he has spent the past several years in nursing homes on both sides of the state border. Virginia would always visit, until recently. Once COVID-19 started tearing through congregate living facilities like wildfires nationwide, his nursing homes clamped down on visitations.
Married for 38 years, Jay and Virginia still talk by phone most days. She hasn’t embraced video calling, so the two rarely see each other’s faces.
“Before the pandemic, we would go out and eat, or go to concerts,” Jay said. “It was a great pleasure getting out of the nursing home for that. I miss the dogs, but primarily I miss her.”
Distance has defined countless relationships during the pandemic, particularly for those in long-term care facilities. Windows separate nursing home residents from visiting children and grandchildren. Some are dying alone. Outbreaks are preventing parents from holding their children with special needs in assisted living centers. Some people, like Jay Leavitt, haven’t been with their loved ones at all.
That coronavirus vaccines are coming to North Carolina long-term care facilities is a joyous moment for residents and their families after nine months of mostly fear and separation. Yet they acknowledge vaccines won’t immediately open the doors for the visits, handholding and hugs they sorely desire.
Health care providers must get consent to immunize residents - some of who aren’t in conditions to offer it themselves. And though nursing homes have been the most fatal settings for COVID-19 in the state, some residents and staff remain skeptical about the new vaccines, and few if any are being mandated to get the shots.
‘A MIXED BAG’ OF ENTHUSIASM AND SKEPTICISM
With contracts from the federal government, CVS and Walgreens will begin administering vaccines in North Carolina long-term care facilities as earlier as Dec. 28 according to the N.C. Department of Health and Human Services (DHHS). These facilities - including nursing homes - will receive the Moderna vaccine which is expected to be approved by the U.S. Food and Drug Administration this week.
The Moderna vaccine doesn’t require the same ultra-cold storage or bulk shipping as its counterpart from Pfizer, making it a more flexible option for the numerous long-term care facilities scattered across the state, said DHHS Secretary Mandy Cohen at a press conference Tuesday.
Both vaccines in early clinical trials have proven to be around 95% effective after two doses - results that encourage nursing home administers.
“Having this vaccine so close really does give a good deal of hope,” said Adam Sholar, president and CEO of the N.C. Health Care Facilities Association, which represents most nursing homes in the state. “But it has been a really hard nine months.”
No setting in the state has been deadlier during the pandemic than nursing homes. Outbreaks have been frequent and fatal, with around 40% of COVID-19 deaths in North Carolina linked to these homes. One of Jay’s recent homes - the Brian Center in Hendersonville - reported 50 cases and eight deaths earlier in the year, and it wasn’t an outlier.
Residential care facilities make up more than 10% of statewide coronavirus deaths.
These long-term care facilities imposed strict visitation policies during the pandemic, with some barring in-person visits altogether, especially in the wake of outbreaks. Such policies, resident advocates say, help prevent the disease but be extremely tough on those who can’t see or touch relatives.
“It’s a two-fold thing,” said Lauren Zingraff of the Raleigh-based nonprofit Friends of Residents in Long Term Care. “You either are sick from the virus itself, or you have become sick from the social isolation.”
Zingraff anticipates many residents will jump at their first opportunities to be vaccinated while others will wait.
“It is definitely a mixed bag, but there’s definitely skepticism,” she said.
A recent Elon University Poll found respondents over 65 were more likely than those in younger age groups to say they’d get vaccinated. Yet, the poll still indicated 40% of people over 65 remained unsure if they’d accept the shots.
Most long-term care facilities could require workers receive the vaccine as a condition of employment, yet Sholar said he isn’t aware of any doing so in the state. Instead of mandates, he believes explaining the details of the drug will best convince residents and staff to embrace the medicine.
“The findings of the FDA and the recommendations of the CDC, the process by which the vaccine was developed, you’re trying to make sure that all the information is out there to try to facilitate an education piece,” Sholar said.
Obtaining proper consent poses a barrier to vaccinating in long-term care facilities. North Carolina requires people agree to receive COVID-19 vaccines, and those with conditions like dementia require a legal representative - usually a relative or guardian - to consent for them. Getting approval can be more difficult as centers try to limit outside visitors. CVS and Walgreens say they can accept consent electronically and by phone, but representatives must still be reached and believe the vaccines are safe before allowing their loved ones receive them.
MISSING MADOX
Ashley Young of Asheville has only seen her son Maddox sporadically since February.
Maddox, 12, has a rare neurological disorder and lives in an assisted living center in New Bern. Before the pandemic, Young, a social worker, would drive five-and-a-half hours east from Asheville every month to be with Maddox.
The coronavirus restricted visits in the spring, and when Maddox’s center - RHA Services - relaxed visitations over the summer, Young herself was still recovering from COVID-19 and couldn’t travel. Then once her quarantine was complete, Maddox’s facility reported a coronavirus outbreak and postponed visits again.
She’s seen him three times since the pandemic began, most recently during Thanksgiving.
“Two hours just wasn’t enough time,” she said of that visit that ended with both Young and Maddox in tears. The center has allowed more visits from 6 feet apart, but Young said these would do Maddox more harm than good as he wouldn’t comprehend why his mother can’t come closer.
This week, the RHA Services center in New Bern reported a massive coronavirus outbreak - 64 cases among staff and residents. Young immediately called the center and learned visitations once more had been paused.
“Now he is left to be exposed to another COVID outbreak, and it will potentially be some time before I will be able to see my son again,” she said.
Maddox isn’t likely to receive the vaccine anytime soon. Children haven’t been included in initial vaccine trials, and the CDC only recommended the Pfizer drug for those 16 and older. Still, Young believes if others get vaccinated, there will be fewer outbreaks and more opportunities for her to travel east across the state and see — and even hold — her son.
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