FRIDAY, Sept. 10, 2021 (HealthDay News) — The number of cases and deaths from COVID-19 in U.S. nursing homes appears to have been grossly underestimated.
According to a new study, that’s because U.S. federal guidelines did not require nursing homes to report cases and deaths until May 24, 2020, months after the pandemic began.
“Because of the delay in the federal reporting system for cases and deaths in nursing homes, there were roughly 68,000 unreported cases and 16,000 unreported deaths from COVID-19 in the early months of the pandemic,” said lead researcher Karen Shen, an applied public and labor economist at Harvard University.
“Accounting for underreporting changes the understanding of the toll on nursing homes across places and across facilities,” she added.
For instance, using the reported figures without factoring in the delay implies similar numbers of nursing home residents died in New York (5,776) and California (5,622), or about 5 deaths for every 100 beds in both states, Shen said.
Once the unreported deaths were accounted for, however, the figures changed dramatically, she said.
“We estimate that nursing homes in New York experienced 9,276 deaths [8 deaths per 100 beds], compared with 6,487 in California [5.5 deaths per 100 beds],” Shen said.
The delay in federal reporting substantially affected nursing home counts, and Shen said the data should not be used without some qualification or correction.
“We would also hope that in future situations, there would be a faster and clearer data collection effort that would avoid some of the confusion that resulted during this pandemic,” she added.
For the new study, Shen and colleagues compared COVID cases and deaths reported to the U.S. National Healthcare Safety Network (NHSN) and state health departments by May 31, 2020.
The sample included numbers for 20 states and nearly 12,000 nursing homes. Researchers expanded these data to include more than 15,000 nursing homes nationwide.
On average, 44% of COVID cases and 40% of deaths were reported to state health departments, but not to the NHSN, the study found.