Possible New COVID Variant Causes Outbreak in Highly Vaccinated Nursing Home

As I have stated repeatedly, if we keep spreading around SARS-CoV-2, it may well mutate into a variant which evades the vaccines for coronavirus disease 2019 (COVID-19). According what recently went on in a Kentucky nursing home, the virus may well have done just that. According to WKYT: “The governor says a COVID-19 outbreak has been reported at a nursing home in eastern Kentucky. There are 41 cases reported, including five residents that have been hospitalized. Dr. Steven Stack says 30% of vaccinated individuals are symptomatic and 83% of the unvaccinated at the nursing home are showing symptoms.” According to Kentucky.com “85 percent of residents and 48 percent of staff opted to get a coronavirus vaccine.”

Initial reports are that this virus is not a known variant. I hope this outbreak is due to problems with the vaccine given nursing home residents and staff. If vaccine protocols for storage and reconstitution are not followed precisely, then the vaccines’ effectiveness will decrease. But baring that, this is very concerning news.

Kevin Kavanagh, MD

There are several take-home lessons. The first is that we should not be fully opening up our economy and relaxing public health measures. The recent updated guidance for nursing homes from the Centers for Disease Control and Prevention (CMS) should certainly be placed on hold. And as discussed in a recent article in Infection Control Today®, this guidance endangers the elderly. Herd immunity cannot be achieved in a nursing home. If one person is spreading the virus and one person is susceptible, viral transmission will occur. And this virus is aerosolized. Thus, if a non-vaccinated person who is shedding the virus visits a vaccinated relative, he can easily spread the virus to all who reside in the facility.

The initial reports appear to indicate the efficacy of the vaccine is diminished by this variant. Research has reported that the Pfizer and Moderna vaccines prevent symptoms in 95% of individuals and prevents hospitalizations in all who have been vaccinated. From the initial report, it appears that there is likely a very high infection rate in those who did not receive the vaccine. In vaccinated individuals there also appears to be protection, but nowhere near 100%. Unvaccinated residents were twice as likely to develop symptoms. It is reported that one vaccinated resident is hospitalized (1 in 71) with COVID-19, compared to 4 unvaccinated residents that are hospitalized (4 in 13).

The guidance that vaccinated individuals, even with the variants, will avoid hospitalizations does not appear to be valid. And we need to slow down the spread of this virus so we can slow down the mutation rates and our vaccine development can catch up with these new variants.