Several states reported the highest average weekly number of new COVID-19 cases in long-term care facilities in November or December, Kaiser Family Foundation reported, and several reported the highest average weekly number of new COVID-19 deaths in such facilities in December.

The KFF issue brief, published January 14 by Priya Chidambaram and Rachel Garfield, used state-reported data from 42 states to study patterns in cases and deaths in long-term care facilities, with 38 states that reported “trend-able” data on average weekly new cases and 39 that reported such data on deaths.

Twenty-eight of the 38 states with qualifying data had their highest average weekly number of new COVID-19 cases in long-term care in either November or December, with 24 reporting their highest average weekly new cases in December.

Of the 39 states with trend-able data on long-term care COVID-19 deaths, 21 reported the highest average weekly new deaths in long-term care facilities in November and December, with 18 reporting the highest number of new deaths in the latter month. The states with the highest deaths in long-term care facilities in December were primarily located in the West and Midwest.

“Mirroring overall COVID-19 cases and deaths, new LTCF cases were highest nationally in December 2020, while new LTCF deaths were highest nationally in April 2020,” the brief noted. “Overall cases are defined as total coronavirus cases in the U.S. population. New overall cases nationally were the lowest at the start of the pandemic, which can be partially attributed to the relatively low testing availability early in the pandemic.”

New cases in long-term care, on the other hand, dropped between the spring and summer and were lowest in summer before increasing again; the authors of the brief said this was possibly due to the measures that facilities put in place to mitigate the spread of the virus.

The fact that the initial vaccine distribution, which prioritized health care workers and long-term care facility residents, is moving more slowly than expected could lead to COVID-19 outbreaks continuing in the long-term care setting, the authors noted.

“Given that the peaks in cases and deaths tend to overlap, it is likely that spread of the virus will mean additional deaths, possibly making the coming months the deadliest of the pandemic for long-term care residents and staff,” they wrote.