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The second wave of COVID-19 in Colorado nursing homes may finally have crested, with more homes declared free from the new coronavirus than found to have new outbreaks for the first time since September.

On Oct. 7, 11 homes had active outbreaks of COVID-19. That increased every week through Jan. 6, when the Colorado Department of Public Health and Environment reported 152 nursing homes had outbreaks. As of this Wednesday, 145 do.

Even with the improvement, more than half of all nursing homes in Colorado still have outbreaks. The state health department considers an outbreak over when four weeks have passed with no new cases linked to a location or event.

COVID-19 outbreaks in assisted living facilities began decreasing last week, though 147 are still considered active.

The nursing home outbreaks from October to December caused 8,989 cases and 693 deaths, though the toll could still rise before all outbreaks are resolved. In the spring, there were 4,437 cases and 707 deaths. It’s not clear how much of the difference is due to improved care, and how much comes from increased testing that found milder cases.

The pattern is slightly different in assisted living facilities. The fall wave’s outbreaks have been linked to 5,034 cases and 303 deaths. While deaths were higher than in the spring, when 206 people died in outbreaks, they didn’t rise nearly as much as cases, which more than quadrupled from 1,157.

It’s not clear if efforts to vaccinate long-term care residents are bearing fruit yet. CVS, which has a contract to vaccinate residents and staff of 119 nursing homes in Colorado, reported they had given first doses in 79 of those homes as of Tuesday. Walgreens, which is responsible for the remaining homes, hasn’t released its data.

People who receive the vaccine aren’t fully protected until about two weeks after they get the second shot, when their immune systems have had time to recognize the virus and prepare a defense. One shot may give some protection, but it’s not clear how much.

It’s also difficult to tell if state policies have made a difference. Gov. Jared Polis announced Dec. 30 that the state would ask the federal Centers for Medicare and Medicaid Services for permission to pause nursing-home visitation until residents are vaccinated. The state hasn’t confirmed if CMS allowed that change, though. Under normal circumstances, visits are considered a right that facilities can’t deny residents.

The rise in long-term care outbreaks tracked closely with cases in the general community, which started rising in mid-September and took off in November. They’ve been slower to come down, though, perhaps reflecting the time that has to pass before the state declares a facility COVID-free.

This content was originally published here.