By on 2.15.21 in Health & Environment, NC in Focus

Residents and employees of nursing homes and similar long-term care facilities (LTCFs) are more vulnerable to COVID-19 related illness and death than the general population. In fact, nationally 38% of COVID-19 deaths have been associated with LTCFs. Because of this, the Centers for Disease Control recommended that individuals in LTCFs be prioritized in COVID-19 vaccination distribution plans.

In North Carolina Governor Roy Cooper’s vaccination rollout plan, he included long-term care residents and staff along with health care workers working directly with COVID-19 in the first phase of distribution (Phase 1a). Following Phase 1a, Phase 1b includes all North Carolinians aged 75 years and older, 6.8% of the state population. Vaccinations for both phases have begun, with some individuals in Phase 1b receiving their vaccination as early as the first week of January. These vaccinations are incredibly important and timely given that North Carolina reported its highest new coronavirus cases and deaths in LCTFs during Winter 2020.

Where are long-term care facilities in NC?

There are 423 LTCFs across North Carolina. Mecklenburg County has the highest number of LTCFs (30) followed by Wake (24), Guilford (21), Buncombe (19), and Forsyth (15). These facilities house 45,674 residents, of which 66% are over 75 years of age.

Map of NC showing locations of long term care facilities across the state

Although these counties have the most LCTFs, the counties with the highest rates of COVID-19 per 100,000 people are: Hyde (11,070), Catawba (10,256), Robeson (10,247), Montgomery (10,191), and Gaston (10,092). Montgomery County is also one of the top 5 counties in North Carolina with the highest rates of COVID-19 related deaths, reporting 260 deaths per 100,000 people. The other four counties are: Rutherford (272), Hertford (228), Columbus (220), and Cleveland (202). These data suggest that although many COVID-19 deaths are related to transmission at LTCFs, there are several other factors that may affect infection rates such as population density and age structure of the general population.

Prioritization of long-term care facilities in NC

It is important that residents and workers of LCTFs be prioritized in vaccination distribution because of their increased vulnerability and exposure to COVID-19. According to NCDHHS as of February 10, 2021, 70% of the first doses sent to LTCFs have been administered to residents, but just 26% of second doses. While this is promising news, we should still continue to monitor cases and outbreaks within LTCFs and the 65+ elderly population at large.

Highest COVID-19 case rates in North Carolina by county

CountyNumber of Covid Cases per 100,000
Hyde County 11,070
Catawba County 10,256
Robeson County 10,247
Montgomery County 10,191
Gaston County 10,092
Stanly County 10,040
Lincoln County 9,897
Caldwell County 9,868
Sampson County 9,787
Cleveland County 9,780

COVID Data by county was last updated 2/4/2021 using Social Explorer Coronavirus Case Data.

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