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Data: FREOPP.org; Map: Naema Ahmed/Axios

The structural issues that have plagued U.S. nursing homes for years will make it difficult for them to prevent coronavirus infections and deaths, even though we now understand the high-risk nature of the facilities.

Driving the news: Within the 80% of nursing homes that have reported coronavirus data to the federal government, nearly 26,000 residents died, the Centers for Medicare and Medicaid Services announced yesterday.

The big picture: Older people are particularly vulnerable to the virus, and nursing homes became devastating outbreak sites right away.

  • And the nursing home industry has long been under scrutiny for its problems with infection control.

Between the lines: Experts say that nursing homes need to be extra vigilant about testing staff and residents, and then isolating patients who do get the virus.

  • That means keeping coronavirus patients out of nursing homes to begin with, which some states failed to do early on when patients were sent from hospitals to recover in nursing homes.
  • But it also means having strict protocols for residents who become infected.

Yes, but: That's when nursing homes' long-standing problems present themselves once again.

  • The physical structure of the nursing home becomes very important, including details about things like shared bathrooms, where the nurses' station is, and how air circulates through the building, David Grabowski, a Harvard professor who studies post-acute care, told me.
  • "Some facilities have tried to set up [coronavirus] units or wings or floors," he said. "Sometimes that’s doable based on the numbers and the layout, and sometimes it’s not.”

It's also important to dedicate specific staff to each population — coronavirus patients and non-infected patients. But nursing homes were suffering from staff shortages long before the pandemic hit.

  • “I don’t know how many nursing homes are doing that well to have dedicated staff for covid versus non-covid patients," Grabowski said. He added that most nursing homes also don't have enough personal protective equipment for their workers.

The bottom line: We've certainly learned from our mistakes in terms of how to protect nursing home residents from the coronavirus. The question is whether we'll be able to effectively apply those lessons to prevent future outbreaks.

Go deeper: Taking care of coronavirus patients after they leave the hospital

Go deeper

Beyond nursing homes

Illustration: Sarah Grillo/Axios

Nursing homes have been the epicenter of the coronavirus outbreak, prompting more urgent discussions about alternative housing situations for elderly Americans.

Why it matters: Deaths in nursing homes and residential care facilities account for 45% of COVID-19 related deaths, per the Foundation for Research on Equal Opportunity — but there are few other viable housing options for seniors.

Updated 44 mins ago - Science

Hurricane Isaias makes landfall in North Carolina

People walk through floodwaters on Ocean Blvd. in Myrtle Beach, South Carolina, on Monday. Photo: Sean Rayford/Getty Images

Hurricane Isaias made landfall as a Category 1 storm near Ocean Isle Beach in southern North Carolina at 11:10 p.m. ET Monday, packing maximum sustained winds of 85 mph, per the National Hurricane Center (NHC).

What's happening: Hurricane conditions were spreading onto the coast of eastern South Carolina and southeastern N.C., the NHC said in an 11 p.m. update. Ocean Isle Beach Mayor Debbie Smith told WECT News the eye of the storm triggered "a series of fires at homes" and "a lot of flooding." Fire authorities confirmed they were responding to "multiple structure fires in the area."

Updated 2 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 12:30 a.m. ET: 18,224,253 — Total deaths: 692,679 — Total recoveries — 10,865,548Map.
  2. U.S.: Total confirmed cases as of 12:30 a.m. ET: 4,713,500 — Total deaths: 155,401 — Total recoveries: 1,513,446 — Total tests: 57,543,852Map.
  3. Politics: White House will require staff to undergo randomized coronavirus testing — Pelosi says Birx "enabled" Trump on misinformation.
  4. Sports: 13 members of St. Louis Cardinals test positive, prompting MLB to cancel Tigers series — Former FDA chief says MLB outbreaks should be warning sign for schools.
  5. 1 🎥 thing: "Tenet" may be the first major film to get a global pandemic release.