State and federal governments didn’t prioritize long-term care when the COVID-19 pandemic began a year ago, with catastrophic results — 170,000 dead nationwide, according to leaders of state and national long-term care associations.

During a virtual news conference Monday, leaders said the government has prioritized the industry for vaccinations, though, which is reducing infection and death rates dramatically.

“No question, (COVID-19) has been the worst crisis in the history of the long-term care sector,” the CEO of the American Health Care Association said Monday.

It turned out to be worse than any “worst-case scenario” that the industry had ever considered, group CEO Mark Parkinson said.

At the beginning of the pandemic, it was clear that long-term care would be the “epicenter,” said Zach Shamberg, CEO of the Pennsylvania Health Care Association, in a news conference.

Thus, long-term care facilities should have been “moved to the front of the line” for testing and personal protective equipment but weren’t, Shamberg said.

“The consequences (of that choice) speak for themselves,” Parkinson said.

Fortunately, the situation has been different with vaccinations.

With 90 percent of long-term residents now vaccinated, new cases have fallen from 30,000 a week at the peak of the pandemic to 3,000 nationwide, Parkinson said.

That is a 90 percent drop.

Likewise, there’s been a 70 percent drop in deaths, which should get even better, as death statistics lag case statistics, Parkinson said.

A large part of the problem was the high number of infections because of asymptomatic people, Parkinson said.

Fifty-nine percent of all COVID-19 transmissions are caused by presymptomatic and asymptomatic people, according to a study of the Journal of the American Medical Association.

Long-term care facilities were defenseless against that non-symptomatic infection, because all their prior infection-control training was based on recognizing symptoms, Parkinson said.

Nobody knew at first that wearing a mask for every interaction with residents was necessary, he said.

It didn’t help that Medicaid — which pays for two-thirds of all care in Pennsylvania’s 700 nursing homes — has been underfunded since 2014, Shamberg said.

Medicaid “drives every investment that providers make,” Shamberg said.

That includes not only buildings and equipment, but the retention and recruitment of staff, he said.

The lack of Medicaid funding has contributed to an ongoing industry “workforce crisis” — although creative thinking helped mitigate that, according to Shamberg.

That creative thinking was realized in the form of a temporary nurses aide training program, whose prime legislative sponsor was State Sen. Judy Ward, R-Blair, Shamberg said, also crediting Gov. Tom Wolf for his support.

It’s critical that long-term care providers have a “seat at the table” as the General Assembly and the administration consider future changes to help the industry, Shamberg said.

Among the issues that need to be dealt with is not only better Medicaid funding, but continuing support for vaccinations of new residents and new staffers, liability protection and promotion of good vaccination information for staff, the officials said.

In Pennsylvania, only 58 percent of long-term care staff has been vaccinated.

Nationwide, it’s much worse, at 40 percent.

Much of the problem has been misinformation, and much of that has come via social media.

The goal of the national organization is for 75 percent of staff to be vaccinated, Parkinson said.

Statewide, Pennsylvania providers have sustained a $5 billion loss in 2020, Shamberg said.

That came from expenses for PPE, testing, hazard pay for staff and other COVID-19 costs, along with census reductions of about 13 percent, he said.

Mirror Staff Writer William Kibler is at 814-949-7038.