Almost one million frail and elderly people live in care homes across the United States. Such facilities are the perfect hot spots for coronavirus outbreaks due to their close living quarters and the high density of vulnerable people to infection. By the latest count, at least 3,600 people living in nursing homes and long-term care facilities have died due to COVID-19, up from 450 deaths in just 10 days.

The figure was tallied by the Associated Press (AP) based on media reports and state health department reports. The federal government has yet to release a report of nation-wide COVID-19 fatalities in care homes, which has many believing that the actual number may be much higher.

For instance, in Italy, Spain, and other EU countries, as many as 50% of all COVID-19 deaths are from care homes.

“Outbreaks in just the past few weeks have included one at a nursing home in suburban Richmond, Virginia, that has killed 42 and infected more than 100, another at nursing home in central Indiana that has killed 24 and infected 16, and one at a veteran’s home in Holyoke, Mass., that has killed 38, infected 88 and prompted a federal investigation. This comes weeks after an outbreak at a nursing home in the Seattle suburb of Kirkland that has so far claimed 43 lives,” wrote Bernard Condon and Randy Herschaft in an AP release.

The most nursing home deaths due to coronavirus infections were reported in New York, which is also the hardest-hit state in the country. Around 2,400 elderly and disabled New Yorkers died from COVID-19 out of about 96,000 total residents in such facilities, according to state officials. Overall, there are now more than 10,000 deaths connected to the coronavirus in New York as of Monday morning.

This recent county-level breakdown of nursing home and assisted living deaths in New York does not go into details such as how many deaths a specific facility registered. New York State Health Commissioner Dr. Howard Zucker said the state will not release the nursing-home specific COVID-19 information, citing privacy laws.

As we age, the immune system that our body uses to fight disease wears down. Not only does the body have a harder time fighting off new infections like COVID-19, but there’s also a higher risk of being afflicted by a chronic disease that makes the immune system even weaker. Seeing how the coronavirus has a high case-fatality rate among the elderly (as much as 10% for those above 70 years of age) and is highly contagious, nursing homes are incredibly vulnerable to the illest effects of the pandemic we’re currently experiencing.

In mid-March, the federal government recognized the danger posed by the coronavirus, baring visitors, ceasing all group activities, and requiring workers to be screened for COVID-19 symptoms every time they show up for their shift.

But this kind of screening can’t possibly avert infections due to asymptomatic individuals. What’s more, many care homes don’t have protective equipment like gloves and masks for their staff nor do they have strict protocols in place that might reduce the risk of infection among the facility’s residents.

Officials at the federal Centers for Medicare and Medicaid Services have issued new guidelines last week, urging nursing homes to designate separate facilities within nursing homes in order to isolate COVID-19 positive patients. They also advise using separate staffing teams for residents.