Covid-19 infections and deaths are spiking anew in nursing homes and other long-term care facilities, hitting worrisome levels not seen since months ago in the pandemic. The unchecked mess in centers nationwide, but especially in the South and West, is prompting more attention to them — from lobbyists boasting White House ties, health worker “strike teams,” and Big Pharma investigators.

But even as the nation’s top overseer of long-term care calls on institutions to step up their infection control and other coronavirus-fighting efforts, researchers say that 1 in 5 nursing homes and other long-term care facilities report they lack enough personal protective equipment and staff. This occurred as recently as in July — not just at the start of the pandemic.

Even as Seema Verma, the head of the Centers for Medicare and Medicaid Services, told the owners and operators of care facilities that her agency has “deep concern … that even in nursing homes that are doing testing on a regular basis, we are still seeing significant spread,” experts from Harvard and the University of Rochester published findings on nursing homes in a health care policy journal, concluding: