Even in the face of a protective shield put up by Donald Trump administration around nursing homes, cases are surging within facilities in states hard hit by the latest onslaught of COVID-19.

An analysis of federal data from 20 states for The Associated Press finds that new weekly cases among residents rose nearly four-fold from the end of May to late October, from 1,083 to 4,274.

Resident deaths more than doubled, from 318 a week to 699, according to the study by University of Chicago health researchers Rebecca Gorges and Tamara Konetzka.

Equally concerning, weekly cases among nursing home staff in surge states more than quadrupled, from 855 the week ending May 31, to 4,050 the week ending Oct. 25. 

That rings alarms because infected staffers not yet showing symptoms are seen as the most likely way the virus gets into facilities. When those unwitting staffers test positive, they are sidelined from caring for residents, raising pressures on remaining staff.

The administration has allocated $5 billion to nursing homes, shipped nearly 14,000 fast-test machines with a goal of supplying every facility and tried to shore up stocks of protective equipment.

But the data call into question the broader White House game plan, one that pushes states to reopen while maintaining that vulnerable people can be cocooned, even if the virus rebounds around them.

"Trying to protect nursing home residents without controlling community spread is a losing battle,” said Konetzka, a nationally recognized expert on long-term care. “Someone has to care for vulnerable nursing home residents, and those caregivers move in and out of the nursing home daily, providing an easy pathway for the virus to enter."

Nursing homes and other long-term care facilities account for about 1 percent of the U.S. population, but represent 40 percent of COVID-19 deaths, according to the COVID Tracking Project.

In Fort Dodge, a manufacturing and transportation center in north-central Iowa, Julie Thorson said she knew she was in for a bad week when several employees at the Friendship Haven nursing home tested positive last Monday. As president of the senior living community, Thorson contacted the county health department. "They were basically not surprised because they’re seeing it all over the county," she said.

Residents also started testing positive. The facility had 11 new cases among residents, as of Friday.

"I was thinking all night what's worse, to have it hit and not know what you are getting into, or to prepare, prepare, and prepare, and then have it hit," she said.

Responding to the study findings, the federal Centers for Medicare and Medicaid Services issued a statement saying that "the bottom line is that the COVID-19 pandemic's effect on nursing homes is complex and multifactorial."