Nursing homes

Cindy Goleman waves goodbye to her mother Peggy White from opposite sides of the window in March 2020 at The Pavilion at Creekwood, a health care and rehabilitation center in Mansfield.

North Texas nursing homes and assisted living communities are bracing for yet another COVID-19 surge as the country approaches the pandemic’s two-year anniversary, with serious concerns about keeping both high-risk elderly residents and dwindling staffing safe from the highly-contagious omicron variant.

Assisted living safety protocols, created to protect some of the area’s most vulnerable populations, will likely stay the same going into the holiday season, experts say.

Residents of nursing homes and assisted living centers are mostly elderly and have underlying medical conditions — all of which can make a person more likely to experience severe illness from COVID-19.

Older Americans have been the most vulnerable during the pandemic. About 75% of the more than 800,000 people who have died of COVID-19 in the U.S. have been 65 or older, The New York Times reported.

The BMJ, a peer-reviewed journal, published research from a team of British scientists that includes an online calculator for estimated risk of death from COVID-19 for hypothetical population segments. The research was done before omicron emerged and covers only residents of Britain, The New York Times reported.

According to the calculator, a vaccinated 75-year-old woman has a 0.45%, or about one in 220, chance of death from the coronavirus.

Both Pfizer and Moderna released early data showing that a booster dose of their vaccines may offer more protection against omicron even though the initial two-dose regimen appears to be less effective.

Yet only about 54% of people 65 and older who are vaccinated against COVID-19 have gotten a booster dose, the Centers for Disease Control and Prevention said.

The long-term care industry is also concerned about staffing; it’s one of the sectors hardest hit by the so-called “Great Resignation.” Nearly a third of the 15,000 U.S. nursing homes recently reported a shortage of nurses or aides, according to AARP analysis of government data released in November.

Nursing homes and assisted living facilities have implemented strict policies to encourage social distancing and masking while limiting outside visitors. Many such facilities also offer regular, on-site COVID-19 vaccine clinics. That trend will continue during the incoming COVID-19 surge due to hit North Texas in a few weeks.

“When you have a staff shortage and put on top of that illness that is caused by the variant, that creates a very big problem,” said Diana Martinez, president and CEO of the Texas Assisted Living Association. “One of the chief worries is trying to keep it out of the buildings and trying to make sure that you have sufficient staff to take care of the needs of your residents.”

Because these facilities have been executing these policies for so long, Martinez said they’re prepared to adjust to another wave of the virus. “I think that our communities are probably going to keep on doing the things they’ve been doing all along,” she said. “They really haven’t taken a break from their infection control practices.”

Highland Springs Senior Living Community in North Dallas will continue its infection prevention strategies, while also increasing mask requirements for employees and visitors during the holiday season, said Jeffrey Getek, senior regional communications manager for Erickson Senior Living, which owns Highland Springs.

Stonegate Senior Living in Lewisville will also continue its pandemic-era safety policies while monitoring the COVID-19 case rate in the area, said Stephanie Ward, director of digital marketing at Stonegate.

Nearly 80% of residents at Stonegate are vaccinated against the coronavirus, Ward said, and many have also received a booster dose. Public health experts say vaccines are the strongest defense against the virus.

Despite relatively high vaccination rates among the elderly, many nursing homes were hit particularly hard by a late-summer surge in delta variant cases.

Nursing homes across the U.S. reported nearly 1,800 COVID-19 deaths among residents and staff in August 2021, the highest number of COVID-19 deaths in a single month since February, according to data analysis by the Kaiser Family Foundation, a non-profit health organization.

The analysis also found that COVID-19 case numbers increased more rapidly in nursing homes than in the community, growing by 440% between July and August 2021. That’s nearly double the rate of case increase experienced outside nursing homes in the same period.

Preliminary data out of South Africa, where the omicron variant was first detected, show the new variant appears to cause less severe disease but is more easily transmitted. Omicron is now the dominant version of the coronavirus in the U.S., accounting for 73% of new infections last week, federal health officials said.

Already, the omicron variant has pushed coronavirus case counts higher than the peak of the recent delta wave, The New York Times reported Thursday.

Vaccination status and vaccine mandates for health care employees, including nursing home staff, have been a point of contention for nursing home leaders.

In early November, the Occupational Safety and Health Administration released new COVID-19 vaccine requirements for U.S. workers, mandating workers in nursing homes, hospitals and other Medicare and Medicaid-funded facilities be fully vaccinated against the virus by Jan. 4.

“While we support the overall intent…, we are concerned that the execution will exacerbate an already dire workforce crisis in long-term care,” Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living, said at the time.

A federal judge suspended the mandate on Dec. 16, ruling the Biden administration cannot force Texas hospitals and nursing homes to get the COVID-19 vaccine.

Last month, nearly a third of the state’s long-term care workers had not yet been fully vaccinated against COVID-19, said Kevin Warren, president and CEO of the Texas Health Care Association, the largest long-term care association in the state.

Protecting current nursing home staff so they can continue to provide care to their residents is a top priority, Martinez said, especially around the holidays.

“When you can’t do your normal, traditional things that you like to do, especially if you’re elderly and you really look forward to those things … it’s sad,” she said.

“For anyone that has an elderly person in their lives that they want to spend time with at the holidays, just please be cognizant that you could be sick and you don’t even know it.” Martinez said. “So take those extra precautions to try and protect your loved one so that you can continue to spend holidays with them here on out.”

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