Government agencies continue to push direct care staff, residents and visitors to get vaccinated and receive their booster shot as soon as they can, noting the latest variant surge and low booster rates among nursing homes.
The Centers for Medicare & Medicaid Services (CMS) discussed the latest statistics on a stakeholder call for the industry on Thursday, hosted alongside the Centers for Disease Control and Prevention (CDC) and kicked off by CMS Administrator Chiquita Brooks-LaSure.
Booster rates for nursing home staff is just 27.6%, well behind the national average of 35%, according to call panelist Dr. Janell Routh, CDC vaccine task force co-lead. Resident booster efforts have fared better, Routh added, noting the statistic has increased to 62%.
“We now know that a booster dose is very effective in raising immunity against omicron,” Routh said during the call.
The CDC is reporting more than 490,000 cases on average each day, a 98% increase just compared to last week, according to Dr. Lauri Hicks, medical epidemiologist with the CDC Respiratory Diseases Branch. Omicron is responsible for an estimated 93 to 97% of all new cases across the country, according to Hicks.
“We are seeing that the omicron variant is about two to three times more transmissible than the last major variant – delta. This aligns with our current experience in this rapid rise in cases that we’re seeing,” added Hicks.
The risk of hospitalization, however, is estimated to be up to 54% lower based on data coming out of countries that experienced the omicron surge earlier than the U.S. Still, hospitals are seeing a 63% increase in admissions compared to last week, and deaths increased 5% during the same timeframe.
“Omicron is certainly testing our defenses. We know that persons who have completed a primary series and even some who have been boosted are testing positive for the omicron variant,” noted Routh. “Data that we have from our UK colleagues does suggest vaccine effectiveness against omicron drops. There are varying estimates for that anywhere between 20 and 50%.”
Hence why the CDC is pushing so hard for the public, especially nursing home residents and direct care staff, to receive the booster if they’re able, Routh told callers.
Following a flurry of stakeholder questions on the matter, agency leaders also clarified on the call that they are not changing the definition of ‘fully vaccinated’ to include boosters.
For now, the CDC considers a person fully vaccinated if they have received two doses of an mRNA vaccine or one dose of the Johnson & Johnson vaccine.
Panelists from both agencies pointed operators to an FAQ post about visitation guidance as well, for listeners to get clarification on how to balance a need for human connection and keeping residents safe during the omicron surge.
CMS originally issued a clarification to its nursing home visitation guidance just before the holidays, a few days after some of the largest aging services organizations urged government officials to provide flexibility in limiting visitation due to the latest surge in COVID-19 cases.
The agency reiterated that residents must allow visitors at all times, “with very limited and rare exceptions, in accordance with residents’ rights.” While CMS said it is concerned about the spread of COVID’s latest variant, they’re also paying attention to the effects of isolation and separation of residents from loved ones.
“It is important to note that federal regulations explicitly state that residents have the right to make choices about significant aspects of their life in the facility and the right to receive visitors, as long as it doesn’t infringe on the rights of other residents,” CMS said in the online document, adding if the resident is aware of the risks and the visit is “conducted in a manner that doesn’t increase the risk of COVID-19 transmission,” the visit must still be permitted.
Brooks-LaSure on the call encouraged nursing homes to use extra precautions for visitation: creating dedicated areas for visitation; wearing masks that are better fitting and with more protection, like surgical masks or KN95s; and conducting visits outside when possible, or in rooms with good ventilation.
“Additionally, nursing home facilities should continue to work with local and state health departments when outbreaks occur,” added Brooks-LaSure. “Health departments have a long standing role in helping facilities manage any type of outbreak, including how to structure visitations.”
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) announced the same day as the call that it sent another letter to Health and Human Services (HHS) Secretary Xavier Becerra requesting an extension to the public health emergency declaration (PHE) in the face of the omicron surge.
“More than half of nursing homes are limiting new admissions at a time when overwhelmed hospitals need our assistance to free up precious beds due to the omicron surge,” AHCA President and CEO Mark Parkinson wrote. “However, with your help, health care providers, including those in long term care, can access key tools available through the PHE declaration to help respond to this unprecedented challenge.”
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