Covid cases are beginning to rise again, steadily at first and now with a sharper increase over the past five weeks, especially in large metropolitan areas.
Hospitalizations across the country rose by nearly 19% in the last week to 15,067, according to data from the U.S. Centers for Disease Control and Prevention. This is especially true in metro areas that were previously epicenters of the Covid crisis, such as New Jersey, where about one in four nursing homes and assisted living facilities in the state have reported an outbreak in the past week, based on state Health Department data.
Latest data also shows that there are 158 active nursing home outbreaks affecting 1,327 residents and 534 employees in New Jersey. Meanwhile, in Los Angeles, Covid cases rose by 35% in the past week, with local officials reporting that case rates in skilled nursing facilities (SNFs) surged to 39, up from 20 the previous week, and 13 four weeks ago.
Given this surge of Covid cases, operators may want to make sure they are ready to administer antiviral treatments, experts who spoke to Skilled Nursing News (SNN) recommended.
“Several of my clients have reported a lot of upticks in positive Covid cases,” Amy Greer, clinical consultant at Zimmet Healthcare Services Group (ZHSG) told SNN. “Which is why I think the emphasis on infection control has kind of always remained just to prevent any further really bad outbreaks like we had, you know, back in 2020 and 2021.”
SNN reported earlier this month that even as 60,000 nursing home and long-term care residents died from Covid in the first five months of the pandemic, antiviral treatments for the virus only reached one in five nursing home residents.
Despite medical guidelines calling for the prompt administration of antiviral treatments to patients that were at high risk of severe illness, hospitalization or death, about 40% of the nation’s 15,000 nursing homes said they didn’t use antiviral medications at all, according to the JAMA Network report.
David Grabowski, health care policy researcher at Harvard Medical School, and Brian McGarry, health economist at the University of Rochester, both gave the nursing home industry a “D grade” for the sector’s overall pandemic performance.
Yet as the pandemic becomes endemic, there may be a chance for the sector to handle re-infections more effectively.
Paxlovid for treatment
There’s some comfort in the fact that the latest surge will be countered with a plentiful supply of antiviral treatments.
Officials at the American Health Care Association (AHCA) told SNN that as of right now, there is an ample supply of Paxlovid, and they have not heard from providers or pharmacies that they are challenged in getting this therapeutic.
Two antivirals – Paxlovid and Lagevrio – are distributed for free by the U.S. government, and facilities can access these through their long-term care pharmacy.
“The good news is that we are better equipped to prevent and manage Covid-19 than ever before thanks to life-saving vaccines and treatments,” Rachel Reeves, AHCA/NCAL spokesperson, told SNN.
Reevesadded that AHCA/NCAL continues to encourage the long term care community and the general public to use appropriate infection prevention control practices, such as staying away from others when sick, practicing proper hand hygiene, and staying up to date on their vaccinations.
“This is especially critical for our elderly residents as we approach cold and flu season,” she said.
She said that providers should talk to their medical director or consultant pharmacist about how to get residents started on these medications early in the course of their infection, even if they were vaccinated or symptoms seemed mild.
“Nursing home staff are committed to working with physicians, pharmacists, and family members to protect residents from severe outcomes due to Covid-19 with every available tool, including therapeutic treatments,” Reeves said. “Public health officials must prioritize our nation’s most vulnerable for these treatments and provide clear guidance to health care professionals.”
Importance of private rooms and bathrooms
Dr. Jasmine Travers, assistant professor at New York University’s Rory Meyers College of Nursing, said that nursing homes having more private rooms and more private bathrooms available to residents is important to infection control going forward.
“That was something that really was effective for the spread of the virus, and so many people were in one room and sharing bathrooms, one resident had the head Covid,” she said. “The other resident is likely to get Covid. So that’s something that’s important to really implement in nursing homes across the board. These private rooms have private bathrooms, then just strengthen infection prevention control practices.”
Travers said that one of the most important training and education areas that nursing assistants have said that they need is in infection control, donning gloves, donning personal protective equipment, and making sure the staff are trained and able to implement these infection prevention and control procedures.
“[We have to] just going back to the policies that were in place earlier on in the pandemic that were really supportive of keeping down the spread of the pandemic, because in some ways, we’ve gotten lax with the lifting of the emergency efforts and just lifting the mandates of vaccinations and such,” she said.
Travers said that staffing levels also have an impact on the spread of Covid.
“If you have more staff or more sufficient numbers of staff, that will help with just the spread of Covid as well,” Travers said. “When you’re short-staffed, you’re just trying to get through the day, and sometimes your corners are cut, so that’s something that needs to be keen on as well.”
Companies featured in this article:
AHCA/NCAL, CDC, New York University Rory Meyers College of Nursing, Zimmet Healthcare Services Group
