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How Nursing Homes are Planning for a Third Surge of COVID-19

November 3, 2020 by

When it comes to COVID-19, the news from around the country isn’t encouraging. Dr. Sanjay Gupta, a neurosurgeon and chief medical correspondent for CNN, said he is concerned that the United States is facing “exponential growth” of COVID-19 cases.

Doctors Believe that Personal Behaviors are Driving the Projections Up

Some people in their fatigue from the lockdown are letting down their guard by attending get-togethers and not wearing masks. Crowds, indoors or out, are potential opportunities to spread the virus on a large scale. At the family level, it’s the funerals and weddings. Thanksgiving, Hanukkah, Kwanzaa, and Christmas are all coming up. The anticipated surge in interstate travel, family gatherings, and indoor socializing are all expected to facilitate the spread of COVID-19.

There is also the upcoming influenza season which,coupled with COVID-19, is likely to put further strain on our healthcare system. That could result in overworked doctors and nurses, a shortage of critical care beds, and scarce personal protective equipment (PPE) all over again.

How Much Worse Can it Get?

The Institute for Health Metrics and Evaluation (IHME) at the University of Washington has a new prediction. The institute estimates that the number of people in the United States to die from COVID-19 could top 385,000 by the first of February. That’s an additional 150,000 deaths over the next 3 months. “Honestly, every time we do a projection, I wish and I pray that we are wrong, and whoever is predicting the smaller number is correct,” said Ali Mokdad, PhD, BS, a professor of global health at the University of Washington.

Nursing Homes, After Seeing Improvements, Now Face A Fresh COVID-19 Threat

With the new projections, Nursing homes across the country are bracing for a third surge of coronavirus. Despite the improvements in testing, older adults in nursing homes — and in all care settings — continue to be under threat from this pandemic.

More than 60,400 nursing home residents have died from COVID-19, with more than 260,500 confirmed cases across the country, according to the Centers for Medicare & Medicaid Services (CMS). The states with the highest number of deaths per 1,000 residents include Massachusetts, New Jersey, Connecticut, Louisiana, Rhode Island, Mississippi, Georgia and Pennsylvania. Health care experts say that despite the high figures, the situation has improved from earlier this year, when the coronavirus was spreading rapidly in nursing homes across the country.

The first spike in coronavirus cases in nursing homes happened in late May, with more than 9,300 confirmed cases in just one week, according to CMS. The second spike was in late July with more than 10,100 confirmed cases in just one week.  “A third spike is coming — but it can be avoided,” said Mark Parkinson, CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL). “It’s still preventable but it will require the public to do something that it has been unable to do until now, which is to show the discipline needed to stop the virus from spreading,” Parkinson said, urging people to “just wear a mask.”  

Improving Conditions in Nursing Homes

Conditions in nursing homes have improved dramatically since March of this year. The two biggest reasons are the availability of personal protective equipment (PPE) and the second thing that’s occurred is the availability of testing.

Nursing homes are continuously making key structural changes and improvements to prepare for an expected third surge of the disease. Here are some of the things being done:

• Testing and Mask Use: Facilities have implemented increased testing, promoted mask use, and changed clinical practices, in an effort to protect older Americans who are at higher risk of complications from the coronavirus.
• Strengthened Infection Control: There is a renewed and strengthened emphasis on infection control at nursing homes.
• Being Proactive: If there’s a nursing home that hasn’t had many or any COVID-related deaths yet, they have to continue to watch what’s happening in their local community and be prepared for outbreaks.
• Getting more funding: Mark Parkinson said he also expects Congress and state legislatures will evaluate the funding plan for skilled nursing facilities in an effort to make them more stable. The CARES Act, which Congress passed in March and added to in April, included a $175 billion Department of Health and Human Services Provider Relief Fund that was accessible to all health care providers impacted by COVID-19. In July, the National Center for Assisted Living, American Seniors Housing Association, LeadingAge and Argentum teamed up to request increased funding to keep senior living residents and staff safe.
• May Shut Down Access to Visitors Again: Nursing homes slowly reopened for visitors or for residents to temporarily leave and visit family. But, with Thanksgiving this month, those newly lifted restrictions will be tested as more people gather. Nursing homes are considering shutting down access to residents’ relatives and friends at a time when many have only recently loosened restrictions. Social isolation will continue to be an issue due to these restrictions.
• Vigilant About Testing Staff: Health care workers themselves face major challenges in preventing the spread of the disease. When workers go home at night or go into the community, they are exposing themselves to the possibility that they could catch COVID. Facilities also need to be vigilant about staff-to-staff infection. Rapid testing in nursing homes will continue to be conducted, in addition to wearing masks and social distancing as key to curbing spread of the virus.
• Awaiting a Vaccine: A vaccine is expected to be available to high-risk individuals, older Americans, and health care providers first, hopefully in early 2021.  

Take Precautions When Making Holiday Plans

The fall and winter holidays are typically spent in the home with family. Respiratory viruses thrive in dry, warm indoor conditions in which people crowd together. Scientists are not telling people to cancel their holiday plans, necessarily. But they are urging people to think of alternative ways to celebrate, encouraging a kind of rationing of togetherness.

Also, wear a mask! Universal mask wearing, defined as 95% mask wearing in public, could save 130,000 lives through the end of February!

Plan for Loved Ones Who Need Nursing Home Care Now or in the Not-So-Distant Future

Residents are in nursing homes and assisted living because they need higher levels of care than generally can be provided at home. If you have a loved one who needs nursing home care or even if your loved one is already in a nursing home, if you haven’t done so already, the time to plan is now! Please contact us as soon as possible to make an appointment for an initial consultation:

Elder Care Fairfax: 703-691-1888
Elder Care Fredericksburg: 540-479-1435
Estate Care Rockville: 301-519-8041
Elder Care DC: 202-587-2797

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Filed Under: Coronavirus Tagged With: , , ,
About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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