Omicron Renews Concerns for Long-Term Care Communities

There's new concerns about omicron and older adults.

Doctors are seeing an uptick in patients over the age of 70 getting hospitalized, as well as an increase in cases at nursing homes and  long term care facilities.

For families, it’s a reminder that this age group is at a much higher risk than the general population due to age and other factors or conditions that compromise their immune systems.

Omicron Risks

Facilities across North Texas at all levels of long term care are once again enacting strict protocols to combat the omicron variant, such as increased masking and new visitation guidelines.

“I think we’re going to start seeing is that some communities who had been much more liberal and allowing large family groups to come in and visit, they’re now starting to say, ‘hey we don’t want groups larger than three to four people because of space limitations.’ The more people you bring in the more risk you have someone coming in sick,” said Carmen Tilton, Vice President of Policy for the Texas Assisted Living Association, in an interview with NBC 5.

Her team has been adjusting to the ever-changing environments during the last two years with COVID-19, made more complicated with new variants that arise just as case counts start to go down and families feel more at ease.

Doctors say for the vaccinated, omicron infections have typically been mild but health experts have warned against assuming it will be a mild disease for every single person who gets infected. For the unvaccinated, the elderly and those with underlying health conditions,  it can be dangerous.

And with omicron four times more contagious than the delta variant that struck in August, there's huge concern for the coming weeks. However, Tilton said communities know the drill by the now.

“It’s going to be challenging. Omicron certainly looks really scary but we know what to do, we know that there when there’s really high transmission in the broader community, that you’re going to have cases that come in," she said.  "So it’s really all about responding to those cases when they crop up, identifying them as early as possible and doing everything you can to minimize the spread once you’ve identified that case. I think a lot of our members are really good at it, unfortunately they’ve had to get really good at it."

Although it’s unknown what kind of impact omicron will have on senior communities, data from the delta variants impact paints a serious picture of what to prepare for. Despite high vaccination rates among long-term care residents this year, the delta variant hit hard. According to a data analysis by the Kaiser Family Foundation, nursing homes in particular reported nearly 1,800 deaths across the U.S. among residents and staff in just August 2021, the highest number in a single month since February.

Long-term care facilities are unique in their own environments, which Tilton said can put residents at more risk than the general public.

“Those are individuals that are in these communities usually for some sort of underlying reason. Either because of dementia or memory care need, or they are there because they have some other deterioration of physical mobility and they’re no longer able to get themselves in and out of the bath tub or shower," explained Tilton. “When you have people who are living in these communal environments, you know that you have both their own underlying health conditions and reasons they are in these communities, but also you have this function of this household is no longer your little nuclear household, your household is now the assisted living community, living  with those other residents and those other staff members."

When it comes to protocols, by no means will we see a return to what happened earlier in the pandemic, when residents were isolated for long periods of time out of fear of infection. Data shows COVID-19 ravaged nursing homes and other long-term care facilities, with the Texas Health and Human Services Commission reporting that nearly 9,000 nursing home resident died of the virus between April 2020 and April 2021.

For more information on the state’s tracking of this data, click here.

Thanks to vaccines and new legislation, Tilton said facilities have learned how to live with the coronavirus while creating a sense of normalcy for residents.

Texas law passed earlier this year now mandates family members, who are deemed "essential caregivers," be allowed to have access to their relatives each day to visit.

“Per the state of Texas, every resident is now guaranteed an essential caregiver, even if that resident has a COVID infection. As far as visitation, the state left the guidelines open ended for facilities to determine what number they wanted to limit that to,” said Tilton.

The state has also left it up to each facility to determine their own masking and vaccination policies as well.

Vaccines are another tool in the toolbox in the fight against omicron, although earlier this month, a federal judge ruled that the Biden administration cannot force staff at Texas hospitals and nursing homes to get the COVID-19 vaccine.

Still, Tilton said some of their members have mandatory vaccine policies with appropriate legal carveouts and exemptions.

It varies by community but she said they've typically seen high numbers of residents across the state getting vaccinated and boosted.

"For staff, there’s a lot more variation. In some communities, upwards of 90 to 95% of their staff is vaccinated and in other communities, it’s not nearly so high," Tilton said. "It's really a decision that’s driven by the community itself, by residents, and by what their families and staff members want."

Staffing Issues

But perhaps the biggest issue nursing homes and senior communities are facing is staffing shortages.

For example, AARP reported last month that nearly a third of the 15,000 U.S. nursing homes had a shortage of nurses or aides.

These shortages are being felt at all levels of long-term care.

“We went into the COVID pandemic with staffing challenges and all we have seen since then is an increased need for staffing,” said Tilton. “The sort of unrelenting nature of this pandemic and working in communities where you’re at this higher vigilance is just really draining on people.”

Tilton said staff are getting burnt out, often leaving long-term care to seek higher paying jobs in hospitals or taking a break entirely. The same issue is being felt in other industries because of the Great Resignation.

So communities are bracing for staffing impacts as workers get sick.

“You’re just kind of fingers crossed hoping that it’s only just a handful of staff and that you don’t have your entire nursing staff and direct care staff who get sick all of the same time,” said Tilton. “I think what a lot of communities are doing is they’re trying to overstaff in anticipation that they’re going to have a higher percentage of people who call in sick or can’t come in. And you’re also really working with staff to ask them and impress upon them the importance of them doing everything they can to try very hard not to get sick over the next couple of weeks."

Lawmakers in Texas are even working to set aside millions of dollars to address staffing shortages.

The Texas Assisted Living Association has a section on its website dedicated to helping people find open positions at communities within their network. To search and apply for job openings across the state, click here.