Rising COVID-19 hospitalizations pose risk to seniors

Coronavirus-related hospitalizations are on the rise again in the U.S., with U.S. elderly deaths increasing and less than half of nursing home residents vaccinated against COVID -19 so far.

These alarming signs point to a tough winter for the elderly, which worries Bartley O’Hara, 81, a nursing home resident, who said he has been “vaccinated to the fullest extent” eye” and track coronavirus hospital trends as they “zoom in” for older adults, but remain flat for younger people.

“The sense of urgency is not universal,” says O’Hara of Washington, DC. But if you’re 21, maybe you should worry about your grandmother. We are all in this together.

A worrying indicator for the elderly: Hospitalizations of people with COVID-19 have increased by more than 30% in two weeks. Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention, said most of the increase was due to older adults and people with existing health problems. The numbers include everyone who tested positive, regardless of why they were admitted.

“When it comes to protecting the elderly, we are doing very badly in this country,” said Dr. Eric Topol, head of the Scripps Research Translational Institute.

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As nursing home leaders redouble their efforts to encourage staff and residents to use the new version of the vaccine, now recommended for people 6 months of age and older, they face self-doubt. complacency, misinformation, and COVID-19 fatigue. They are calling on the White House to help with an “all-in-one” approach.

Katie Smith Sloan, president of LeadingAge, which represents nonprofit nursing homes, said clear messages about what vaccines can do – and what can’t – are needed. .

She says outbreaks of infections don’t mean the vaccine has failed, but it’s hard to combat that misconception.

“We need to change our message to be exactly what it does, which is to prevent serious illness, hospitalization and death,” Sloan said. “This virus is very insidious and it keeps popping up everywhere. We just need to be realistic about that.

Issues include unwarranted reluctance to rapidly prescribe the antiviral Paxlovid to the elderly, which prompted five major medical associations to host a web-based education session for physicians. Doctor, “Vax & Pax: How to Keep Your Patients Safe this Winter”.

The easing of restrictions, broader immunity among the general population and mixed messages about whether the pandemic is over have allayed young people’s feelings of intimidation. That might be a welcome development for most people, but the attitude has seeped into nursing homes in disturbing ways.

It has become more difficult to get family consent to vaccinate nursing home residents, said nursing home leaders. Some residents who can give their own consent are refusing the shots. Only 23% of nursing home staff are up-to-date on COVID-19 vaccines.

Cissy Sanders of Austin, Texas, encountered many obstacles when trying to give booster injections to her 73-year-old mother, who is currently in a nursing home. No enhanced clinic has been planned. The facility told her they couldn’t find the person giving the vaccine. So she planned to take her mom to Walgreens later this month.

She said: “I am concerned about the increase in hospitalizations and deaths among seniors, and at the same time concerned about my mother’s nursing home’s lack of urgency in vaccinating residents and staff. ” with the latest booster shot.

Staff and guests are potential entry points for the virus into nursing homes. The best facilities use a layered approach, protecting residents with masks, screening questions, temperature checks, and advanced infection control.

“What we have learned during COVID is that the rate of spread depends on how quickly the community spreads,” said Tina Sandri, CEO of Forest Hills of DC, a nursing home in the nation’s capital. copper. “I feel safer in my building than anywhere else, including the grocery store.”

Meanwhile, hospitals across the country are seeing a large influx of elderly patients, which Topol called “alarming”. Nationally, the daily hospitalization rate for people 70 years of age and older with confirmed or suspected COVID-19 infection rose from 8.8 per 100,000 people on November 15 to 12.1 per 100,000. on December 6, according to statistics of the Ministry of Health and Health. Human Services. In California and New York, Topol said, hospitalizations of seniors with COVID-19 have surpassed hospitalizations during spring and summer omicron waves.

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At NYU Langone Health, the hospital’s chief epidemiologist Dr. Michael Phillips said an increasing number of seniors are being hospitalized with COVID-19. But the biggest increase he’s seen has been in the emergency department, which is “very, very busy” with COVID-19, as well as flu patients.

Dr Wesley Long, a pathologist at Houston Methodist in Texas, said his hospital has also seen an increase in COVID-19 hospitalizations over the past few weeks – and many more elderly people with other health problems. Some were hospitalized for various illnesses and tested positive for COVID-19 in the hospital. Good news? “We haven’t seen an increase in ICU admissions yet,” he said.

The new combined booster shot, targeting both omicrons and the original coronavirus, offers protection against one of the main omicron variants that have given rise to recent cases: BQ.1.1, especially good at getting rid of immunity.

“But our booster rate for seniors is pathetic,” says Topol, with only about a third getting the shot.

Long said health care providers at Houston Methodist promote boosters “every time we get the chance.” But they don’t give it to people hospitalized with COVID-19, who are typically told to wait three months after being infected before getting the shot.

Phillips also urges people to get booster shots, especially if they’re at risk for serious illness or plan to spend time with someone. He says they see more hospitalizations among unvaccinated people.

The number of deaths, as well as the number of hospitalizations, is currently increasing.

The final worry is that many elderly people will die. Last spring and summer, the overall death rate fell as more people were protected from previous vaccinations and infections. But the COVID-19-related death rate for the oldest people — adults 85 years and older, making up 2% of the population — has risen to 40%.

During the pandemic, 1 in 5 deaths from COVID-19 were among people in a long-term care facility.

Walid Michelen, medical director of seven nonprofit nursing homes run by the Archdiocese of New York, said Americans need to continue to take the pandemic seriously.

“It won’t go away. It’s here to stay,” he said. “We will have a new variant, and who knows how aggressive that variant will be? That kept me up all night.”


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