The novel coronavirus, also known as COVID-19, is in the U.S. and will continue to spread. It is particularly threatening to those with weakened immune systems and the infirm. That puts elderly loved ones squarely at risk, especially when they’re around other people with compromised immune systems, such as nursing homes and assisted living facilities.
Here are the facts about the Coronavirus, some health tips, and things you and nursing homes can do to help protect your loved ones from this global pandemic.
The Coronavirus: New Threat, Familiar Foe
The World Health Organization states that coronaviruses are a family of illnesses, not just one virus. Several viruses in the family are known to cause respiratory illnesses in humans. “These range from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19,” according the WHO website.
In other words, this is a new member of that virus family. While the common title used in media may be “Coronavirus,” the term actually refers to the family of illnesses. What’s spreading now is novel coronavirus, which causes COVID-19. It’s a new, different version and was unknown prior to its discovery in Wuhan, China, in December of 2019.
Although this virus is in the same family as the common cold, it is a much more serious risk to the health of the frail elderly. Some in the media have insisted that this virus is no worse than a common cold, but the medical experts, the WHO, Medicare officials, and epidemiologists who study viruses all agree that COVID-19 must be taken very seriously.
Coronavirus Symptoms, Its Spread, and How to Protect Yourself
Again, according to the World Health Organization, the most common symptoms of COVID-19 are a fever, tiredness, and a dry cough. These can escalate to aches and pains, sore throat, runny nose, nasal congestion, or diarrhea. Around 80% of people who contract the disease will recover without special treatment. Serious illness strikes about one of every six who contract it, with the elderly and those with compromised immune systems being most vulnerable. Mortality rates among those aged 80 and above are being pegged at an alarming 15%.
The disease is spread in the moisture expelled by an infected individual when they cough or sneeze. Tiny droplets of moisture containing the virus land on surfaces awaiting transfer to other people. The WHO suggests that contact with the eyes, nose, and mouth from these droplets is what spreads the disease in the vast majority of cases. Therefore, when someone who has the disease – even a mild case – coughs or sneezes, they lay the groundwork for it the disease to spread.
Protecting yourself, therefore, is fairly straightforward. A popularly shared and confirmed legitimate missive from James Robb, former professor of pathology at the University of California, San Diego, offers these tips on protecting yourself:
- Discontinue handshakes.
- Avoid touching high-use objects, such as light switches, door knobs, handrails, elevator buttons, gasoline handles, etc., with your fingers. Use your knuckle to flip switches, and use disposable gloves or paper towels when interacting with other things if possible.
- Use disinfectant wipes when available, such as at grocery stores. Be sure to wipe the shopping cart handle and child seat as well.
- Wash your hands thoroughly whenever you’ve been in places where other people are present. Wash your hands for at least 20 seconds, using soap, and warm running water. When soap is unavailable, use hand sanitizer with at least 60% alcohol content.
- Keep a bottle of hand sanitizer at each entrance of your home and in the car for on-the-go use.
- Cough or sneeze into a disposable tissue and discard. Use your elbow if absolutely necessary, but be aware that the clothing may contain infectious virus that can be spread for a week or more.
If the focus on hand-washing and keeping the hands clear of infection seems odd, consider that a study published by the Journal of Occupational Health and Environmental Hygiene found that ten subjects doing office work by themselves for three hours touched their faces, on average, 15.7 times per hour. Similar studies have produced results between 3 and 23 touches per hour. The point is, we unconsciously touch our faces a lot, and that enables the disease to spread – unless we wash our hands.
Nursing Homes and Your Loved Ones – Preparation and Prevention
Elder care facilities like nursing homes and assisted living facilities are at great risk. COVID-19 is highly contagious, and the elderly or infirm may not have the immune system strength to resist it. Once the virus hits a facility, every resident could be in jeopardy. The Center for Disease Control (CDC) recently traced the country’s highest concentration of COVID-19 cases to a nursing home facility in the state of Washington.
In the face of the outbreak, guidelines have been issued from multiple sources to help these facilities increase their prevention measures and prepare. The Center for Medicare and Medicaid Services (CMS), which is part of the Department of Health and Human Services (DHS) and oversees virtually all nursing homes in the U.S., issued thorough guidelines. Some of the measures include:
- Screening visitors, contractors, and staff for travel history and possible infection
- Restricting activities to reduce exposure
- Requiring all who enter to wash their hands immediately upon entry
- Develop and deploy remote communication methods so residents can contact loved ones safely
As of March 9, 2020, CMS was urging all nursing homes in the United States to discourage visitors from entering their facilities. In the case where COVID-19 is present in the community, visitors are being restricted altogether. Where a case of COVID-19 is in a nearby county or community, visitors are being limited, which means they will only be allowed into the facility in an end-of-life situation, or where the visitor is essential to the health or well-being of the resident. Preventing the spread of this virus is on all of us, not just the staff of the nursing homes. When the facility tells us not to visit, we need to respect that, even though we want to go see our loved one. Even where we are not at high risk for death from COVID-19, the nursing home you enter may be full of those at high risk. Prevention is not just about preventing your infection – it also means preventing someone else’s.
People in nursing homes don’t just need blood pressure medicine. They need supplies up and down the line. So how can you find out how a facility is preparing for novel coronavirus/COVID-19?
Ask the Nursing Home Facility What Its Plan Is
Nursing homes have policies in place if there’s a tornado, if there’s a flood, or if there’s a hurricane coming. They have policies in place for all kinds of emergencies and contingencies. What about this emergency? You may want to ask them. In fact, there are a number of questions you should ask.
- What is the facility’s plan for dealing with the COVID-19 threat?
- Are they well-supplied with food, medications, adult diapers and the other things residents need, and do they have enough to last the duration of an outbreak?
- What measures are they implementing regarding visitors, contractors, and staff?
- Under what circumstances will they accept an infected person from a hospital?
- Does the facility have any special features, such as an Airborne Infection Isolation Room (AIIR)?
- Are residents or patients being kept abreast of the latest developments, and prepared for changes to the facility’s operation?
- Does the facility have ample amounts of CDC-approved cleaning supplies, and is it disinfecting high-touch surfaces often?
- Are group activities being canceled?
The last question to ask may be the most important: How can you help? Nursing homes across the country are faced with staffing shortages as it is. There may be nothing you can do, but it does not hurt to ask. We must do everything we can to protect our often-overlooked senior population from this potentially deadly disease.
When Nursing Home Facilities Ignore the Warnings
Nursing homes must comply with numerous regulations, intended to keep their residents safe. If you or a loved one are in a facility that is not taking prudent steps to protect residents from this threat, alert a doctor, nurse, other healthcare professionals, or your area’s long-term care ombudsman.
To neglect to take recommended and immediate steps to protect residents could be viewed as neglectful behavior. We at the Law Offices of James Scott Farrin hope that this information helps you and enables you to help others.
UPDATE 3/13/20: The Centers for Medicare & Medicaid Services (CMS) issued a strict ban on nursing home visits excepting end-of-life visits, and even those will be heavily scrutinized. The emergency rule also included a waiver of the three-day rule that requires Medicare beneficiaries to spend three days at a hospital on an inpatient basis in order to receive a subsequent 100 days of covered care at a skilled nursing facility. To read more about this new development, click here.