The first vaccines began to flow earlier this year into senior living communities, signaling that the lockdowns and restrictions of 2020 would soon be a distant memory.
An increasingly infectious strain of Coronavirus, the delta variant, threatens to reverse some of that progress, so the industry is creating some adjustments, such as reinstituting mask mandates.
Operators of senior living facilities face many risks, such as the possibility of local or statewide mandates or restrictions being reinstated, which could decrease occupancy. It could also cause new outbreaks among their workforce or residents.
Staff members are at risk of delta outbreaks given current labor challenges, including a shortage of workers. According to National Investment Center for Seniors Housing & Care (NIC), average staff vaccination rates are hovering around 65% since mid-March 2021. Delta variants could lead to a trend in hospitals and health systems where staff vaccination mandates are becoming more prevalent.
Senior living residents are vaccinated at a much higher rate than staff. However, because of their immune systems’ unique way, some may still contract “breakthrough cases” even if they are fully vaccinated. The disease is tested for in fully vaccinated older residents of senior living facilities, although breakthrough cases of Covid-19 are thought to be rare.
Covid-19 vaccines, however, do work – along with other evidence that indicates Pfizer and AstraZeneca vaccines significantly reduce symptomatic infections, hospitalizations, and deaths. Some public health officials have used the phrase “pandemic of the unvaccinated” to describe the problem, which is a much more likely situation for unvaccinated people than for vaccinated people.
Providers of senior living remain in a difficult position. In the event of a surge in cases locally, other lockdowns or restrictions could hinder recovery efforts, especially if they put a damper on tours or moves-ins. Operators would prefer to avoid seeing their residents test positive, even though vaccinated residents are much more protected than unvaccinated residents.
Because of that uncertainty, senior living providers are taking additional steps to protect their residents and prepare for possible disruptions in the future. Many of them, including those in Florida and Missouri where Covid-19 cases are rising, is cautiously optimistic about the path forward due to those efforts.
The senior living industry mustn’t give up on fighting Covid-19, especially given the widespread distribution of the delta variant, says Dr. Kevin O’Neil, the chief medical officer at ALG Senior.
Reason for concern
Unvaccinated people across the country are suffering from the delta variant. As a result, hospitalizations are up in 45 states, yet not at the last year’s levels, with Arkansas, Florida, Louisiana, Mississippi, Missouri, and Nevada recording the highest gains.
The risk of contracting Covid-19 for vaccinated people is lower than for unvaccinated individuals, but rare cases have arisen from the delta variant. The majority of these are thought to be mild or asymptomatic.
Even people who have been vaccinated face an increased risk of catching a severe case of Covid-19. It’s not surprising that breakthrough cases of Covid-19 occur as people age because their immune systems weaken, O’Neil said.
Older adults can contract Covid, but those who have gotten their shots are better protected against infection and are less likely to experience severe symptoms than those who haven’t.
Covid-19 has been detected among residents of some senior living communities who were vaccinated recently. Covid-19 was diagnosed after attending a Fourth of July concert in Florida by senior living residents who were mainly vaccinated. Twenty-one residents at a place of continuing care and retirement (CCRC) in Spokane, Washington, tested positive for Covid-19 in May, despite getting vaccinated.
Covid-19 is a dangerous disease, so the industry shouldn’t cease its efforts to stop its spread. It is more likely for a variant to replicate and mutate the longer it spreads throughout a population. A new variant may have more excellent immunity to vaccines than the previous one.
Pegasus Senior Living’s health and wellness consultant, Sandra Petersen, is also concerned about the spread of the delta variant. According to Petersen, a coronavirus in the general population could be disastrous for senior living services, leading their Covid-19 program efforts.
In addition to adverse outcomes, the industry also faces a “significant” risk of derailment if a significant viral outbreak resurgence occurs in states with low vaccination rates, she explained. Even so, it’s difficult to predict the final result.
In some places, operators are anxiously watching to see if local officials will reimpose restrictions due to the rising case counts.
Yet, Sholty is confident that the company won’t face restrictions everywhere it operates.
Dealing with the Delta Variant
There is also the risk that a new surge of cases of Covid-19 will lead to new regulations or restrictions, as well as residents or staff getting sick from the delta variant. Some localities have already done it. Effective July 26, city officials in St. Louis are again mandating masks in public spaces and public transportation. A mask mandate has also been reinstated in Los Angeles in response to an increase in traffic-related cases.
During the current pandemic, Arrow Senior Living COO Amanda Tweten has firsthand experience with the challenges of running a senior living community. Springfield, Missouri, which is experiencing new outbreaks of Covid fueled by variants, is home to four of the 26 communities managed by the operator.
Since this time last year, Arrow has managed to prevent any new Covid-19 infections in those communities thanks to some preventive measures. Although the operator does not mandate vaccination for their employees, the unvaccinated staff is tested twice a week for flu. They must always wear masks while out in the community.
Every person who walks into the community has a temperature taken and is screened for possible exposure.
In all of its properties, the provider has set the goal of reaching 70% vaccination rates. Despite not reaching that level of “community immunity,” Arrow has been able to keep residents safe without instituting many of the lockdowns seen in the early 2020s.
One of the senior living providers grappling with the delta coronavirus strain is Denver-based Solera Senior Living. Its Florida campus is home to one of the eight communities.
In addition to worrying about new cases spreading among staff and residents’ loved ones, Crystal Roberts worries about new restrictions due to a recent uptick in cases.
The community is also screening everybody who comes into Covid for safety reasons, as Arrow does. This year, the company also required workers to get vaccinated and has recently mandated that all visitors and employees wear masks throughout its communities.
A six-month-old vaccine requirement has also made a big difference in operators’ confidence in combating the new outbreak at PRS’ continuing care retirement communities (CCRC). Sholty strongly believes that senior living facilities must follow suit.
The industry is calling on other senior housing providers and care facilities to establish vaccine mandates of their own. Over 40 other health organizations encourage their members to require vaccinations for health care workers. For instance, LeadingAge and AARP encourage vaccinations for health care workers.
81.7% of LeadingAge member communities’ residents and 67% of their staff have been immunized, as of July 11.
End of the day, providers may find themselves having to make hard choices regarding how to balance maintaining residents’ safety with keeping them from feeling isolated during this period. If that meant rolling back some loosened rules, it might not be a good time
Whether mandates are in place or not, providers should communicate loudly and the importance of vaccinating staff, O’Neil said.
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