Hospitalizations Signal Increased COVID Risk for US Seniors

CHospital admissions for coronavirus are climbing again in the United States, the share of older adults in US deaths is increasing, and less than half of nursing home residents have received their COVID-19 vaccines to date.

These worrying signs point to a tough winter for seniors, which worries 81-year-old nursing home resident Bartley O’Hara, who says she’s “grafted to the pupils” and follows coronavirus hospital trends “as we get closer” for older adults. , but stay flat for younger people.

“The sense of urgency is not universal,” said O’Hara of Washington DC. But “If you’re 21, you should probably be worried about your grandma. We’re all in this together.”

A disturbing indicator for the elderly: Hospitalizations of COVID-19 patients increased by more than 30% in two weeks. Director of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky said much of the increase was driven by older people and people with pre-existing health conditions. The numbers include everyone who tested positive, regardless of why it was accepted.

The head of the Scripps Research Translation Institute, Dr. When it comes to protecting the elderly, Eric Topol said, “We’re doing a terrible job at this in this country.”

Nursing home leaders are facing complacency, misinformation and COVID-19 fatigue as they redouble their efforts to empower staff and residents with a new vaccine version now recommended for those 6 months and older. They seek help from the White House with an “everyone on duty” approach.

Katie Smith Sloan, president of LeadingAge, which represents nonprofit nursing homes, said there is a need for clear messages about what the vaccine can and cannot do.

Breakthrough infections don’t mean the vaccine has failed, but that misperception is hard to combat, he said.

“We have to change our message to be true to what it does, which prevents serious illness, hospitalization, and death,” Sloan said. “This virus is sneaky and it keeps popping up everywhere. We just need to be realistic about it.”

Problems include unwarranted hesitation in quickly prescribing the antiviral drug Paxlovid to the elderly; this resulted in five major medical societies holding a web-based training session for doctors: “Vax & Pax: How to Keep Your Patients Safe This Winter.”

Relaxation of restrictions, broader immunity in the general population, and mixed messages about whether the epidemic was over softened the sense of threat young adults felt. This may be a welcome development for many, but this attitude has infiltrated nursing homes in disturbing ways.

Nursing home leaders say it’s becoming more difficult to get family approval to vaccinate nursing home residents. Some residents who can give their consent are turning down vaccinations. Only 23% of nursing home staff know about up-to-date COVID-19 vaccines.

Cissy Sanders of Austin, Texas, faced many obstacles while trying to get support for her 73-year-old mother, who was in a nursing home. No support clinics were planned. The facility told him they couldn’t find a vaccine, she said. So she made plans to take her mom to Walgreens later this month.

“I am concerned about the increase in hospitalizations and deaths among the elderly and the lack of urgency in vaccinating residents and staff at my mother’s nursing home,” she said in recent support.

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

“What we’ve learned during COVID is that the rate at which it’s spreading depends on the rate at which the community is spreading,” said Tina Sandri, CEO of Forest Hills of DC, a nursing home in the nation’s capital. “I feel safer in my building than anywhere else, including the grocery store.”

Meanwhile, hospitals across the country are seeing an influx of elderly patients, which Topol calls “quite alarming.” Nationwide, the daily hospitalization rate for people aged 70 and over with confirmed or suspected COVID-19 is from 8.8 per 100,000 people on 15 November to 12.1 per 100,000 people on 6 December, according to statistics from the Ministry of Health. e rose. Human Resources. Topol said hospitalizations for seniors with COVID-19 in California and New York have already exceeded those in the spring and summer ohmicron waves.

Chief hospital epidemiologist at NYU Langone Health, Dr. Michael Phillips said that an increasing number of seniors are being admitted to his hospital with COVID-19. But the biggest increase he’s seen is in the emergency room, which is “very, very busy” with COVID-19 alongside flu patients.

A pathologist at Houston Methodist in Texas, Dr. Wesley Long said his hospital has also seen an increase in COVID-19 admissions over the past few weeks, with many of the patients being seniors with other health conditions. Some are admitted for different illnesses and test positive for COVID-19 in the hospital. Good news? “We haven’t seen an increase in admissions to ICU,” he said.

Targeting both the micron and the original coronavirus, the new combination booster vaccine protects against one of the main omicron variants that have recently increased cases: BQ.1.1 is particularly adept at evading immunity.

“But our support rates among the elderly are pathetically low,” Topol said, and only a third are vaccinated.

Long said healthcare providers at Houston Methodist encourage the booster “every chance we get.” However, they generally do not apply it to people hospitalized with COVID-19, who are told to wait three months after being infected to catch the virus.

Phillips also urges people to take their booster, especially if they are at risk of serious illness or plan to spend time with someone like that. He said they saw far more hospitalizations among those who were not vaccinated.

Deaths are increasing, as are hospitalizations.

The ultimate concern is that more seniors will die. Last spring and summer, death rates fell overall as more people received vaccination and protection from previous infection. But for adults aged 85 and over, who make up 2% of the population, the share of COVID-19-related deaths rose to 40%.

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

Chief medical officer of seven nonprofit nursing homes operated by the Archdiocese of New York, Dr. Walid Michelen said Americans should continue to take the epidemic seriously.

“It’s not going. It’s here to stay,” he said. “We’re going to get a new variant, and who knows how aggressive that variant will be? It keeps me up at night.”

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Associated Press writer Nicky Forster contributed from New York.

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