January 10, 2023 – It may appear that we are returning to some semblance of “normal” at this point in the COVID-19 pandemic. But many people remain at higher risk for serious consequences like hospitalization and death, particularly older Americans.
For example, Legula Estiloz was diagnosed with COVID-19 at the age of 104. “She and I both fell ill at the same time, a few days after Christmas 2020,” says her son Tim Estiloz.
“I went in to wake her up for breakfast and she was just soaked, sopping wet — her sheets and her nightgown,” says Tim.
Legula, a resident of The Willows, a skilled nursing community in Oakmont, PA owned and operated by the Presbyterian SeniorCare Network, sought care at nearby Magee Hospital. Both Legula and Tim were swabbed for COVID-19 and tested positive. They had a slight fever and were tired. Legula lost her appetite for months. But none lost their sense of smell or taste or had breathing problems.
The COVID-19 vaccines were not available at the time. “It’s all the more miraculous that she survived it at that age, without the benefit of the vaccine to get through it,” he says.
Americans age 65 and older are disproportionately more likely to die from COVID-19. For example, 22% of COVID-19 deaths are in people aged 65 to 74, even though this age group makes up less than 10% of the US population. CDC Numbers Show. The picture is worse for those aged 75 to 84 – a group that accounts for 26% of deaths but less than 5% of the population.
The oldest Americans, those over 85, are responsible for 27% of deaths but make up only 2% of the US population.
Add to this the yet-to-be-fully appreciated Ascension impact of the latest Omicron subvariant, XBB.1.5, and the future remains far from certain.
Legula, who survived COVID-19, suffered a heart attack before spring 2020 and was diagnosed with breast cancer.
Your prognosis is good now, says Tim. “She’s doing quite well. I think she was better than me for a while.” She plays sheet music on the piano, enjoys “dancing” in her wheelchair and catches a ball thrown from 3 or 4 feet “every time”.
To summarize her pandemic experience, Legula “battled breast cancer, had radiation treatment, she fell once, she survived COVID, and she survived a heart attack,” says Tim. Despite the admitting doctor’s warning that his mother might not survive the night of her heart attack, she recovered and celebrated her 104th birthday in January 2021th Birthday.
“And now, God willing, she’ll be celebrating her 106th in a few days.”
Bivalent booster buy-in
A key factor in Legula’s recovery: She’s also up to date on her COVID-19 vaccinations and boosters.
The bivalent boosters — which target some Omicron strains and the original coronavirus — are 84% more effective at keeping seniors from hospitalization, says David Gifford, MD, chief medical officer at the American Health Care Association/National Center for Assisted Living in Washington. direct current.
A Preprint study published Jan. 3 in journal The lancet confirms that. Although not peer-reviewed, the researchers looked at 622,701 people aged 65 and older and found that those who received the bivalent booster were 81% less likely to be hospitalized and 86% less likely to have COVID -19 died when others who did not receive it.
But just over a third of Americans age 65 and older, 38%, have them received a bivalent booster, compared to 15% of all Americans age 5 and older, CDC data shows. So there’s plenty of room for improvement, experts say.
“We have this ongoing pressure among our members to increase the adoption rate of boosters among residents,” says Lisa Sanders, director of media relations at LeadingAge, a national association of nonprofit providers and aging services, including nursing homes, senior communities, and affordable housing for older adults .
One of the biggest misconceptions, she says, is “thinking that the bivalent booster isn’t necessary.” In addition, continuous education and access to vaccines remain important “because there is a lot of misinformation”.
“The message needs to be clear: You need to get the bivalent booster,” says Sanders, “especially now after the holidays and [when] new variants are emerging.”
COVID and community life
As older Americans are more vulnerable to the severe effects of COVID-19, what about environments where they live together, such as homes? B. Nursing Homes, Qualified Nursing Facilities and Other Nursing Centers? At the beginning of the pandemic, these sites faced greater challenges in controlling infection from the coronavirus.
“Long-term caregivers have known from day one that older adults with chronic medical conditions are most vulnerable to this virus. They have witnessed unspeakable tragedies over the past 3 years,” says Gifford.
“Unfortunately, ageism has been on full display during this pandemic, as evidenced by long-term care facilities that initially begged health officials for resources, to no avail,” he says.
Where are you now?
On the plus side, defensive and preventative measures have come a long way since the pandemic began, says Gifford. “While older adults are still the most vulnerable, we have the tools to protect them from serious illness and hospitalization. First and foremost, seniors need to stay current on their COVID immunizations, which means they get the updated, bivalent booster.”
Florida at the top
The three US states with the most residents aged 65 and over are California, Florida and Texas. As a percentage, more than 1 in 5 Floridians, or say 21%, are in this age group as of 2021 US Census figures.
With one of the most vulnerable elderly populations in the country, the Florida Health Care Association in Tallahassee continues to promote the effectiveness of the COVID-19 vaccine and booster shot. Kristen Knapp, the association’s senior director of strategy and communications, says: “While the booster shot may not prevent infection, we know it can help residents become seriously ill or be hospitalized.”
COVID-19 vaccination is not a requirement for admission as a resident or for hiring staff. But Knapp says anyone who tests positive for COVID-19, whether vaccinated or not, must follow infection control protocols.
The Feds get involved
On November 22, the White House announced a campaign Promotion of booster vaccinations in older adults. The focus is on reaching seniors and other communities hardest hit by COVID-19, making vaccination even more convenient, and raising awareness through paid media.
The initiative includes new enforcement guidance from the Centers for Medicare & Medicaid Services to ensure nursing homes provide updated COVID-19 vaccines and timely treatment to their residents and staff.
Shortly thereafter, LeadingAge partnered with the American Health Care Association to create an “All Hands on Deck” initiative to meet White House goals. One strategy is to get hospitals more involved. That’s important, Sanders says, because about 90% of nursing home admissions are for people who have been transferred from a hospital.
Future variants continue to pose a threat, but the vaccines are incredibly effective at preventing hospitalizations and deaths, experts point out.
“We continue to monitor and prepare for anticipated surges like this winter and encourage everyone, including our residents and staff, to get their boosters,” says Gifford.
Constant attention must be paid to the fact that this is a community issue, Sanders says. “There’s a human tendency to want to push it away and say, ‘Oh, that’s her problem.’
“Really, that’s all our problem and if we take every step to protect ourselves and each other, we’ll be better off as a society.”