November 21, 2022

How We Can Help Long-Term Care Facilities Protect Against the Tripledemic

Community COVID-19 Transmission Rate | Source: CDC

 

The beginning of autumn and winter is historically the time when illnesses spread, and this year is no exception. Throughout the past few weeks, you may have heard or read about a “Tripledemic,” a new term that is being used to describe a large influx of respiratory viruses, among all ages, that are being treated at health care facilities.

As COVID-19 continues to create complications for adults and children, health care physicians are also diagnosing cases of the flu and higher cases of respiratory syncytial virus –– commonly known as RSV.

While respiratory illnesses are making the rounds, this is also the time of year when families and friends are getting together more frequently and visiting loved ones in long-term care facilities. The holiday season creates more foot-traffic in the nearly 1,900 nursing homes, assisted living communities and personal care homes throughout Pennsylvania, increasing the risk for residents to contract an illness.

According to the Centers for Disease Control and Prevention (CDC), Pennsylvania continues to see substantially high levels of COVID-19 community transmission. Academic studies have shown that outbreaks of COVID-19 in nursing homes follow the trend of COVID-19 case spikes in the surrounding community.

Year-over-year COVID-19 data collected by the National Healthcare Safety Network (NHSN) shows the trends in cases among Pennsylvania nursing home residents. As of the end of October, cases among nursing home residents were already tracking higher than the previous two years.

 

PA Covid Trend Model for 2020-2022
Image by PHCA

 

As of November 11, 2022, the Department of Health (DOH) reports that seasonal influenza activity in Pennsylvania is higher than at the same time during the past five flu seasons, putting seniors even more at risk of contracting an infection. Because COVID-19 and flu symptoms are commonly mistaken for one another, the CDC recommends specific testing to be able to confirm a diagnosis.

Experts have also sounded the alarm for the third leg of the “Tripledemic” known as RSV, commonly found in children as well as older adults. Positive cases and detections for RSV have increased in the past three months in Pennsylvania and across the United States. The CDC national graph below shows virus trendlines from 2021 to 2022.

 

CDC data for RSV percentage positive over 2021-2022 year
Source: CDC

 

RSV can infect anyone – especially children, the elderly, people with heart and lung disease, or anyone with a weak immune system (immunocompromised) – but it is more dangerous in infants and the elderly. According to the CDC, “older adults are at greater risk than young adults for serious complications from RSV because our immune systems weaken when we are older.”

RSV symptoms for adults will be similar to the common cold. They could develop a lung infection, pneumonia, asthma or chronic obstructive pulmonary disease (COPD). Worsening symptoms of RSV can lead to breathing problems, and in some cases, congestive heart failure. 

Because all three illnesses have similar symptoms, medical professionals recommend older adults take tests to determine which infection a resident has. There is currently a COVID-19, Flu, and RSV combined test which is still pending FDA authorization.

Furthermore, in an effort to help mitigate the spread of COVID-19, influenza and RSV, PHCA is urging the public to be mindful of their own health before entering a long-term care facility. Long-term care providers have infection control protocols set up to help protect the health and safety of residents and staff. It is important that anyone entering a long-term care facility respect the protocols put in place.

It is also important to provide vaccine education for seniors to further enhance levels of protection for their health. PHCA encourages residents in long-term care facilities to stay up-to-date on their COVID-19 boosters and this year’s flu shot. If eligible, the bivalent COVID-19 booster is available and provides broad protection against COVID-19, while providing better protection against the omicron variant.

You can also learn more about RSV on the CDC website, and follow CDC recommendations to safeguard yourself from contracting and transmitting the disease. There are currently no vaccines for RSV. However, like other contagious viruses, it is important to wash your hands often, avoid touching your face, and keep distance from people who are sick.

Additional precautions to consider when visiting a long-term care facility include:

  • Be mindful of any contact you may have had with people in your community that may have tested positive for COVID-19 or fell ill to any other transmissible virus.
  • Consider taking a COVID-19 test 24-48 hours in advance of a visit. 
  • Contact the long-term care facility to inquire about visiting. Make sure there isn’t a current outbreak in a facility that would create visitation complications. 
  • Consider limiting the amount of people visiting a resident in a long-term care facility to help reduce the risk of spreading COVID-19 or other illnesses, especially the number of younger children who may have more difficulty in adhering to infection control policies. Providers may limit how many visitors are allowed in a resident’s room –– including a roommate –– to determine safe social distancing. A provider might also be able to provide a communal space for visitors to gather with a loved one. Consult with the provider in advance of a visit.
  • Consider inquiring with the long-term care provider about setting up a virtual visit to further reduce the risks of spreading a virus.
  • Face masks or face coverings are still encouraged  in all health care settings. Be prepared to sanitize your hands, have your temperature checked and answer survey questions to determine any concerns of recent contact with the COVID-19 virus.

 

Resources

PHCA Press Release: Call for Public Support

PHCA calls for community support to keep long-term care residents healthy

Respiratory Syncytial Virus Infection (RSV)

More information about RSV, including symptoms, care and research, can be found on the CDC website.

The IoA Senior Friendship Line

During the holiday season, some seniors may not have family come to visit them. The Friendship Line, offered by the Institute of Aging, is the only accredited crisis line in the country for adults aged 60 years and older. The program provides trained volunteers who specialize in emotional support by having a friendly conversation with depressed older adults. Though the line is mainly used for suicide prevention, seniors can call if they are lonely or just want to talk.

 

Citations
  1. American Health Care Association. “Just the Facts: What Caused COVID-19 Outbreaks in Nursing Homes”. Accessed Nov 19, 2022: covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=Pennsylvania&data-type=Risk&null=Risk.
  2. Centers for Disease Control and Prevention. “CDC Covid Data Tracker”. Accessed Nov 18, 2022: covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=Pennsylvania&data-type=Risk&null=Risk.
  3. Centers for Disease Control and Prevention. “Respiratory Syncytial Virus Infection (RSV)”. Accessed Nov 21, 2022: https://www.cdc.gov/rsv/index.html.
  4. Department of Health. “2022/2023 Influenza Season Data”. Oct. 30, 2022. Accessed Nov 21, 2022: https://www.health.pa.gov/topics/disease/Flu/Pages/2022-23-Flu.aspx.
  5. U.S. Food and Drug Administration. “COVID-19 Bivalent Vaccine Boosters”. Updated Nov 16, 2022. Accessed Nov 21, 2022: https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-bivalent-vaccine-boosters.
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