COVID-19 and 2021: Looking into the Crystal Ball

Published in the Pawtucket Times on December 28, 2020

Novel coronavirus (COVID-19) cases continue to surge across the nation.  Yesterday, nearly 18,986,236 Americans have contracted COVID-19 with over 331,930 dying, says the John Hopkins Coronavirus Research Center. Projection models say that deaths may spike to over 500,000 by March 2021.

As 2021 approaches, the Centers for Disease Control and Prevention (CDC) has announced that 1.9 million people throughout the nation have gotten a dose of COVID-19 vaccine.  CDC also warned that a new variant COVID can be more rapidly transmissible than other circulating strains of SARS-COC-2.

Even with the dissemination of a safe and effective COVID-19 next year, many experts say that COVID-19 will around for a long time.  We are now seeing New Year predictions being made about COVID-19’s future impact on the delivery of care to seniors. The New York-based Aloe Care Health, one of the world’s most advanced voice-activated medical alert and communication service for elder care, recently brought seven experts together, to make predictions as to how COVID-19 pandemic will impact the provision of healthcare, insurtech, caregiving services and aging services in the upcoming year.  

Predictions from Health Care Experts

According to a statement released by Aloe Care Health on Dec. 22, these invited experts see a ‘Better Year Ahead.”  Here are some of their insightful predictions: 

Jay H. Sanders, M.D., CEO, The Global Telemedicine Group, member of the Aloe Care Advisory Board, observed: “The best examination room is where the patient lives, not where the doctor works. And, any variant of the following: telemedicine is to healthcare as Amazon is to shopping; as Netflix is to the movie theater, and as on-line banking is to your local bank.” 

“While 2020 turned the world upside down, it also revealed the massive gaps and deficits that exist in caregiving and senior care. I think 2021 will be the ‘Year of the Caregiver’ as companies, the senior care industry, and leading service organizations come to terms with how to best serve these underpaid and undervalued everyday heroes,” stated Amie Clark, Co-Founder and Senior Editor at the Clackamas, Oregon-based The Senior List.  

Donato Tramuto, Author, Chairman and Founder of Health eVillages, noted: “After a year highlighted by the devastating impact of COVID-19, vaccinations and other measures bring us hope to combat the virus in 2021. However, it is also important that we pay attention to the unintended consequences of COVID-19. As we safely social distance to decrease exposure risk, we must find ways to intervene and deal with the social isolation and loneliness caused by the lack of connection. I expect the next decade to bring innovations in business and healthcare to help us rebuild our community of connections and address the loneliness epidemic.” 

“Aging-in-place will continue to gain traction. Remote patient monitoring, personal emergency response technology, and other health matters will be addressed in-home. Health Insurance companies will redouble efforts to advance digital care management, using data to prevent acute health episodes. Covid19 will accelerate the digital adoption of remote patient care and communication. Masks will be required or desired in many public forums for much of 2021. Sadly, social distancing may be here to stay,” predicted Bob Hurley, Executive Advisor in Digital Health, eHealth; member of the Aloe Care Advisory Board. 

“COVID has demonstrated the power of telehealth to support health care workers, the older population and caregivers. It is amazing to see the adoption rate grow amongst all ages and the importance it addresses for the safety and independence of vulnerable populations. I expect innovative concepts to grow and expand in 2021 that will further empower providers and the population as a whole to live healthier and fulfilling lives,” anticipates Vicki Shepard, Health and Aging Expert, co-founder of Woman Business Leaders (WBL): Women Leading Healthcare 

“The last several months have given every one of us a dose of radical empathy for people who are isolated and alone. My profound hope is that this translates into better care for one another, especially older adults, in 2021 and beyond. And as our population ages overall (more than 10,000 of us reach 65 every day), I hope too that we collectively evolve beyond so many limiting, false, and often unconscious preconceptions about aging. This starts with products that are more thoughtfully, more beautifully designed, and extends right through to our everyday interactions.” Says Ray Spoljaric, CEO and Co-Founder, Aloe Care Health  

Finally, Jordan Mittler, Director and Founder of Mittler Senior Technology, adds: “In 2021, older adults will continue to rely on simple technology to interact with friends and family, as well as to function independently. Normalcy will take time to resume, and senior communities need to use home devices to function in society. Online shopping, online healthcare, online banking, and virtual communication will be major components of the lives of elders as we go into 2021.”  Jordan leads an inspiring group of teens teaching elders how to use technology to improve communication and daily activities. 

Predictions from a Rhode Island Physician

Over the months, Michael Fine, M.D., Chief Health Strategist, City of Central Falls, says that the COVID-19 pandemic made seniors to feel isolated and vulnerable. “As people get vaccinated it will let people feel more comfortable about moving around.  But January and February will be very hard month,” he warns. 

As we move into 2021, Fine predicts that “many people will think twice before moving to congregate settings of any sort, and we will live with new and burdensome precautions for a long time.”  He thinks that Rhode Island will lose some of its assisted living facilities and nursing homes due to the ongoing pandemic.  

Next year, Fine recommends that older Rhode Islanders stay close to home until they are vaccinated and use food delivery services where possible.  “The best way to cope is to use the telephone a lot and go out walking as much as possible, and to listen to lots of music and read a lot,” he says.   

“COVID-19 has changed how we live our lives.  Wearing a face mask and social distancing are the new normal. “I think we will go back to life as it was.  But it will take 3 to 5 years,” says Fine.   

Fine, who formerly served as the state’s Director of Health, has some thoughts about combating the COVID-19 surge in the Ocean State.  “My advice continues to be to shut bars and restaurants for indoor dining and to keep schools open, until we drop to below 2 new cases/100,000 population per day.  Everyone who works outside their homes should be tested twice a week, and every employer should make sure that’s happening, and everyone positive should be isolated for 10 days, and all contacts go into quarantine. We need employers to take the lead on this, because government has not been able to get it done,” states Fine.

Spotlight on Government Action

“It is time we all look hard at our political leadership, which has chosen to keep factories, bars and restaurants open, at the cost of hundreds of lives and a robust economy, while the virus is spreading in our communities, hitting people of color hardest.  We need to look at ourselves and our faith communities as well, allowing this to happen instead to speaking up for the sanctity of human life,” says Fine. “Democracy depends on the consent of the governed.  We all went along.  This response represents the most fundamental kind of institutional racism, the kind that puts profit in front of the lives of people of color and the communities in which people of color live,” he adds.

“All level of government failed.  SARS-CoV-2 is a cold virus.  We remain completely unprepared for a truly dangerous virus, which is evolving somewhere around the world, and will hit elders and people of color hardest again,” warns Fine. 

Older Georgian Voters Key to Winning Senate Runoff Election

Published in the Pawtucket Times on December 21, 2020

Weiss Both Democrats and Republicans know that the proverbial clock is ticking.  It’s 15 days before the Georgia’s Senate runoff election scheduled for Jan. 15.   At press time, 1,336,136 registered Georgia voters have gone to the polls, says the U.S. Election Project.   The percent turnout of registered voters is 17.5 percent.    

Although Democrat presidential candidate Joe Biden beat President Trump to take the White House and the House Democrats maintain a very slim majority in their chamber, GOP Senate Majority Leader Mitch McConnell can still block Democratic legislative proposals by controlling the upper chamber’s agenda.  He must keep two GOP Senate seats up for grabs in next month’s U.S. Senate runoff in Georgia.  A Democratic win will give the party a majority 50 Senate seats, with Vice President Kamala Harris breaking a tie.  In order to pick up the two GOP Senate seats, held by incumbent Senators David Perdue and Kelly Loeffler, Democrats must successfully mobilize voters and adequately fund the campaigns of the Democrat candidates Jon Ossoff and Raphael Warnoc. 

Capturing Georgia’s Senior Vote 

A new poll, released on Dec. 11 by AARP Georgia, predicts that age 50 and over voters may well bring the two Democratic Senate candidates to Capitol Hill.  Social Security, Medicare and Nursing home protections are key issues for these older voters, says the pollsters.

 The survey of 1,250 2020 Georgia voters, including 857 age 50-plus voters and an oversample of 358 Black voters age 50-plus, was conducted on behalf of AARP by the bipartisan team of Fabrizio Ward and Hart Research Associates between Nov. 30 and Dec. 4, 2020.  The telephone/cell phone poll results were published in a 11-page report, “50+ Voters and the Georgia State Runoff Elections.”   

According to AARP Georgia’s bipartisan poll, both U.S. Senate races are statistically tied, with Democrat Jon Ossoff (48 precent) narrowly leading Republican incumbent David Perdue (46 percent) and Democrat Raphael Warnock (47 percent) edging out Republican incumbent Kelly Loeffler (46 percent). But among voters age 50 and over, the poll shows both the Republican candidates lead their Democratic challenger by identical margins, 53 percent for Perdue and Loeffler versus 42 percent for Ossoff and Warnock. Just percent of the voters are undecided.

Further, the poll found majorities of Republicans and Democrats age 50 and over are more likely to vote for a candidate advocating for policies that protect older Americans, like using Medicare’s buying power to help lower drug prices. “These results show that both races are a dead heat and time is running out for candidates to address the concerns of 50-plus voters,” said AARP Georgia State Director Debra Tyler-Horton in a statement announcing the release of the poll’s results. “To win, candidates must discuss the issues that matter to 50-plus Georgians now – like preventing cuts to Social Security and Medicare, lowering drug prices and protecting seniors in nursing homes,” she says.  

Georgia’s Republican and Democratic 50-plus voters told the pollsters that they are much more or somewhat more likely to support a Senate candidate who advocates to protect Medicare (Republicans 83 percent, Democrats 96 percent) and to allow the national health insurance program to negotiate with drug companies (Republicans 93 percent, Democrats 94 percent).  The survey’s respondents also wanted Congress to protect Social Security (Republicans 90 percent. Democrats 93 percent). 

Additionally, the older survey respondents call for more protections for nursing home residents during COVID-19 (Republicans 79 percent, Democrats 95 percent).  They want Congress for providing tax credits for family caregivers to help offset costs (Republicans 69 percent, Democrats 90 percent), and support the strengthening of federal age discrimination laws (Republicans 53 percent, Democrats 81 precent). 

As to today’s COVID-19, pandemic, the AARP Georgia survey findings indicate that older Georgian’s willingness to get vaccinated against COVID-19 has increased a substantial 14 points—from 41 percent to 55 percent—since September, when over half said they would not agree to be vaccinated.  And two in five 50-plus voters told pollsters that nursing home safety is “extremely important” to them in 2020.  It’s especially important to Black voters (53 percent), people who know someone who died from COVID-19 (51 percent), and to those who worry a lot about getting COVID-19 (48 percent). 

NCPSSM to Encourage Turnout of Older Georgia Voters

Recognizing the importance of mobilizing Georgia’s older voters, the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) announced the launching of a voter outreach campaign in the Peach State to encourage turnout and promote Democratic Senate candidates Warnock and Ossof as advocates for the state’s seniors. The campaign includes radio ads in the Atlanta market, postcard mailings to thousands of National Committee members and supporters throughout the state, and social media outreach to the Georgia’s voters.The National Committee has made a five-figure advertising buy on three Atlanta radio stations beginning December 15th through the runoff election on January 5th. 

“Only two candidates are ready to put Georgia seniors’ health and economic well-being first, Jon Ossoff and Rev. Raphael Warnock,” the radio ad tells voters.  Postcards are being mailed to more than 7,000 National Committee members in Georgia, bearing the message, “Your best future starts with your vote for John Ossoff and Raphael Warnock.”

“We need the leadership, vision and determination of Raphael Warnock and Jon Ossoff to fight for seniors in the U.S. Senate. They will work to protect Social Security and Medicare from harmful proposals to cut the benefits Georgians have earned.  They will be voices to strengthen the critical lifelines of Social Security and Medicare during the COVID pandemic, when older Georgians are counting on their earned benefits more than ever,” said Max Richtman, NCPSSM’s president and CEO.  “Georgia has 1.3 million Social Security beneficiaries and 1.8 million Medicare enrollees.  The average Social Security benefit in Georgia is $1,500 per month.  Those benefits provide $45.3 billion in annual economic stimulus to communities across the state, he notes.

While Warnock and Ossoff earned the National Committee’s endorsement by making it clear that they will standup to protect and strengthen Social Security, the incumbent GOP Senators David Perdue and Kelly Loeffler have paid lip service to protecting Social Security, says Richtman.  As U.S. Senators, they have supported GOP positions of cutting the benefits of future beneficiaries and deferring Social Security’s payroll tax last August that will force workers to repay those funds back in early 2021, he says.

Controlling the Senate’s Legislative Agenda

“Wins by Warnock and Ossoff would not only be a victory for Georgians. It would give President-elect Biden and his party the power in the U.S. Senate to actually get things done for seniors after four years of obstruction, says Richtman.

For a copy of AARP Georgia’s poll findings, go to:
https://www.aarp.org/content/dam/aarp/research/surveys_statistics/politics/2020/2020-election-battleground-states-senate-georgia-runoff-election.doi.10.26419-2Fres.00401.029.pdf

Tackling surge of COVID-19 in Nursing Homes

Published ion RINewToday on December 15, 2020

Over the months, while public health officials watch the uptick in new COVID-19 cases, Congress releases two reports, one taking a snapshot of nursing home performance and resident deaths throughout the first eight months of the pandemic, and the other one sounding the alarm about the impact of COVID-19 on the nation’s nursing homes and warning it is now getting worse.  

About three months ago, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) announced the release of a 67-page report on care provided in nursing homes and other long-term care facilities throughout the nation during the ongoing COVID-19 pandemic. The comprehensive report, titled “COVID-19 and Nursing Homes: What Went Wrong and Next Steps,” reviewed U.S. nursing home performance during the early fall and summer months of the pandemic. According to the report, more than two out of five deaths due to COVID-19 in the United States are linked to nursing homes and other long-term care facilities.

Stopping the Spread of COVID-19 in Nursing Homes

“Partisan finger pointing, rather than meaningful analysis, cannot serve as a useful guide for policymakers in crafting the necessary bipartisan reforms in response to the unprecedented challenges facing this entire sector and its employees working on the frontlines during this pandemic,” says the Senate Finance committee report, released on Sept. 23. It stressed that suggestions that coronavirus-related deaths in nursing facilities “are attributable solely, or even primarily, to acts or omissions by the current administration falls well short of addressing the multi-faceted problems in this sector.”

The report added, “Such a one-dimensional approach necessarily overlooks several factors that fueled the outbreak of COVID-19 in nursing homes across the United States, and around the world. Minimizing, or devoting scant attention to such factors, makes it enormously difficult for members of Congress to come together in support of long-overdue reforms and bipartisan solutions to the complex problems facing nursing homes today.” 


The report, produced by the majority staff of the Senate Finance Committee, examined what steps might have prevented these fatalities by minimizing the spread of COVID-19 in the facilities and discussed what actions could be taken now to slow the surge of deaths in nursing homes during this and future pandemics.  

While new coronavirus cases have surged to nursing homes throughout the nation and despite federal and state efforts to stall the spreading of the virus, the Senate Finance Committee report noted that facilities have already received significant relief assistance from Congress and the Trump administration totaling approximately $21 billion in addition to technical assistance, guidance and training.

The report’s findings noted that for years preceding the COVID-19 outbreak in March, private nursing homes have had widespread deficiencies in infection control and prevention.  The majority staff also found that state governments and health officials in some of the hard-hit states fell short of their responsibility to ensure quality care, and in multiple states, staffing and supply shortages persisted for years prior to the pandemic. 

Nursing homes around the world have struggled with many of the same issues as the United States during the pandemic, including Europe, the United Kingdom and Canada, noted the report.

State governments in some cases also failed to enforce federal guidelines for these care facilities as required through their participation in Medicare and Medicaid, particularly guidance provided to minimize coronavirus transmission in their facilities, noted the report. In addition, the majority staff found that nursing home staff who work in multiple facilities unknowingly played a key role in spread of COVID-19 in nursing homes. 


Finally, the Senate Finance Committee report also noted that several governors pressured nursing facilities to accept COVID-19 patients when personal protective equipment (PPE) was still in short supply and some did so even after the federal government made temporary hospitals available in their jurisdictions. 
·       
The Senate Finance Committee report provided, to members of the Senate Finance Committee with detailed background information on the many challenges that nursing homes continue to face during this year’s public health crisis. It provides Congressional lawmakers with specific recommendations, based on best practices that some facilities and public officials adopted during the ongoing pandemic to protect their residents and staff.  It also includes additional suggestions to better protect the nation’s older Americans from elder abuse, neglect and exploitation.

 
Updating the Grim Toll of COVID-19 Deaths in Nursing Homes 

Last week, U.S. Senators Bob Casey (D-PA), Ranking Member of the Special Committee on Aging, and Ron Wyden (D-OR), Ranking Member of the Finance Committee, released their report that warned that the already dire situation in nursing homes is worsening.

“It’s with great sadness that we are once again giving a grim update on the toll that COVID-19 is continuing to take on nursing homes. It’s abundantly clear that inaction has contributed to the loss of more than 104,000 mothers, fathers, grandparents, friends and neighbors who lived and worked in nursing homes and long-term care facilities across the country,” said Senators Casey and Wyden, in a statement announcing the report released on Dec. 10. “Experts are predicting that we are heading into the most severe months of the COVID-19 pandemic, marred by climbing caseloads and increasing stress on our Nation’s health care system,” they say, calling on the Senate colleagues to hammer out and pass a comprehensive COVID-19 relief bill. 

According to the eight-page report, entitled, “The Cost of Inaction: 19 Deaths an Hour and Rising,” last month, more than 15 nursing home residents died from COVID-19 per hour, with 19 residents dying each hour during the week of November 22, 2020, the most recent week reported.

The Senate Aging Committee report noted that the number of weekly COVID-19 deaths among nursing home residents has increased 133 percent since Labor Day, and 96 percent among nursing home workers during the same period. Workforce shortages have also increased since Labor Day: In November, one in six nursing homes nationwide reported that they do not have a sufficient workforce, says the report.

The Democratic Senators warned that COVID-19 cases will surge in nursing homes if Congress does not come together to hammer out bipartisan legislation to stop the spread of the pandemic.

These new report findings serve as a warning as to what will come if Congress does not come together to alleviate the COVID-19 crisis in nursing homes, says Casey and Wyden. It calls for a national strategy to save lives in nursing homes, including providing facilities with a sufficient supply of PPE, ample access to testing, resources for vaccine distribution, funding for strike teams and adequate workforce supports, and accountability measures to uphold resident rights and permit safe visits with family.

Finally, in the Ocean State…

Just days ago,the latest update of the AARP Nursing Home COVID-19 Dashboard, released by AARP’s Public Policy Institute, unveiled a new report in a series on improving the care of care provided in the nation’s nursing homes. “Rhode Island’s nursing homes continue to face alarming trends,” says the AARP report.

Using data released by the Centers for Medicare & Medicaid Services—which is self-reported by nursing homes—the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff. The dashboard will continue to be updated every four weeks.

In the four weeks analyzed, from October 19 to November 15, AARP’s dashboard reports that Rhode Island nursing homes had a dramatic increase in resident and staff cases, and a higher percentage of facilities reporting they are without a 1-week supply of PPE.

“With coronavirus surging across the country, nursing home residents and staff remain in grave danger as the virus reenters nursing homes and other facilities at an alarming pace,” said AARP State Director Kathleen Connell.  “Facilities continue to have shortages of the staff and PPE needed to keep residents and workers safe and stop the spread. Our state leaders must act now to save lives,” she said.

Connell added, “AARP will continue fighting to protect nursing home residents now and offering solutions to improve our long-term care system for the decades to come.”

For copies of Senate reports go to: https://www.aging.senate.gov/imo/media/doc/The%20Cost%20of%20Inaction.%2019%20Deaths%20and%20Hour%20and%20Rising.pdf

https://www.finance.senate.gov/imo/media/doc/SFCNursingHomesCOVIDMajorityStaffSFCReport23Sep2020FINAL.pdf.

The complete dashboard is available at aarp.org/nursinghomedashboard.