One Year Later – Two Surveys Examine Impact of COVID-19

Published in RINewsToday on May24, 2021

Over the year the raging pandemic has impacted on the physical and mental health of Americans. With daily COVID case counts now the lowest since last year and hospitals seeing less coronavirus hospitalizations, most states, including Rhode Island, are now opening up.

According to the American Psychological Association’s (APA) latest Stress in AmericaTM poll (findings released on March 11, 2021), the nation’s health crisis is far from over. Just one year after the World Health Organization declared COVID-19 a global pandemic, many adults report increased negative behaviors, such as undesired changes to their weight and increased drinking, that may be related to their inability to cope with prolonged stress.

APA’s survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61 percent) experienced undesired weight changes—weight gain or loss—since the pandemic started, with 42 percent reporting they gained more weight than they intended. Of these individuals, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10 percent stated they gained more than 50 pounds, noted the poll’s findings.

Gaining Weight Bad for Your Health

Weight changes come with significant health risks, including higher vulnerability to serious illness from COVID-19.  According to the National Institute of Health, people who gain more than 11 pounds are at higher risk of developing Type II diabetes mellitus and coronary heart disease, and people who gain more than 24 pounds are at higher risk of developing ischemic stroke. 

For the 18 percent of Americans who said they lost more weight than they wanted to, the average amount of weight lost was 26 pounds (median amount lost was 12 pounds). Adult respondents also reported unwanted changes in sleep patterns and increased alcohol consumption. Two in 3 (67 percent) said they have been sleeping more or less than desired since the pandemic started. Nearly 1 in 4 adults (or 23 percent) reported drinking more alcohol to cope with their stress.

“We’ve been concerned throughout this pandemic about the level of prolonged stress, exacerbated by the grief, trauma and isolation that Americans are experiencing. This survey reveals a secondary crisis that is likely to have persistent, serious mental and physical health consequences for years to come,” said Arthur C. Evans Jr, PhD, APA’s chief executive officer, in a March 21st statement announcing the results of the study’s findings. 

Evans calls on health and policy leaders to come together quickly to provide additional behavioral health supports as part of any national recovery plan.

The researchers found that the pandemic took a particularly heavy toll on parents of children under 18-years old. While slightly more than 3 in 10 adults (31 percent) reported their mental health has worsened compared with before the pandemic, nearly half of mothers who still have children home for remote learning (47 percent) say that their mental health has worsened; 30 percent of the fathers who still have children home said the same. 

APA’s study also found that parents were more likely than those without children to have received treatment from a mental health professional (32 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic began (24 percent vs. 9 percent). More than half of fathers (55 percent) reported gaining weight, and nearly half (48 percent) said they are drinking more alcohol to cope with stress.

As to essential workers, (either persons working in health care or law enforcement), the majority said that they relied on a lot of unhealthy habits to get through the year-long pandemic. Nearly 3 in 10 (29 percent said their mental health has worsened, while 3 in 4 (75 percent) said they could have used more emotional support than they received since the pandemic began. Essential workers were more than twice as likely as adults who were not essential workers to have received treatment from a mental health professional (34 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic started (25 percent vs. 9 percent).

Furthermore, people of color noted that unintended physical changes occurred during the pandemic. Hispanic adults were most likely to report undesired changes to sleep (78 percent Hispanic vs. 76 percent Black, 63 percent white and 61 percent Asian), physical activity levels (87 percent Hispanic vs. 84 percent Black, 81 percent Asian and 79 percent white) and weight (71 percent Hispanic vs. 64 percent Black, 58 percent white and 54 percent Asian) since the beginning of the pandemic.

Black Americans were most likely to report feelings of concern about the future, say the researchers, noting that more than half said they do not feel comfortable going back to living life like they used to before the pandemic (54 percent Black vs. 48 percent Hispanic, 45 percent Asian and 44 percent white).  They also feel uneasy about adjusting to in-person interaction once the pandemic ends (57 percent Black vs. 51 percent Asian, 50 percent Hispanic and 47 percent white).

“It’s clear that the pandemic is continuing to have a disproportionate effect on certain groups,” said APA President Jennifer Kelly, PhD. “We must do more to support communities of color, essential workers and parents as they continue to cope with the demands of the pandemic and start to show the physical consequences of prolonged stress,” says Kelly.

COVID-19’s Impact on Seniors

A newly released AARP study, released on May 10, 2021, has found that more than a year into the coronavirus pandemic, most adults age 50 and older say that it has had a negative impact on their mental health. Researchers found that seven in 10 older adults reported an increase in sadness or depression due to the COVID-19 pandemic, and nearly 8 in 10 said they had increased concern about the future, worry or anxiety. Half of adults 50 and older reported feelings of anxiety in the last two weeks, and 56% noted difficulties falling asleep or staying asleep, say the study’s findings.

“If you are feeling stressed and anxious after the last year, you are far from alone!” said Alison Bryant, Senior Vice President of Research at AARP in a statement announcing the survey results. “As our survey highlights, most older adults’ mental health and wellbeing was affected by the pandemic—and some of the ways we coped might not have been great for our health, either. With many communities returning to normal, we hope older adults will consider taking steps to reclaim their health this spring and summer,” she said.

Coping with the COVID-19 pandemic

According to the AARP study findings, seniors are responding to the increased stress in a variety of ways. About one in four of the respondents reported they are eating comfort foods or “unhealthy foods” like chips and candy more often than before the pandemic. And 27 percent of people 50 and over have increased the time they spend praying or meditating. One in 10 survey respondents reported seeking mental health care in the last year, a third of whom did so specifically because of the pandemic. Overall, 15 percent of older adults said that experiencing the pandemic made them more likely to seek help from a mental health provider if they had concerns.

AARP’s survey also highlighted how the pandemic increased loneliness and isolation among those age 50 and over.  Among older adults, 58 percent reported feeling increased loneliness, and 62 percent were less likely to socialize with friends and family compared to before the pandemic.

AARP Rhode Island Shows RI Facilities Remain Hotbed for COVID-19

Published in RINewsToday on February 14, 2021

As the Rhode Island Health Department (RIDOH) announces that cases of COVID-19 are declining and is loosening up restrictions on the reopening of bars and our social gatherings, AARP Rhode Island warns that the state’s nursing homes remain a hotbed for COVID-19 infections, and the “death rate remains disturbing.”  Rhode Island’s largest aging advocacy group calls on the General Assembly to take action this session to enact legislation to protect facility staff and residents. 

Since the beginning of the pandemic, more than 162,000 residents and staff in nursing homes and other long-term care facilities have died nationwide, and nearly 1.3 million people are known to have been infected with coronavirus in these facilities. Rhode Island has recorded 1,430 deaths in skilled nursing facilities, nursing homes, assisted living facilities and other eldercare facilities.
On Feb. 11, AARP Rhode Island released its Nursing Home COVID-19 Dashboard, the data revealing that the COVID-19 pandemic crisis in these facilities still continues despite incremental improvements in all four dashboard categories.

The dashboard analyzes federally reported data in four-week periods going back to June 1, 2020. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

Taking a Snapshot 

According to the data (Dec. 21 to Jan. 17) from AARP Rhode Island’s latest Nursing Home COVID-19 Dashboard, the rate of new coronavirus cases per 100 residents declined from 15.7 to 10.6 among residents and from 12.5 to 10.6 among staff. While cases are lower than in the previous time period, resident cases remain the second highest in New England in AARP’s dashboard analysis, with nearly four times the cases in Rhode Island nursing homes reported in October and November.

Meanwhile, the latest dashboard data indicated that resident death rates dropped from 2.60 to 1.82 for every 100 people living in a nursing home and that nursing home staff cases dropped from 12.5 per 100 workers to 10.6.The dashboard also reveals that PPE shortages dropped sharply. Shortages of personal protective equipment (PPE) have declined from 20.3 percent of nursing homes without a one-week supply to 4.3 percent — the lowest number since the first dashboard report in June, 2020. Staff shortages were relatively steady, dropping from 41.9 percent of facilities reporting shortages to 40 percent.

AARP Rhode Island calls on Governor Gina Raimondo and Lt. Governor Dan McKee to protect nursing home residents and staff from COVID-19. “We are approaching the one-year anniversary of the first known coronavirus cases in nursing homes, yet they remain appallingly high, said AARP Rhode Island State Director Kathleen Connell in a statement announcing the release of the latest dash data said, “The devastation this pandemic has brought to nursing home residents and their families has exposed fundamental reforms that must be made in nursing homes and to the long-term care system. We cannot lower our guard, she says.

AARP Rhode Island’s COVID-19 Legislative Agenda

The Rhode Island nursing home industry has struggled with quality care and infection control for years. Connell called for Rhode Island lawmakers to act immediately, focusing this year on: 

1.   Enacting or making permanent the components of AARP’s five-point plan:·         

— Prioritizing regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff—as well as for inspectors and any visitors.·  

—  Improving transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.·         

— Ensuring access to in-person visitation following federal and state guidelines for safety, and require continued access to virtual visitation for all residents.·        

—  Ensuring quality care for residents through adequate staffing, oversight, and access to in-person formal advocates, called long-term care Ombudsmen.

2.      Reject immunity and hold long-term care facilities accountable when they fail to provide adequate care to residents.

3.      Establishing minimum nursing staffing standards.

4.      Ensuring that increases in facility’s reimbursement rates are spent on staff pay and to improve protections for residents.

5.      Ensuring progress is made so that in-person visitation can safely occur and facilitating virtual visitation.

“Additionally, our leaders must reject policies that take away the rights of residents to hold nursing homes accountable when they fail to provide adequate care, Connell added. “Now is not the time to let nursing homes off the hook for abuse, neglect, and even death.”  AARP Rhode Island wrote a letter to Gov. Raimondo, urging her to withdraw her nursing home immunity Executive Order.  At press time, there has been no reply.

As the first year of the COVID-19 pandemic approaches, RIDOH notes that 64 percent of all deaths have women and men in Rhode Island’s nursing homes and assisted living facilities. In the past 13 days, 116 new cases in these facilities have been diagnosed – with 41 new deaths. At weekly updates from Dr. Nicole Alexander-Scott, it used to be that the death statistics were broken down by age, noting how many were lost “in their 60s, in their 70s”, etc. but notably this no longer is reason for pause and expression on condolence.

Unless Rhode Island lawmakers act quickly, older Rhode Islanders in these facilities will continue to be at a very high-risk of catching COVID-19 and the fatality death rate will remain disproportionately high for seniors. As residents receive their vaccine shots, first and second, we in turn hope that the refusal rate of staff to the vaccination is going down.

It’s time to act. 

The full Nursing Home COVID-19 Dashboard is available at  www.aarp.org/nursinghomedashboard.  

For more information on how COVID is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes.

AARP’s new COVID-19 Dashboard for national/local Nursing Home Data

Published in RINewsToday.com on October 26, 2020

While public health experts are predicting a second spike of the COVID-19 virus, expecting it to hit the nation as early as – now – and reaching its peak in December, AARP releases its Nursing Home COVID-19 Dashboard created to provide four-week snapshots detailing the infiltration of the virus into the nation’s nursing homes and its impact on residents and staff.  AARP’s latest Public Policy Institute analysis is the result of the Washington, DC-based aging advocacy group’s successful efforts to push for the public reporting of nursing home COVID-19 cases and deaths.

Using data collected 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 first release of the dashboard on October 14 reveals that nursing homes in every state reported shortages of PPE, ranging from 8 percent of facilities in the best-performing states, to 60 percent in the lowest-performing state. The dashboard also compared state and national data on COVID-19 cases and deaths, staff cases and staffing shortages.

Key Findings of AARP’s First Dashboard

The AARP Public Policy Institute will analyze data and report on key findings as the dashboard is updated over time.  Here are some observations about AARP’s first Dashboard (using data from August 24 to September 20, in which 95 percent of the nation’s 15,366 nursing homes submitted data for this time period):

According to the database, in every state, nursing homes indicated a shortage of PPE (defined as not having a one-week supply of N95 masks, surgical masks, gowns, gloves and eye protection during the previous four weeks). Nationally, about one quarter (25.5 percent) of nursing homes had a PPE shortage during the Aug. 24 to Sept. 20 reporting period. In the highest performing state, 8 percent of nursing homes had a PPE shortage; in the lowest-performing state, 60 percent did not have a one-week supply.

The researchers note that while considerable attention has been paid to infections among nursing home residents, it is also critically important to consider direct-care staff. In the four weeks ending Sept. 20, one-quarter (24 percent) of nursing homes had at least one confirmed COVID-19 case among residents, and twice as many (50 percent) had at least one confirmed staff case. Per 100 nursing home residents, there were 2.6 COVID-19 resident cases and 2.5 staff cases, corresponding to a total of about 55,000 cases nationally.

Finally, there is considerable variation across states. COVID-19 deaths in the four weeks ending Sept. 20 averaged 0.5 per 100 residents across the nation (about 1 out of every 200 residents). At the state level, the death rate was as high as 1.2 per 100 residents (about 1 out of 80), and several states reported no resident deaths in the past month.

Looking at Rhode Island, AARP’s first dashboard detailed the following: 

·         2.2 COVID cases per 100 residents

·         0.2 COVID deaths per 100 residents

·         1.7 staff cases per 100 residents

·         19.7 percent of nursing homes without a 1-week supply of PPE

·         28.9 percent of nursing homes with staffing shortages

AARP’s dashboard will be updated every four weeks to track trends over time and will evolve to include more categories to follow other measures of interest.

As Others See It – in Rhode Island

“We have been very clear in our messaging: No state has done a good enough job to protect nursing home residents and staff,” said AARP Rhode Island State Director Kathleen Connell. “That said, it is good to see that in the first round of data postings on the AARP Nursing Home COVID Dashboard shows Rhode Island in better-than average shape compared to other states. But to our point, anyone in Rhode Island with a loved one in a nursing home expects – hopes and prays – for more than ‘better than average.”

“As we see daily reports of increased cases and deaths, safety concerns for nursing home residents and staff should be increasing as well. The pandemic is far from over and among many complicated aspects of dealing with it is transparency. The COVD Dashboard provides the public with a benchmark and tracks monthly changes; people need to pay attention and demand action at all levels to make nursing homes safer. These aren’t just numbers. These are lives,” says Connell.

On the other hand, the Rhode Island Department of Health questions the accuracy of AARP Nursing Home COVID-19 Dashboard as it relates to its Rhode Island findings. “The data don’t accurately reflect the Rhode Island reality in part because of how the questions are phrased,” says Joseph Wendelken, RIDOH’s Public Information Officer, specifically related to PPE data. “The question asks about PPE in the nursing homes. Nursing homes receive a weekly supply of PPE from their corporate warehouses. The question asks about one point in time. On occasion, reporting happens shortly before facilities receive their re-supply,” he says.

“RIDOH has taken several steps to protect nursing home residents, says Wendelken, noting that his department has built Congregate Setting Support Teams to conduct targeted to facilities regarding infection control, PPE, testing, and staffing. 

“We have weekly contact with facilities. We’ve worked with facilities to develop creative plans for reopening. We have implemented regular testing of staff every 10 to 14 days. We will take the lessons and experience we’ve gained from these past seven months and apply them to the increase in cases we see today,” adds Wendelken. 

According to Scott Fraser, President/CEO, of the Rhode Island Health Care Association (RIHCA), the AARP analysis shows what his organization has been saying in the last few weeks and months—that COVID-19 cases in nursing homes continue to drop. “Rhode Island is below the national average in all categories measured for this dashboard,” he says, stressing that the number of cases in nursing homes is dropping as is the number of deaths,” notes Fraser.  

The successful efforts to protect nursing home residents and staff can be directly linked to the measures the facilities have taken since the pandemic first hit, notes Fraser. “We are stocking up on PPE. We initially suspended visitation.  We are testing staff regularly and residents when necessary.  We are carefully monitoring visitors and vendors who come into our homes.  We isolate and quarantine anyone who tests positive or any new resident who moves into our facilities,” he says. 

Fraser says that RIHCA continues to advocate for regular testing of vendors who come into the state’s nursing homes, including ambulance drivers, lab technicians, and hospice workers.  RIHCA continues to call on RIDOH to renew the policy of having two negative tests before a hospital patient can be released to a nursing home and to allow those certified nursing assistants who received temporary emergency certifications to obtain their permanent licenses.

A Call to Action

More than 84,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19, representing 40 percent of all coronavirus fatalities in the U.S., according to Kaiser Family Foundation’s most recent analysis released on Oct. 8. Yet in its statement announcing the release of its Dashboard, AARP charges that federal policymakers have been slow to respond to this crisis, and no state has done a good enough job to stem the loss of life. 

According to AARP, policymakers have taken some action, such as requiring nursing homes to self-report COVID-19 casers and deaths at the federal level, ordering testing, and providing limited PPE and other resources to nursing homes. But more must be done, says the nation’s largest aging advocacy group in its statement urging elected officials “to acknowledge and take action to resolve this national tragedy — and to ensure that public funds provided to nursing homes and other long-term care facilities are used for testing, PPE, staffing, virtual visits and for the health and safety of residents.”

COVID-19 cases across the U.S. are again on the rise, and nursing homes remain a hotbed for the virus, says AARP promising to “continue to shine a light on what’s happening in nursing homes so that families have the information they need to make decisions, and lawmakers can be held accountable.”

AARP has called for the enactment of the following five-point plan to protect nursing home and long-term care facility residents — and save lives — at the federal and state levels:

·         Prioritize regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff — as well as inspectors and any visitors.

·         Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.

·         Require access to facilitated virtual visitation, and establish timelines, milestones and accountability for facilities to provide in-person visitation.

·         Ensure quality care for residents through adequate staffing, oversight and access to in-person formal advocates, called long-term care ombudsmen.

·         Reject immunity for long-term care facilities related to COVID-19.

To see AARP Nursing Home COVID 19 Dashboard, go to:

www.aarp.org/content/dam/aarp/ppi/pdf/2020/10/rhodeisland-nursing-home-dashboard-october-2020-aarp.pdf