AARP: Making Seniors a Priority in Getting COVID-19 Vaccines

Published in Pawtucket Times on January 11, 2021

Last month, a statement the Rhode Island Department of Health (RIDOH) announced recommendations from the Rhode Island COVID-19 Vaccine Subcommittee for hospitals that vaccinations would begin for frontline hospital workers against COVID-19. This recommendation was made at an emergency meeting of the Subcommittee. RIDOH has accepted this recommendation and has communicated to hospitals that they may begin vaccinating these workers, as soon as vaccine arrives.

Two doses will be needed for someone to be fully immunized. Second doses will start arriving in Rhode Island in roughly three weeks. Rhode Island expects to receive approximately 10,000 doses of Pfizer vaccine the first week it is available, and approximately 19,000 doses of Moderna vaccine the first week it is available. Vaccine will come to Rhode Island in weekly allotments over the coming months, says RIDOH.

Epidemiologists, primary care providers, pharmacists, pediatricians, long-term care advocates, ethicists, nonprofit leaders, school leaders, faith leaders serve on Rhode Island’s COVID-19 Vaccine Subcommittee.  This group is responsible for performing an independent review of the process for evaluating the safety and efficacy of the vaccine. The Subcommittee is advising RIDOH on how to prioritize distribution of the vaccine to ensure that it is done equitably, and in a way that best protects the State as a whole.

At press time, the U.S. Food and Drug Administration (FDA) has granted an Emergency Use Authorization for a COVID-19 vaccine developed by Pfizer, and a vaccine made Moderna.

Making COVID-19 Vaccine Available Throughout the Ocean State

“After a rigorous scientific review, we know that COVID-19 vaccine is safe. We also know that it is one of the most effective vaccines ever developed,” announced Director of Health Nicole Alexander-Scott, MD, MPH in the Dec. 14 statement. “In the coming weeks and months, as vaccine becomes more available, getting vaccinated will be one of the most powerful things you can do to keep yourself and the people you love safe from COVID-19. We are going to work to ensure that every person in every community in Rhode Island has access to the vaccine, especially those communities hardest hit by this virus,” she said.

Added, Philip Chan, MD, MS, Consultant Medical Director for RIDOH’s Division of Preparedness, Response, Infectious Disease, and Emergency Medical Services, “We have never had a vaccine that has been – or will be – more closely monitored than the COVID-19 vaccine.”

“Teams of scientists at the national level have been scrutinizing thousands of pages of technical data for weeks, focusing on vaccine effectiveness, safety, and the manufacturing process, and our own local review has happened here in Rhode Island. I absolutely plan on getting vaccinated when it is my turn.,” said Chan.

According to RIDOH, the national vaccine trials for the COVID-19 vaccine involved tens of thousands of people to make sure they meet safety standards and people of different ages, races, and ethnicities. There were no serious safety concerns. (When vaccinated against COVID-19, people do sometimes develop post-vaccination symptoms such as soreness at the spot of the shot and headaches. This is normal, healthy, and expected. It means your immune system is working to develop protection.) Several systems are in place to do ongoing safety monitoring of the vaccine.

As of January 8, the last update on RIDOH’s COVID-19 Data Tracker, out of the 31,541 does administered, 29,743 have been vaccinated with their first of two doses, only 1,798 people were fully vaccinated with two doses.

Don’t look for the roll out of COVID-19 to take days or weeks, it will take months to complete, warns RIDOH officials. Phase 1 of the vaccination program is expected to run through late March.  At press time, the state is currently working its way through the top three tiers of this phase, including hospital staff, healthcare workers, EMS personnel, home health and hospice workers, nursing home staff and residents, high-risk incarcerated persons, first responders, school nurses, and even hard-hit communities.

Finally, those in the final two tiers of Phase 1 to be vaccinated include outpatient providers (Dentists, primary care), Dialysis Center workers and death care professionals, expected to begin Jan. 25, and adults over 75 years of age, expected to start by February.

Phase 2 is expected to kick-in by late March.  A number of factors are being considered to target the distribution of COVID-19 vaccinations a person’s age, high-risk conditions, occupation and geography.  

Make Older Rhode Islanders a Priority in Receiving Vaccines

AARP Rhode Island, representing 132,000 older Rhode Islanders, calls for Governor Gina Raimondo to make the state’s seniors a priority in its time-line for on distributing COVID-19 vaccines.  The Jan. 8 correspondence, cosigned by Kathleen Connell, State Director of AARP Rhode Island and Phil Zarlengo, the group’s State President, called on Raimondo “to increase COVID vaccination transparency,” as it relates to older Rhode Islanders.

AARP Rhode Island asked the Governor to include the numbers of Rhode Islanders vaccinated by age and other criteria on a daily/weekly basis on RIDOH’s COVID-19 Data Tracker.  Specially, the largest state-wide advocacy group called for the state’s website to include:

·         the numbers and percentages of older Rhode Islanders by race and ethnicity, that have been vaccinated:

·         the number of Rhode Islanders vaccinated and their age demographics on a daily/weekly basis;

·         a clear and easy-to-understand schedule of vaccine administration for all populations; and the process by which individuals may seek and obtain a vaccine;

·          the numbers and percentages of long-term care residents, by facility, that have received their first and second doses of vaccines;

·         the numbers and percentages of long-term care staff, by facility, that have received their first and second doses of vaccines.

While acknowledging the many challenges the state officials must tackle in determining how to equitably, safely and effectively distribute COVID-19 vaccines, Connell and Zarlengo call for Rhode Islanders age 50 and older to be made a priority in receiving a vaccine.

“The data clearly show that the older people are, the higher risk they face if they contract COVID-19.  Given that older individuals are at a greater risk of death from COVID-19, we strongly urge you to ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.  These individuals must be given priority access to vaccines, in addition to those individuals receiving care in nursing homes and other long-term care facilities,” say Connell and  Zarlengo.

“For years, the long-term care system has been shifting away from institutional care in nursing homes to home and community-based settings (HCBS). Here in Rhode Island, a significant percentage of long-term services and supports are provided in the home or settings such as assisted living facilities, residential care facilities, veterans homes, and in individuals’ own homes,” says Connell and Zarlengo, stressing that this why the state should prioritize seniors, especially those with underlying conditions, receiving care in these additional settings and the staff providing care, to receive a COVID-19 vaccine.

Finally, AARP Rhode Island’s correspondence urges the Governor to ensure that all providers are fully complying with established state procedures for vaccine distribution and prioritization. “We urge you to investigate and take swift action against anyone who attempts to commit fraud, including by inappropriately selling the vaccine or intentionally providing vaccines to those who do not meet qualifying criteria in an attempt to circumvent the distribution process.”

From AARP’s National

 “We urge public health officials at the state and local level, as they decide on vaccine allocations, to rely on the evidence and make plans backed by science.  As production is ramping up, AARP is advocating hard to ensure every older American who wants to get the vaccine can get it.  It’s also vital that distribution plans for authorized vaccines are smoothly implemented.  There’s no time to waste: it’s time for full-scale mobilization, and any delays or early bottlenecks in distribution systems need to be addressed urgently,” says AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy A. LeaMond in a Dec. 28 statement.  

 

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

Study: One in Five Americans Are Unpaid Family Caregivers

Published in the Woonsocket Call on May 17, 2020

As the nation sees a growing number of aging baby boomers, workforce shortages in health care and long-term care settings, increased state funding for community-based services, and a growing number of seniors requiring assistance in their daily activities, caregivers are needed more than ever. According to a recently released report from National Alliance for Caregiving (NAC) and AARP, an increasing number of unpaid family caregivers are stepping up to the plate to care for their older family members or friends. The caregiver report’s findings indicate that the number of family caregivers in the United States increased by 9.5 million from 2015 (43.5 million) to 2020 (53 million) and now encompasses more than one in five Americans (19 percent).

First conducted in 1997, with follow up surveys in 2004, 2009 and 2015, the Caregiving in the U.S. studies are one of the most comprehensive resources describing the American caregiver. Caregiving in the U.S. 2020 was conducted by Greenwald &a Associates using a nationally representative, probability-based online panel. More than 1,700 caregivers who were age 18 or older participated in the survey in 2019.

Demand for Caregiving Rising as Nation’s Population Gets Older

The 107-page Caregiving in the U.S. 2020 report also reveals that family caregivers are in worse health compared to five years ago. As the demand for caregiving rises with the graying of the nation’s population, the report calls for more be done to support this vital work.

“As we face a global pandemic, we’re relying on friends and family to care for the older adults and people living with disabilities in our lives,” notes C. Grace Whiting, JD, President and CEO of NAC, in a May 14 statement announcing the release of this report. “Caregivers are essential to the nation’s public health, and the magnitude of millions of Americans providing unpaid care means that supporting caregivers can no longer be ignored, she says, noting that report’s findings reveals that growing need.

According to Whiting, family caregivers care for more people than five years ago and they take on more care responsibilities as roughly one in four care for two or more people. “Many individuals are caring for a longer time, with nearly a third (29 percent) of caregivers nationwide reporting they have been caregiving for five years or more—up from 24 percent in the last study,” states Whiting.

Who are today’s caregivers?

This new caregiver study shows that 39 percent are men and 61 percent are women. The average age is 49.4 years. The profile of the family caregiver is also changing, too. While caregiving spans across all generations, Caregiving in the U.S. 2020 found more young people providing care, including 6 percent who are Gen Z and 23 percent who are Millennials. Nearly half (45 percent) are caring for someone with two or more conditions—a significant jump from 37 percent in 2015.

As to ethnicity, the caregiver report notes that six in 10 are non-Hispanic White (61 percent), 17 percent are Hispanic, and 14 percent are African American.

The report’s findings indicate that one in 10 of the caregiver survey respondents are enrolled in college or taking classes (11 percent), 9 percent have served in the military and 8 percent self-identify as lesbian, gay, bisexual, and/or transgender.

Caregivers in Poorer Health, Feeling Financial Strain

Caregiving in the U.S. 2020 also found that caregivers face health challenges of their own with nearly a quarter (23 percent of caregivers find it hard to take care of their own health and 23 percent say caregiving has made their health worse. The report also notes that personal finances are a concern for family caregivers: 28 percent have stopped saving money, 23 percent have taken on more debt and 22 percent have used up personal short-term savings.
Sixty one percent of the caregiver respondents work and have difficulty in coordinating care.

The May 2020 caregiver report states on average, caregivers spend 23.7 hours a week providing care, with one in three (32 percent) providing care for 21 hours or more, and one in five (21 percent) providing care for 41+ hours—the equivalent of a full-time unpaid job.

“The coronavirus pandemic is exacerbating the challenges family caregivers were already facing from a personal health, financial and emotional standpoint,” said Susan Reinhard, RN, PhD, Senior Vice President at AARP. “Family caregivers provide vital help and care for their loved ones, yet this survey shows that they keep getting stretched thinner and thinner. We must identify and implement more solutions to support family caregivers—both in the short term as we grapple with coronavirus and in the long term as our population ages and the number of family caregivers declines.”

: “Without greater explicit support for family caregivers in coordination among the public and private sectors and across multiple disciplines overall care responsibilities will likely intensify and place greater pressure on individuals within families, especially as baby boomers move into old age,” warns the report’s authors, calling on Congress and state lawmakers to develop policies that ensure that caregivers do not suffer deteriorating health effects and financial insecurity.

Thoughts from AARP Rhode Island…

“The wealth of information in this report is an essential guide to policymakers,” said AARP Rhode Island State Director Kathleen Connell. “It reveals important trends and underlines future needs. For AARP, it provides information on how, as an organization, we can best serve Rhode Island’s 136,000 family caregivers. The challenges they face vary, making it very important that we can provide focused resources that meet any one caregiver’s needs. The report’s overall takeaway – that the number of caregivers is rising dramatically – is a call for increased awareness and support. This responsibility starts at the very top of federal, state and municipal government and flows all the way down to family members who can better share caregiving responsibilities. Many will be asked to step outside their comfort zone, so we all will have to work together,” adds Connell.

Connell noted that the report points out the shift from traditional residential health care settings to community-based settings. “The research reaches a clear conclusion,” Connell observed. “Families will have to fill new roles, learn new skills and absorb more out of pocket caregiving expenses. This will create additional the stress for many family caregivers. That’s why it is so important that we develop the training, tools and other resources caregivers require.”

A 2019 AARP report, Valuing the Invaluable, calculated that Rhode Island family caregivers provide 114 million unpaid hours of care annually. Based on the average $15.76 per hour wages of paid caregivers, family caregivers represent an economic value of an estimated $1.8 billion.

The 2020 study was funded by AARP, Best Buy Health Inc. d/b/a Great Call, EMD Serono Inc., Home Instead Senior Care®, The Gordon and Betty Moore Foundation, The John A. Hartford Foundation, TechWerks, Transamerica Institute, and UnitedHealthcare.

For a copy of Caregiving in the U.S. 2020, go to
https://www.aarp.org/content/dam/aarp/ppi/2020/05/full-report-caregiving-in-the-united-states.doi.10.26419-2Fppi.00103.001.pdf.