HHS Climate and Health Outlook tackles climate-related hazards

Published in RINews Today on July 25, 2022

Over two and a half months ago, the Biden administration launched a new initiative, called the Climate and Health Outlook, to serve as a resource to help people, health professionals, and communities protect individual and community health impacted by climate events.

On May 6, 2022, the U.S. Department of Health and Human Services’ (HHS) Office of Climate Change and Health Equity (OCCHE) launched the first installment of its new public information series called the Climate Health Outlook – https://www.hhs.gov/sites/default/files/climate-health-outlook-may-2022.pdf (Outlook). HHS’s new Outlook series connects weather forecasts to health resources to create actionable data they say will saves lives and reduces illness and health risks associated with climate-related hazards like extreme heat, wildfires, hurricanes, droughts, and vector-borne diseases that impact human health.

According to HHS, this inaugural edition of the Outlook will take on extreme heat, which has been a key target of the Biden administration’s efforts to build resilience to the impacts of climate change. As part of this and future editions, the Outlook series will add a health lens to seasonal weather and climate outlooks from the National Oceanic and Atmospheric Administration (NOAA) to inform health professionals and the public about weather- and climate-related health risks months in advance and provide resources to prepare.

“We’ve seen what exposure to extreme heat can do,” said HHS Secretary Xavier Becerra in a statement announcing the new federal initiative. “It can lead to illness and death and makes it much harder to do a day’s work outdoors. Many people in the United States have jobs that require them to work outside to feed their families regardless of the weather. Our new Climate and Health Outlook protects people and their health by giving advance notice to the communities that will be most impacted in the coming months.” she said.

“Our communities across the country will soon be facing heatwaves that will be an additional strain on our health systems,” adds  Assistant Secretary for Health Admiral Rachel Levine. “This information will save lives when used by public health officials, employers with outdoor workers, and schools and local health departments and the individuals they serve. Having information in advance can reduce illness and deaths from extreme heat exposure,” she says.

The Outlook illustrates where the greatest health risks from heat will be in the United States during the early 2022 heat season, presenting estimates of which U.S. counties are expected to experience extremely hot days and identifies the vulnerable populations in those counties that could be impacted by heat exposure. It also provides a set of actionable resources from HHS that are targeted to the public, specific populations, health care professionals, and public health officials to reduce health risks from heat.

HHS says that the Outlook will be updated and improved regularly as future data and feedback are collected. Future editions will address other climate-related threats to the health of people living in the United States, with a focus on those most vulnerable. For a copy of  HHS’s Office of Climate Change and Health Equity’s May issue of Climate and Health Outlook: Extreme Heat, go  to https://www.hhs.gov/sites/default/files/climate-health-outlook-may-2022.pdf.

On a Personal Note… Surviving the Dog Days of Summer

Just days ago, Rhode Island officials announced its first heat wave  It took 3 days of 90 degrees or above to make this call. 

Despite the fact that 618 people throughout the nation killed by extreme heat annually, according to the U.S. Centers for Disease Control and Prevention (CDC), says heat-related deaths and illnesses are preventable.  

The following tips provided by CDC’s website provide sound tips for helping us stay safe when the temperatures soar.

During an ongoing heat wave, seniors, infants and young children, and people with mental illness, those overweight, and chronic diseases (including heart disease) are at the highest risk of heat-induced illness that can cause a person to become confused or lose consciousness. Seek medical attention immediately for anyone showing signs of heat stroke. Heat stroke can be life-threatening.

With temperatures rising, wear appropriate clothing that is lightweight, light-colored and loose fitting. 

During extreme heat and humidity, stay in your air-conditioned house or air-conditioned room, if you have that option. Electric fans may provide temporary comfort, but when the outside temperature soars into the high 90s, they won’t prevent heat-related illnesses. Try taking a cool shower or bath. 

Keep in mind: Use your stove and oven less during the heatwave to reduce the inside temperature. Try traveling to an air-conditioned place like a shopping mall, movie theatre, or even go to your local library or cooling shelter? Each city and town, or one nearby, should have cooling centers open. In Providence pools and splash pads have extended hours. For a listing of cooling shelters by city and town, go to https://riema.ri.gov/planning-mitigation/resources-businesses/cooling-centers  (If you need additional assistance call 2-1-1). Even being in a cool space for just a few hours can help your body stay cooler when you have to go back outside.

During a heatwave, go to your local gym to exercise so you can limit your outdoor activities. If you go outside, do this in the morning or evening hours when it’s cool. Start your working or exercise slowly and slowly pick up the pace. If the heat makes your heart pound and you gasp for breath, stop all activity. Go immediately to a shady area especially if you become lightheaded, confused, weak or faint, to cool off, this will allow your body to recover from the heat. Drink water.

Sunburn can affect your body’s ability to cool down and can make you dehydrated. So, when going outside, wear a wide-brimmed hat, sunglasses, and put on sunscreen of SPF 15 (“broad spectrum” or “UVA/UVB protection”) or higher 30 minutes before going outside.  Continue to reapply it according to the package directions. 

Hot heavy meals can heat up your body. When going outside drink plenty of fluids, regardless of how active you are.  Don’t wait until you’re thirsty to drink. Most important, if your doctor limits the amount you drink or has you on water pills, ask how much you should drink while the weather is hot.

Also, stay away from very sugary or alcoholic drinks because they cause you to lose more body fluid. You might consider avoiding cold drinks, because they can cause stomach cramps. Room temperature water is better now.

Finally, heavy sweating removes salt and minerals from your body, and they need to be replaced.  A sports drink can replace the salt and minerals you lose when sweating. If you are on a low-salt diet, have diabetes, high blood pressure, or other chronic conditions, always talk with your doctor before drinking a sports beverage or taking salt tablets. 

Do not leave children or your pets in cars that can quickly heat up to dangerously high temperatures even with a window cracked open. You put them at risk of getting heat stroke or dying. If you leave your pets outside, leave them plenty of water and in a shaded area. Watch metal pieces in your car, like seatbelts, which can heat up to unbelievably high – and even burning to the skin – temperatures.

During a heat wave, always visit or get in touch with older adults (family or friends) at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young children, of course, need much more frequent watching.

For CDC’s website page on “Extreme Heat” go to https://www.cdc.gov/disasters/extremeheat/.

For warning signs and symptoms of heat-related illness and what to do, go  to https://www.cdc.gov/disasters/extremeheat/warning.html.

It’s time. Staff vaccinations required for nursing homes as 10 RI facilities see new COVID cases

Published in Rhode Island News Today on August 24, 2021

With the COVID-19 Delta variant spiking across the country especially among the unvaccinated, last Wednesday, President Joe Biden announced at an afternoon address at the White House that the U.S. Department of Health and Human Services will require nursing homes to require all workers to be fully vaccinated against COVID-19 as a condition for those facilities to continue receiving federal Medicare and Medicaid funding.

According to federal data, of the 1.6 million nursing home workers across the  nation, about 540,000 — 40 percent of the work force — are unvaccinated.  

Since the spread of the Delta variant, there has been a rise in the number of COVID-19 cases, especially in those states that have low rates of vaccinated workers. Both the U.S. Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS) data confirm a strong relationship between the increase of COVID-19 cases among nursing home residents and the rate of vaccination among nursing home workers.

These new emergency federal regulations, crafted  by CDC and CMS, would apply to nearly 15,000 nursing home facilities, which employ approximately 1.6 million workers and serve approximately 1.3 million nursing home residents.

Rhode Island Gov. Dan J. McKee, along with other states, has already taken a similar step to protect nursing home residents by requiring all staff to be vaccinated and the new federal mandate will ensure consistent and equitable standards throughout the country. 

At a COVID-19 update held at the state the state capitol in early August, McKee called for the new vaccine mandate (as a term of employment) to take effect on Oct. 1st.

On August 23rd, Pfizer’s vaccine was fully approved by the FDA. Approvals of Moderna, Johnson & Johnson and booster shots are expected to follow soon.

According to CMS, the new mandate is a key component of protecting the health and safety of nursing home residents and staff by ensuring that all nursing home staff receive COVID-19 vaccinations. Over the past several months, millions of vaccinations have been administered to nursing home residents and staff, and these vaccines have shown to help prevent COVID-19 and have proven to be effective against the Delta variant.

“Keeping nursing home residents and staff safe is our priority. The data are clear that higher levels of staff vaccination are linked to fewer outbreaks among residents, many of whom are at an increased risk of infection, hospitalization, or death,” said CMS Administrator Chiquita Brooks-LaSure in a statement announcing the new vaccine mandate.  “We will continue to work closely with our partners at the CDC, long-term care associations, unions, and other stakeholders to advance policies that keep residents and staff safe. As we advance these new requirements, we’ll work with nursing homes to address staff and resident concerns with compassion and by following the science,” she said.

CMS says that it’s requiring all nursing home staff to be vaccinated is in keeping with the federal agency’s authority to establish requirements to ensure the health and safety of individuals receiving care from all providers and suppliers participating in the Medicare and Medicaid programs. About 62% of nursing home staff are currently vaccinated as of August 8 nationally, and vaccination among staff at the state level ranges from a high of 88% to a low of 44%. The emergence of the Delta variant in the United States has driven a rise in cases among nursing home residents from a low of 319 cases on June 27, to 2,696 cases on August 8, with many of the recent outbreaks occurring in facilities located in areas of the United States with the lowest staff vaccination rates.

Last May, CMS issued new regulations that require Long-Term Care (LTC) facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) to educate residents, clients, and staff about COVID-19 vaccination and, when available, offer a COVID-19 vaccine to these individuals. These regulations also mandate that LTC facilities report weekly COVID-19 vaccination data for residents and staff to the CDC’s National Healthcare Safety Network (NHSN).

CMS will continue to analyze vaccination data for residents and staff from the CDC’s National Healthcare Safety Network (NHSN) data as an additional method of compliance monitoring and in keeping with current practice, as well as deploy the Quality Improvement Organizations (QIOs)—operated under the Medicare Quality Improvement Program—to educate and engage nursing homes with low rates of vaccinations.

CMS strongly encourages nursing home residents and staff members to get vaccinated as the Agency undergoes the necessary steps in the rule-making process over the course of the next several weeks. CMS expects nursing home operators to act in the best interest of residents and their staff by complying with these new rules, which the Agency expects to issue next month.  CMS also expects nursing home operators to use all available resources to support employees in getting vaccinated, including employee education and vaccination clinics, as they work to meet this staff vaccination requirement.

Rhode Island Long Term Care Facilities with new cases in the last 14 days (as of 8/14/2020):

These RI nursing homes are on the RI Dept. of Health list with increased cases –

Alpine – Coventry – 5-9 cases

Avalone – Warwick – less than 5

St. Antoine – North Smithfield – less than 5

Woonsocket Health – Woonsocket – less than 5

All America Assisted Living – Warwick – less than 5

Anchor Bay – Johnston – less than 5

Smithfield Woods – Smithfield – less than 5

Sunrise House – Providence – less than 5

Bridge at Cherry Hill – Johnston – 5-9

Tockwotton – Providence – less than 5

AARP Strongly Supports Biden’s Vaccine Mandate in Nursing Homes 

In response to the Biden Administration directing all nursing homes that receive Medicare or Medicaid funds to require vaccinations for all staff, Nancy A. LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer, stated:  

“The Administration’s announcement today requiring vaccinations for nursing home staff is a significant step in the fight against this pandemic. Around 30% of COVID deaths have been among residents and staff in nursing homes and other long-term care facilities, even though they represent less than 1% of the population. As the new variants are emerging, facilities cannot let preventable problems be repeated. Increasing vaccination rates in nursing homes is one of the most common sense and powerful actions we can take to protect the lives of vulnerable older adults.”

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.

Don’t Just Single Out Nursing Homes 

“We appreciate the Administration’s efforts to increase COVID-19 vaccinations in long term care. Unfortunately, this action does not go far enough. The government should not single out one provider group for mandatory vaccinations. Vaccination mandates for health care personnel should be applied to all health care settings. Without this, nursing homes face a disastrous workforce challenge,” warns Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) 

“Focusing only on nursing homes will cause vaccine hesitant workers to flee to other health care providers and leave many centers without adequate staff to care for residents. It will make an already difficult workforce shortage even worse. The net effect of this action will be the opposite of its intent and will affect the ability to provide quality care to our residents. We look forward to working with the Administration in the coming days to develop solutions to overcome this challenge,” says Parkinson.

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.

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.