This past week, we learned of two states lifting mask mandates and opening businesses up to 100% capacity as the pandemic continues. The moves were effective last Wednesday in Mississippi and will be effective this Wednesday in Texas. In a third state, Arizona, as of Friday, a mask mandate still is in place, but restaurants, bars, gyms, movie theaters, bowling alleys and water parks are permitted to be open at 100% capacity.
These announcements came after a March 1 press briefing by the White House COVID-19 Response Team and public health officials during which Centers for Disease Control and Prevention Director Rochelle Walensky, M.D., MPH, said she was “really worried about reports that more states are rolling back the exact public health measures we have recommended to protect people from COVID-19.”
“Now is not the time to relax the critical safeguards that we know can stop the spread of COVID-19 in our communities, not when we are so close,” she said.
Research released Friday by the CDC found that “mask mandates and restricting any on-premises dining at restaurants can help limit community transmission of COVID-19 and reduce case and death growth rates.” And we know from previous nursing home research (senior living-specific data are more difficult to come by) that stopping the spread of COVID in the greater community can help stop it within long-term care facilities.
Michael Wasserman, M.D., CMD, a geriatrician and immediate past president of the California Association of Long Term Care Medicine, echoes Walensky’s concerns.
“Lifting of mask mandates and occupancy restrictions flies in the face of science and experience around the world and puts older adults and others at greater risk,” he told me, calling such decisions “irresponsible, immoral and dangerous.”
“The shame regarding these decisions is that we are so close to winning the battle against COVID-19,” Dr. Wasserman said.
Senior living operators must continue to be vigilant in their efforts to fight the coronavirus by having abundant personal protective equipment, readily available testing, stellar infection control practices, and emergency preparedness, he said, noting that those factors are part of CALTCM’s “quadruple aim.”
A fifth part of the equation, Dr. Wasserman said, is vaccination, which he said is “making a huge difference.”
“Getting residents and staff vaccinated is critical,” he said, warning, “however, it doesn’t mean that the virus won’t or can’t be transmitted.”
The American Health Care Association and LeadingAge said it is possible to get 75% of the nation’s approximately 1.5 million nursing home staffers vaccinated by June 30. The same rate of vaccination probably will take more time at senior living communities, which in many locations have been prioritized after nursing homes.
One challenge has been that the vaccination rate among staff members — people who are out in the greater community when they’re not working — still lags that of residents. A month ago, the CDC said that among 11,460 skilled nursing facilities that had conducted at least one vaccination clinic during the first month of the Pharmacy Partnership for Long-Term Care Program, a median of 77.8% of residents and 37.5% of staff members received one or more vaccine doses through the program.
At a time when families are pleading to see their loved ones who live in senior living communities, the lifting of restrictions in some states will “absolutely” affect the ability of some communities to loosen their visitation restrictions, Dr. Wassermann said.
“The vaccine has created an incredible opportunity for vaccinated older adults to see, and even hug, their vaccinated loved ones,” he said. “The lifting of restrictions increases the potential of continued transmission of the virus.”
Unvaccinated senior living residents and staff members, as well as unvaccinated members of the greater community who are vulnerable, will be at the greatest risk from these state actions, Dr. Wasserman added.
The good news, he said, is that “it does appear that vaccinated older adults should still be able to interact with vaccinated friends and family. We don’t have all of the data yet, but the data that we do have is encouraging.”