“We’re not there yet.”
That’s the message from the U.S. Centers for Disease Control and Prevention to operators of independent living, assisted living, continuing care retirement and affordable senior housing communities, as well as adult day centers. During a virtual session Monday about challenges and strategies for managing COVID-19, the agency said that its guidance is not yet changing for those types of providers.
“The spread of COVID-19 is still high,” said Mary Good, Ph.D., of the CDC’s Community Intervention–Critical Populations Task Force. “We know people are eager to return to a pre-pandemic lifestyle. Vaccines are bringing us closer, but we’re not there yet.”
Good said that although each community is unique, they all share a common thread of serving older adults. With that in mind, the CDC continues to recommend prevention strategies, including masking, social distancing, hand hygiene and avoiding medium to large gatherings.
Good defined large gatherings as those bringing together multiple households, which can increase the possibility of virus transmission in older adults who have underlying conditions or are at risk for serious disease. She tempered that definition by adding that providers should work with local and state public health officials to determine what is considered practical and acceptable.
“The CDC is here for public health,” Good said. “We are sticking to the guidance because case counts are still very high. We recommend avoiding large gatherings and doing what you can to stagger numbers, but balancing that with what you know about your specific communities and your local guidance.”
Towson, MD-based Edenwald Senior Living reopened for visitation, dining and all community amenities, keeping social distancing, masking and infection control restrictions. Although the community has a 100% resident vaccination rate, President and CEO Mark Beggs said that it still sees the occasional positive COVID-19 case through screenings.
Beggs said he recently mandated COVID-19 vaccination for staff members and expects Edenwald to achieve a staff vaccination rate of 96.2%. The community also offers continuing vaccinations to new residents and employees as well as private-duty nurses who come into the community, he said.
Only four staff members resigned over the vaccination mandates, Beggs said, adding that fears of mass staff walkouts are unfounded.
“If that’s your fear, maybe you’re not a great employer or you don’t treat your staff well,” he said. “I felt if the residents spoke by getting 100% vaccinated; that’s enough. This is their home. They don’t have the opportunity to leave. I felt it was my obligation to see that through for them.”
Carol Cummings, senior director of optimum life engagement and innovation at Brookdale Senior Living, said that with just under 700 senior living communities in 43 states, the country’s largest senior living company ultimately left the decision about reopening to individual communities. Properties were instructed to use the status of local restaurants as a benchmark, believing that local authorities have considered the COVID-19 situation in issuing their guidance.
“Our main challenge is, how do we ease restrictions in this largely unregulated setting post-vaccine?” Cummings said, adding that Brookdale has a 90% resident vaccination rate. Noting that independent living residents can and do leave communities to eat in local restaurants and visit with family members, she said residents want, and should be able to have, similar experiences in their own community.
“We don’t want to be creating unnecessary gaps or barriers for residents so vastly different from what’s happening outside their doors,” Cummings said. “I think we’d like to see the CDC, as you look at your guidance and decide to change it for these settings, we’d like to see you recommend easing restrictions as it relates to independent living.”
Susan Farrall, a member of the CDC’s Older Adult Vaccination Team, said that opening communities is “a little bit like skating on ice.”
“Do you know for sure that ice is good and solid? Do you know no one can fall through?” Farrall said. “Do you want to take a chance? As much as we would like to tell you what the answer is, we need to have data.”