California’s new public health rules make it harder to visit nursing homes – J.
Citing the latest surge in Covid cases, California health officials on January 7 implemented some of the strictest rules yet for people visiting nursing homes and aged care facilities.
The instructions, stricter than those for hospital visits, require all visitors who wish to see their loved ones inside to present proof not only of vaccination (including a third vaccine or a booster), but also of a recent negative Covid test: either a negative PCR test carried out within the previous two days, or a rapid antigen test carried out within 24 hours. Proof of a negative Covid test is also required for external visits.
Across the Bay Area, Jewish nursing homes and retirement centers have had to adapt quickly to new demands, balancing the need for emotional support and personal connection for older adults with the obvious risks of an epidemic. Communal meals and other social activities are once again restricted, making visits from loved ones all the more important.
Some senior centers have arranged to provide on-site testing to visitors, while others have not, complaining that the strict new rules are, once again, keeping family members “in lockout” and their locked-in relatives.
The guidelines will remain in effect for a month, until February 7 – while the Ministry of Public Health “will continue[s] to assess current conditions” to “determine any further updates”. Citing the increased transmissibility of the omicron variant, the order outlining the new rules states: “Based on experience from previous peak periods of Covid-19…the impact of such outbreaks in facilities can be devastating.”
Indeed, since the start of the pandemic, nursing homes and residential centers for the elderly have become a hunting ground for the new coronavirus and have experienced its deadliest impacts. In California, residents of skilled nursing facilities accounted for 13% of the total number of deaths in the state, according to the Los Angeles Times.
State data shows that Covid deaths have remained stable during the omicron wave – although the deaths are generally considered a lagging indicator.
But with nearly all senior center residents fully vaccinated against the virus, and with the variant causing less severe disease than previous strains, there has been some pushback against the state’s new rules. Opponents say they have made it “functionally impossible” for loved ones to visit as the pandemic is about to enter its third year.
We could continue to self-isolate in place, forever, and no one would get sick. But a meaningful and useful existence is crucial for everyone. Probably more in the older population.
Andrea DuBrow, a social worker who chairs a patient advocacy group at Community Reutlinger, a Jewish facility for the elderly in Danville, is exasperated by the new rules. His mother, Gale DuBrow, 75, has dementia and Alzheimer’s disease and lives in Reutlinger’s memory care unit.
“I like idea to be tested to show negative status and went to get tested again yesterday,” DuBrow wrote in a recent email. “But the idea conflicts with the reality of testing availability which is incredibly limited and slow right now.”
Rapid tests have been hard to find nationwide due to massive demand, despite over 70 million produced each month. DuBrow was unable to find any despite his efforts.
She was able to get a fancy PCR test from a nearby lab. But due to a backlog, her result did not come back for four days. This did not meet the 48-hour window required by the state.
“Right now, I’m just a little fucked up,” she said.
Meanwhile, DuBrow’s mother is in pain. “She can’t understand a video call. She doesn’t understand talking on the phone. I must be able to see her and have my eyes on her.
Outside visits aren’t a solution either, DuBrow said, and in the past they’ve left her mother feeling disoriented.
Throughout the pandemic, public health officials have had to make difficult decisions based on evolving science, weighing complex questions of medical ethics and the public good.
“I pity anyone who tries to work as an authority in any public health agency,” said Paul Silka, an emergency physician at East San Jose Regional Medical Center.
Silka reflected on the pros and cons of restrictive public health measures like the ones California has put in place. It “really raises huge ethical questions” that require us to carefully weigh the benefits and risks, he said.
“We could continue to self-isolate in place, forever, and no one would get sick. But what we do know is meaningful, a purposeful existence is crucial for everyone. Probably more in the older population.
Some local Jewish facilities for the elderly are trying to lessen the impact of the new rules on families by offering on-site testing to visitors.
In fact, the city and county of San Francisco require all skilled nursing facilities to provide supervised, on-site rapid antigen testing. The Ministry of Public Health “will do its best to provide testing for this purpose,” Public Health announced Dec. 30. ordinance announcing the rule states.
At the San Francisco Campus for Jewish Life, which has a skilled nursing unit as well as a rehabilitation center and residential living center, President Daniel Ruth said rapid on-site antigen testing are provided to all visitors, exceeding city health requirements. department.
At Moldaw Residences, a retirement community in Palo Alto, a handful of family members who visit daily and are deemed essential to provide face-to-face emotional support to loved ones have been added to weekly “surveillance tests.” treatment done for everyone on campus — including residents and staff — said executive director Elyse Gerson.
About five frequent visitors have been added to the testing list, which uses PCR testing, Gerson said.
“We are thinking about how to accommodate [daily visitors] so their loved ones don’t feel isolated,” she said.
Moldaw only receives one box of about 40 rapid antigen tests per week through a state program, and they are used to supplement PCR testing for staff. Gerson called the rapid tests “very valuable”.
Reutlinger executive director Clara Allen told J. it’s been “challenging” to implement new public health guidelines and accommodate family members who feel left out. She also said the Danville facility is considering the possibility of providing testing for visitors.
Silka, the emergency doctor, warned of the harmful effects of isolating or locking older people in what he called a “cognitive desert”.
Sometimes “we think we’re paternalistically protecting them,” he said, “but in reality, we’re cutting them off. Is it really for the greater good?