California is again limiting visits to nursing homes amid Omicron surges

As it has swept into schools, hospitals and offices, Omicron has made its way into California’s nursing homes and assisted living facilities, prompting industry leaders to warn that it is likely to increase workforce in the coming days. They may need help from the state and, once again, forcing families to struggle with visitor restrictions.

By Christmas, a few hundred health care workers in skilled nursing facilities across the state had COVID-19. But in the days following the holiday, the number rose to over 5,650 active cases this week. Infections have also begun to rise among residents of one of the most vaccinated clusters in the state. So far, thanks in large part to vaccines, deaths have been relatively flat.

“We should be concerned that this will continue to go up,” said Michael Wasserman, a geriatrician and immediate past president of the California Association of Long-Term Care Medicine.

To prevent further escalation of cases, the state’s public health official, Tomas Aragon announced new rules For visitors to long-term care settings starting Friday – the strictest anywhere. Those who wish to see their loved ones indoors must present both proof of vaccination, which includes, if eligible, a booster and a negative COVID test result. People who have not been fully vaccinated can go out, but are still required to provide proof of a negative test – within one day of arrival for antigen tests, and within two days for PCR tests. Inside. There are some limited exceptions, such as if a resident cannot leave their room.

The updated requirements have worried some advocates and families, with painful reminders of the early days of the pandemic when the meeting ground was halted, even as they wanted to keep their loved ones safe.

“It makes me feel better in some cases, but the discomfort is going to be problematic,” said Erika Shimahara, who regularly visits her elderly parents at a memory care facility in Redwood City. “If the facility can provide testing, I will do everything for that.”

Tony Chicotel, a staff attorney for the California Advocates for Nursing Home Reform organization, agrees.

San Francisco, in which a different requirement That rapid antigen tests are carried out on site before visitors enter nursing homes, it has said that its health department “will use its best efforts to supply tests for this purpose.” But it is not clear how many tests will be supplied with potentially thousands of visitors on any given day. And there is no such statewide promise. “For many people,” said Chicotel, “their is almost impossible to come by… I am beside myself with despair and sadness.”

He is also concerned that some nursing homes may see the new visitor restrictions as an opportunity to cut corners.

“It’s significantly less safe without visitors,” he said, “and, you know, less fun.”

Shimahara worries about it too. Earlier in the pandemic, her parents lived in an isolated facility in San Francisco where visitors had to schedule appointments to stay. Shimahara said, without telling her and knowing she wouldn’t be around, the facility sent someone to perform a cognitive test on her mother, which made her mother uncomfortable. Shimhara filed a complaint and the facility was cited. But, she said, “this is an example of what can happen when you keep visitors out.”

For Wasserman, the idea of ​​testing people amid a coronavirus boom where fully vaccinated people are routinely infected makes scientific sense. But he and others are upset that staff members are not subject to the same level of testing.

“We’re asking for much more from residents’ caregivers and loved ones than from facilities and staff,” he said. “I believe it is morally wrong.”

Nursing home workers should be vaccinated and the state recommends that they undergo routine testing for the virus. The California Department of Public Health did not immediately respond to a request for comment about the new rules.

Nursing homes were among the places hardest hit by the pandemic. Fewer than 2% of California seniors live in skilled nursing facilities, yet these congregation settings living with some of the most vulnerable residents account for about 13% of the state’s COVID deaths. Assisted living facilities have also been devastated, and families have been forced to reevaluate care plans for elderly loved ones.

Industry groups say they are already grappling with staff shortages as workers contract the virus.

“We certainly suspect we’ll need some serious processing anytime soon,” said Deborah Sweat, a spokeswoman for the California Association of Health Facilities, a trade association representing nursing homes and other facilities.

According to the latest state data, some facilities have dozens of positive workers — including 84 at Laguna Honda in San Francisco, 34 at Avocado Post Acute in San Diego County and 47 at California’s Veterans Home in Los Angeles County. With people working overtime, nurse registries exploited and counties thin on resources, Pacina’s organization has warned the state that facilities are likely to need outside help in the coming days.

“There are a lot of facilities on admission right now,” he said, which means they are not admitting new patients because they are dealing with COVID cases.

Christy Billickum encouraged her brother-in-law, Bob Billickum, to spend time outside painting at their Palo Alto home last July. Now, he is unable to walk or talk and needs more skilled care. (Dai Sugano/Bay Area Newsgroup)

Christie Billikum is now grappling with that reality. Billikum, who cares for her husband, Ed, and her twin brother, Bob, was featured in a story by this news organization last year that explored how the pandemic has changed the way we care for aging loved ones. K’s already finished emotional work. Bob, like Ed, has dementia and has experienced a rapid decline physically and cognitively over the past several weeks. She was admitted to Stanford Hospital shortly after the new year, and it quickly became clear that she needed to go to a skilled nursing facility rather than return to Billicham’s home, where she and round-the-clock caregivers took care of her. needs were met. But the nursing homes they’ve arrived at are either not admitting new residents right now or asking families to sit tight as they settle their policy.

“It’s in suspense,” Billicham said. “We’re just screwing our way up.”

There are also facilities in many ways.

“We don’t want to see the end of the meeting,” Pacina said. “We think it’s a grand goal to test everyone. We have absolutely no testing resources.”

William Snow’s father, in his early 90s, lives at a memory care facility in Palo Alto, which recently moved to temporarily ban most visitors amid the latest surge. His mother, who still lives independently but regularly visits her husband, has struggled.

“She understands,” said Snow. “But it happened quickly and it’s been tough emotionally for him.”