January 10, 2023 – It might look like we've returned to some type of “normal” at this point within the COVID-19 pandemic. Yet many individuals, especially older Americans, remain at higher risk for serious outcomes like hospitalization and death.
Legula Estiloz, for instance, was diagnosed with COVID-19 on the age of 104. “She and I both got COVID at the same time, a few days after Christmas 2020,” says her son Tim Estiloz.
“I went in to wake her up for breakfast and she was completely soaked, soaking wet – her sheets and her nightgown,” says Tim.
Legula, a resident of The Willows, a nursing facility in Oakmont, PA owned and operated by the Presbyterian SeniorCare Network, sought care at nearby Magee Hospital. Both Legula and Tim were swabbed for COVID-19 and tested positive. They had a low-grade fever and were drained. Legula had no appetite for months. But neither lost their sense of smell or taste or had trouble respiratory.
The COVID-19 vaccines weren’t yet available on the time. “It is all the more miraculous that she survived at that age, and without even having the benefit of the vaccination,” he says.
Americans ages 65 and older are disproportionately dying from COVID-19. For example, 22% of COVID-19 deaths are within the 65-74 age group, though this age group represents lower than 10% of the U.S. population. CDC figures The picture is even bleaker for those aged 75 to 84 – this group accounts for 26% of deaths, but lower than 5% of the population.
The oldest Americans, those 85 and older, account for 27 percent of deaths, though they make up only two percent of the U.S. population.
Add to this the not yet fully appreciated influence of the most recent emerging Omicron sub-variant XBB.1.5, and the long run stays anything but certain.
Legula survived COVID-19, but suffered a heart attack before spring 2020 and was diagnosed with breast cancer.
Her prognosis is nice now, says Tim. “She's doing pretty well. I think for a while she was doing better than me.” She plays the piano, enjoys “dancing” in her wheelchair and catches a ball “every time” she throws it from a meter away.
To sum up their pandemic experience, Legula “battled breast cancer, underwent radiation treatment, she fell once, she survived COVID, and she survived a heart attack,” Tim says. Although the admitting doctor warned that his mother won’t survive the night of her heart attack, she recovered and celebrated her 104th birthday in January 2021.th Birthday.
“And now, God willing, she will celebrate her 106th birthday in a few days.”
Bivalent Booster Buy-In
A key think about Legula's recovery: her COVID-19 vaccinations and booster shots are also up to this point.
The bivalent booster shots – which goal specific omicron strains and the unique coronavirus – are 84% simpler at stopping hospitalization in older people, says Dr. David Gifford, chief medical officer of the American Health Care Association/National Center for Assisted Living in Washington, DC.
A Preprint of the study published on January 3 in the journal The Lancet confirms this. Although the study was not peer-reviewed, researchers checked out 622,701 people ages 65 and older and located that those that received the bivalent booster shot were 81% less prone to be hospitalized and 86% less prone to die from COVID-19 than others who didn’t receive the vaccine.
But only somewhat greater than a 3rd of Americans aged 65 and over, 38%, have receive a bivalent boostercompared with 15% of all Americans ages 5 and older, CDC data show. So there's loads of room for improvement, experts say.
“There is ongoing pressure among our members to increase the uptake rate of booster vaccinations among residents,” says Lisa Sanders, director of media relations at LeadingAge, a national association of nonprofit providers and services for older adults, including nursing homes, senior living communities and inexpensive housing for older adults.
One of the largest misconceptions, in response to the expert, is “the assumption that the bivalent booster is not necessary.” In addition, continuous education and access to vaccines remain vital, “because there is a lot of misinformation.”
“The message must be clear: You must get the bivalent booster shot,” says Sanders, “especially now after the holidays and [when] New variants are emerging.”
COVID and community life
Because older Americans are more vulnerable to severe outcomes from COVID-19, the query arises: What about facilities where they live together, resembling nursing homes, expert nursing facilities and other care centers? Early within the pandemic, these places faced greater challenges in controlling infection from the coronavirus.
“Long-term care professionals have known since day one that older people with chronic illnesses are the most vulnerable to this virus. They have been at the bedside witnessing unspeakable tragedies over the past three years,” Gifford said.
“Unfortunately, age discrimination has been on full display during this pandemic, as demonstrated by long-term care facilities that initially begged health authorities for resources to no avail,” he says.
So where are they now?
On the positive side, defense and prevention measures have made great strides because the pandemic began, Gifford says. “While older adults are still the most vulnerable, we have the tools to protect them from severe illness and hospitalization. First and foremost, seniors need to keep their COVID vaccinations up to date, which means getting the updated, bivalent booster shot.”
Florida at the highest
The three U.S. states with essentially the most residents age 65 and older are California, Florida, and Texas. Percentage-wise, greater than 1 in 5 Floridians, or 21%, are on this age group, in response to 2021. US census figures.
Because the elderly population is amongst essentially the most vulnerable within the country, the Florida Health Care Association in Tallahassee continues to advertise the effectiveness of the COVID-19 vaccine and booster shots. Kristen Knapp, the association's senior director of strategy and communications, says, “While the booster shot cannot prevent infections, we know it can help prevent residents from becoming seriously ill or needing to be hospitalized.”
A COVID-19 vaccination shouldn’t be a requirement for resident admission or staff employment, but Knapp says anyone who tests positive for COVID-19, whether vaccinated or not, must follow infection control protocols.
The government intervenes
On November 22, the White House announced a campaign to Promoting booster vaccinations among older adultsThe focus is on reaching seniors and other communities hardest hit by COVID-19, making vaccination much more convenient, and raising awareness through paid media.
The initiative includes recent enforcement guidelines from the Centers for Medicare & Medicaid Services to make sure that nursing homes offer current COVID-19 vaccines and timely treatment to their residents and staff.
Shortly thereafter, LeadingAge partnered with the American Health Care Association to launch the All Hands Aboard initiative to assist achieve the White House's goals. One strategy is to get hospitals more involved. That's vital, Sanders says, because about 90% of nursing home admissions are patients who’ve been transferred from a hospital.
Constant vigilance
While future variants remain a threat, experts say the vaccines are incredibly effective at stopping hospitalizations and deaths.
“We continue to monitor and prepare for expected increases like we did this winter and encourage everyone, including our residents and staff, to get their shots booster,” Gifford says.
You need to always keep in mind that it is a community problem, says Sanders. “There is a human tendency to push it away and say, 'Oh, that's their problem.'”
“It really is all of our problems. And if we all take measures to protect ourselves and others, we will be better off as a society.”