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Hospitalizations signal growing risk of COVID-19 for American seniors


Coronavirus-related hospital admissions are rising again in the US, with the elderly accounting for a growing share of US deaths and less than half of nursing home residents up to date on COVID-19 vaccinations .

These alarming signs point to a tough winter for the elderly, worrying 81-year-old nursing home resident Bartley O’Hara, who says he’s been ‘vaccinated to the eyeballs’ and is tracking trends in coronavirus hospitals as they “zoom in” for older people, but remain stable for younger people.

“The sense of urgency isn’t universal,” said O’Hara of Washington, D.C. But “if you’re 21, you should probably be worried about your grandma. We’re all in this together.”

A troubling indicator for seniors: hospitalizations of people with COVID-19 have increased by more than 30% in two weeks. Much of the increase is due to older people and those with existing health conditions, said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention. The figures include everyone who tested positive, regardless of the reason they were admitted.

When it comes to protecting the elderly, “we’re doing a terrible job in this country,” said Dr. Eric Topol, director of the Scripps Research Translational Institute.

As nursing home leaders redouble their efforts to bolster staff and residents with the new version of the vaccine, now recommended for ages 6 months and older, they face complacency, misinformation and related fatigue. to COVID-19. They’re calling on the White House for help with an “all hands on deck” approach.

Clear messages about what the vaccine can do — and what it can’t — are needed, said Katie Smith Sloan, president of LeadingAge, which represents nonprofit nursing homes.

Breakthrough infections don’t mean the vaccine failed, she said, but that misperception has been hard to combat.

“We need to change our messages to be specific about what they do, which is to prevent serious illness, hospitalizations and deaths,” Sloan said. “This virus is insidious, and it keeps popping up everywhere. We just have to be realistic about it.”

Issues include an unwarranted reluctance to quickly prescribe the antiviral pill Paxlovid to the elderly, prompting five major medical companies to host an online training session for doctors, “Vax & Pax: How to Keep Your Patients Safe This winter”.

The easing of restrictions, broader immunity in the general population and mixed messages about the end of the pandemic have softened the sense of threat felt by young adults. This may be a welcome development for most, but the attitude has seeped into nursing homes in troubling ways.

Obtaining family consent to vaccinate care home residents has become more difficult, care home leaders say. Some residents who can give their own consent refuse the shots. Only 23% of nursing home staff are up to date on COVID-19 vaccinations.

Cissy Sanders of Austin, Texas faced multiple hurdles trying to get a callback for her 73-year-old mother, who is in a nursing home. No recall clinic was scheduled. The facility told her they couldn’t find a vaccinator. So she planned to take her mom to Walgreens later this month.

“I am concerned about the rise in hospitalizations and deaths among the elderly, and concerned about the lack of urgency at my mother’s nursing home to get residents and staff vaccinated” with the latest reminder, he said. she declared.

Staff and visitors are potential entry points into nursing homes for the virus. The best facilities use a layered approach, protecting residents with masks, screening questions, temperature checks and heightened infection control.

“What we’ve learned during COVID is that the rate of spread depends on the rate of community spread,” said Tina Sandri, CEO of Forest Hills of DC, a nursing home in the nation’s capital. “I feel safer in my building than anywhere else, including the grocery store.”

Meanwhile, hospitals across the country are seeing an influx of elderly patients that Topol calls “quite alarming.” Nationally, the rate of daily hospitalizations for people 70 and older with confirmed or suspected COVID-19 fell from 8.8 per 100,000 people on November 15 to 12.1 per 100,000 people on November 6. December, according to statistics from the Ministry of Health and Health. Personal services. In California and New York, Topol said, hospitalizations of the elderly with COVID-19 have already exceeded those of the spring and summer omicron waves.

At NYU Langone Health, the hospital’s chief epidemiologist, Dr. Michael Phillips, said a growing number of older people are being admitted to his hospital with COVID-19. But the biggest increase he’s seen is in the emergency department, “which is very, very busy” with COVID-19, as well as flu patients.

Dr. Wesley Long, a pathologist at Houston Methodist in Texas, said his hospital has also seen an increase in COVID-19 admissions over the past two weeks – and many patients are elderly people with other health issues. health. Some are admitted for different illnesses and test positive for COVID-19 in hospital. The good news? “We haven’t seen an increase in ICU admissions,” he said.

The new combined booster injection, which targets both omicron and the original coronavirus, provides protection against one of the main omicron variants causing cases lately: BQ.1.1, which is particularly adept to escape immunity.

“But our recall rates in the elderly are pathetically low,” Topol said, with only about a third of them.

Long said Houston Methodist health care providers promote the recall “every chance we get.” But they’re not giving it to people hospitalized with COVID-19, who are usually told to wait three months after being infected to get it.

Phillips also urges people to get their boosters, especially if they are at risk of becoming seriously ill or planning to hang out with someone who is. He said they are seeing a lot more hospitalizations among unvaccinated people.

Deaths, like hospitalizations, are now on the rise.

The ultimate concern is that more old people will die. Last spring and summer, death rates declined overall as more people gained protection from vaccination and previous infections. But the share of COVID-19-related deaths among the oldest people – adults aged 85 and over, who make up 2% of the population – has risen to 40%.

During the pandemic, 1 in 5 deaths from COVID-19 were in people who were in a long-term care facility.

Dr. Walid Michelen, chief medical officer of seven nonprofit nursing homes run by the Archdiocese of New York, said Americans must continue to take the pandemic seriously.

“It’s not going away. It’s here to stay,” he said. “We’re going to have a new variant, and who knows how aggressive that variant is going to be? It’s keeping me awake at night.”

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Associated Press writer Nicky Forster contributed from New York.

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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute Science and Education Media Group. The AP is solely responsible for all content.

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