The U.S. Public Health Emergency (PHE) that was first declared in January of 2020 ended in 2023. The three years between the beginning and end of the PHE were transformative for the nation and nearly catastrophic for the long-term care industry. More than 200,000 residents and staff of nursing homes died of COVID-19 during this period, bringing intense scrutiny to nursing home operators and state and federal public health officials. The industry has not fully recovered since.
The end of the PHE brought relaxation of masking requirements, the end of free testing, and the resumption of student loan repayments. The end of restrictions and special procedures caused a sigh of relief among those who labored under the most difficult conditions. We all imagined COVID would recede to a sad memory over the next several months. However, that may be too good to be true.
Health officials began to see a steady increase in the number of COVID cases last August. The numbers are lower than during the early stages of the pandemic, but experts warn that we are facing new COVID variants, and we don’t have a good idea how the contagion will play out.
While nursing homes are still required to report COVID cases in their facilities, states are no longer required to report, so current data on overall infection rates are not available through the Centers for Disease Control (CDC). It appears this spike in infections is unlikely to come close to the initial outbreak from 2020-2022. We have broad immunity in the population, relatively high rates of vaccination, and tested treatments for active infections. These were elements missing from our earlier encounter with the virus.
As is the way with most viruses, COVID changes over time into new variations or strains. When a virus shows significant genetic variation it is considered a variant. Current interest is directed toward a variant called JN.1, now the most widely circulating variant. Scientists are concerned about this variant since it seems to be highly transmissible.
The vaccine distributed this winter will be effective against the most active variants observed in the spring, including the Eris variant. Experts expect COVID vaccine to be a permanent resident of the annual fall ritual for Americans, along with the influenza injection.
Health experts worry that the healthcare system, including nursing homes, has become complacent following the end of the PHE. As a result, government officials have abandoned the strict disciplines of infection control and testing that marked the height of the early pandemic. If this is true, leaders will need to reinforce the lessons we learned earlier and begin to refresh the habits that marked our working lives over the past three years.
But then again, maybe it’s not complacency but simple fatigue. No one worked longer, harder, or at more tedious work than nursing home staff and the pharmacists who provided care. Memories of those days, and dread at the thought of their return, can result in anxiety.
We have time now to reflect on our experience. What went wrong in 2021 and how did we respond? Staff shortages, equipment shortages, and drug shortages were common back then. How did we cope, and what can we do now to prevent the next crisis? Maybe the staff that weathered the last storm have moved on, and our current colleagues don’t have the memories of the grueling hours and constant struggles. Mentoring them on what to expect and helping them rise to the occasion is now a necessity.
Challenges lie ahead, but the number of cases should be lower and the tools we have at our disposal are better. What we do now can help repair some of the damage done to our industry during the last crisis.