A doctor speaking with a nursing home resident

Nursing homes have the opportunity to avoid respiratory illness outbreaks this season by targeting three key goals, the U.S. COVID-19 Response Coordinator told an industry audience on Friday.

Speaking at a member webinar hosted by the American Health Care Association/National Center for Assisted Living, Ashish Jha, MD, MPH, outlined factors aimed at reducing the transmission of influenza, COVID-19 and respiratory syncytial virus (RSV) among residents and staff.

Levels of these three respiratory viruses are high, he reported: The worst flu season in the last decade is yet to peak, COVID-19 cases are up by 60% and hospitalizations have risen 20% in the last two weeks and RSV is still filling hospital beds. The concern, Jha said, is that a lot of people will get infected and sick, straining the ability of healthcare systems to care for patients.

But with two difficult seasons behind them, nursing homes have “an opportunity to have a very different winter” Jha said. He recommended that facilities take the following steps:

Ensure that all residents and staff are up-to-date on flu and COVID-19 vaccinations: For the same reasons that last year’s flu shot is no longer effective, new and more immune-evasive variants mean updated COVID-19 shots are needed as well. There is also waning immunity to COVID-19, particularly in older and high-risk Americans, Jha said.

Make good use of treatments and testing: Regular testing of residents for respiratory viruses is a critical step in halting further transmission and identifying who will benefit from treatment, such as COVID-19 oral antiviral pills. The data has shown that people can get Paxlovid “in almost any circumstance,” he noted.

Improve indoor air quality: At least 90% of viral illness is transmitted indoors, and in places without great ventilation, Jha said. Even small measures taken to improve air flow and air cleanliness — such as introducing portable air filters or scheduling HVAC system servicing or upgrades — has been shown to make a dramatic difference in keeping respiratory transmission risk low. 

Jha also asked operators to reach out to AHCA/NCAL and LeadingAge with input on the barriers they face to achieving those goals. For example, “dozens, if not hundreds” of long-term care facilities have reached high levels of vaccination with updated bivalent COVID-19 shots. But others are struggling to do so, with relatively small proportions of residents vaccinated, he said.

Federal agencies are working with industry advocates “to make sure we are actively delivering on and addressing those barriers,” Jha said. “This winter can be different if we work together,” he added.

The full webinar recording is accessible to AHCA/NCAL members.

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