Dying From COVID-19 Without Getting Infected: Indirect Impacts of the Pandemic on OAs

Long-term care facilities have seen the infections and deaths of residents as well as employees since COVID-19 began a pervasive invasion in January 2020. As we enter our third year of initial infections followed by infection with the Delta and Omicron variants, the destruction continues to take a toll on our facilities and current/prospective residents.

In her story in The New York Times Magazine, Kim Tingley examined the impact of COVID-19 on the US death rate and how the virus has caused an excess number of deaths for patients indirectly impacted by the pandemic.

Although heart disease and cancer remain the number one and number two causes of death, the third most common cause now is COVID-19 infection. The age-adjusted death rate in the United States increased by nearly 17%, the greatest jump in the rate in 75 years. This increase reflects higher rates of deaths from strokes, heart disease, and Alzheimer disease, unrelated to COVID-19 infections.

The pandemic caused the cancelation of elective surgeries, including a full range of interventions from colonoscopies to joint replacements. It has been estimated that the delay in colonoscopies will result in an additional 10,000 deaths from colon cancer over the next decade.

Many older adults lack the technical knowledge of being able to connect with physicians for telemedicine visits. These video visits provide a limited ability to perform head to toe assessments, identify changes in gait or balance, or have more intimate discussions about psychosocial issues.

Some of these excess deaths were results of COVID-19; however, a proportion of these cases stemmed from patients being unable to access physician office visits or barriers to hospital care, out-patient radiology, or laboratory testing. Many of these deaths were deemed preventable.

Regarding Alzheimer disease, the Centers for Disease Control and Prevention reported that 64,000 more people died than were expected in 2020. The deaths, in part, were attributed to the social isolation imposed during the lockdown and the inability of long-term care residents to visit with their family members at the height of the epidemic. The loss of staff as part of the Great Resignation included employees who had knowledge of the individual needs of residents in skilled nursing facilities, assisted living, and home health care, which compounded the decline of people with dementing illnesses.

As the latest survey of the pandemic wanes, we still need to focus on prevention, screening, mental health and catching up with the health care needs of our residents, our staff, and ourselves.

Reference:
Tingley K. Counting COVID-19 cases doesn’t capture the pandemic’s impact. The New York Times Magazine. January 26, 2022. https://www.nytimes.com/2022/01/26/magazine/covid-19-data-public-health.html