To the editor:
The COVID-19 virus seems to be largely striking the elderly, as has been the case with other flu and cornaviruses of the 20th and 21st centuries, e.g. Asian flu, swine flu, SARS, MERS and the seasonal flu.
An exception was was the 1918 flu. It took the lives of 5%, in some places 10%, of the world's young adults ages 20 to 40 — fewer numbers of children and the elderly. (This phenomenon was felt to be due to the immunity of elders who had lived thru the 1890 flu epidemic.)
In Massachusetts, as of this writing, 60% of the COVID fatalities have occurred in nursing homes, with near 80% of the total occurring among those age 70 and up.
Could the virus lead to resolve to re-think nursing homes' practices, so as to make them less helpless in the face of lethal pandemics?
Should COVID-19 or other viruses surge in the fall, or during years to come, there could exist the possibility of daily tests for nursing home staff, with back-up staff tested and ready to substitute in case of quarantine. Any breach in the walls would be avoided at all costs. Staff are the first line of defense. Along with new patients, those coming from the outside world arrive with no assurance that the best of social distancing was successful.
This practice, to some extent, could continue indefinitely as the threat of COVID-19 continues indefinitely, vaccine notwithstanding. After all, the flu and other coronaviruses mutate regularly, unlike measles, for example, whose vaccine confers lifetime immunity.
There could also be a reassessment of need for the temporary rehab patients to be in a nursing home in the first place. Some may be able to stay at home with home-health aides, away from nursing home group living, which is a more likely source of infection.
The home health industry could step into the spotlight as the source of a new type of worker — newly trained, licensed, professionalized and compensated accordingly. It's possible that cost of such care may be less expensive than that of nursing home care.
This is, of course, a reach at the moment. But daily testing of staff, though not very cost effective, is maybe one that needs to come true.