For many, restrictions surrounding the COVID-19 pandemic have become negligible. Few are still wearing masks indoors, the gaps in social distance have closed and there are fewer signs up reminding people to wash their hands.
For some people, the impacts of the pandemic have passed. However, for those living in long-term care facilities, it is still a major part of their lives.
“We need to weigh a resident’s safety with their mental health needs and emotional needs. We can’t go into long lockdowns, or have such harsh restrictions. They should have the same rights as people living outside,” North Dakota Long Term Care Association Director of Emergency Planning Vanessa Raile said.
Having seen the impact that COVID-19 restrictions have had on residents, many in the industry have decided it is time to make a change.
The NDLTCA found that workers and residents in long term care were voicing their complaints. The organization, which represents the majority of North Dakota’s long-term care facilities, started a push to lower pandemic restrictions.
“They don’t have faith in us and our industry. I support this because it should be our responsibility, not the enforcers’ responsibility to say what we have to do. Let us decide what we have to do,” Jim Cornelius, executive director of Benedictine Living Community in Wahpeton, said.
The NDLTCA has been asking for five main changes to be made to COVID regulations that have been put in place by the Centers for Medicare and Medicaid Services or CMS. CMS is a federal agency that regulates and certifies skilled nursing facilities. It has set the guidelines for COVID prevention and protection.
The five requests the the NDLTCA has put forth are:
1. Stop the process for screening entrants.
2. Stop NHSN reporting, a system by which the CDC tracks COVID rates.
3. Update testing matrix, a system of testing used to determine outbreak risk at facilities.
4. Allow staff, residents and visitors to “unmask.”
5. Return long term care facilities to something closer to their pre-pandemic state.
Raile said making these changes to the current guidelines will help to relieve the pressure that has been placed on residents’ mental health.
Statements written to the CDC and CMS from residents as part of the campaign to lower restrictions have included language such as “I just wish Jesus would take me home,” and “it is like the old west and there is a robber coming in everyday,” in reference to the mask mandate, according to Raile, who has been copied on letters sent to the CDC and CMS.
While the guidelines were initially useful, Raile said that they aren’t helpful now as facilities have a better understanding of how to deal with the disease.
“It’s not that we are going to get rid of everything, but if we have the authority to determine when we need it. I think it is just a matter of letting us control what we can, instead of having to do it their way,” Cornelius said.
While the NDLTCA believes that facilities can properly handle the pandemic without the restrictions, mandates from the federal level remain in place.
“We really don’t understand it, except for this outbreak that is going to come this fall. Looking at past outbreaks, the pattern is a spike in the fall. They are afraid for these vulnerable populations. They are not putting the confidence within the long term care facilities or taking into consideration what the residents want,” Raile said.
For the past two years, COVID-19 has had spikes in infection rates during the fall months. These spikes have brought with them the majority of COVID cases recorded.
Currently, North Dakota’s infection rate is higher than it was at this time last year, according to the North Dakota Department of Health’s published report. Within a seven-day period of July 28, 2022, there were 1,880 new cases of COVID-19. On July 29, 2021, that number was around 400 new cases.
In contrast, the mortality rate from the disease is down from previous years. This drop has been attributed to the COVID-19 vaccine which came out in 2021.
Currently the majority of residents in North Dakota long term care facilities are vaccinated. NDLTCA represents around 9,000 residents with 93% of them being vaccinated, according to Raile. A regulation by CMS made it so that at least 80% of caretakers at long term care facilities had to have received the vaccine.
According to the United State Center for Disease Control, infection rates in North Dakota nursing homes are up from this time last year, mirroring the rates outside of nursing homes. At the end of the July 17, 2022 week, there were 3.8 cases per 1,000 residents; at the end of the July 18, 2021 week that number was at .3 cases per 1,000 residents.
The duration of the pandemic has taken its toll on residents of long term care facilities.
In an informational flyer sent out by NDLTCA asking for residents and workers to write letters, they state that “Depression and loneliness are taking over our resident population. The single most important thing we can do for residents is have them see their caregivers face, provide a hug, and tell them they matter.”
The mental health aspect of the restrictions has also had an impact on workers. Cornelius has found multiple workers needing to take mental health days off due to added stress and anxiety. He believes that this is a contributing factor to the current nursing nationwide nursing shortage.
The NDLTCA’s push to lower restrictions at a federal level is one of the first in the country. A few other state organizations have similar campaigns.
“From what we heard we are one of the first states to start this campaign, we are really proud that we are the leader in this and we will try to get things changed,” Raile said.
Changes may be able to be made at the state and federal level, the county health department follows guidelines made by them.
“We follow the recommendations set forth by the CDC and NDDoH for COVID-19 mitigation efforts,” Health Services Director for the Richland County Department of Health Kayla Carlson said.
The News Monitor reached out to the North Dakota Department of Health but did not receive a response. St. Gerard’s Community of Care declined to comment at this time.