The Invisible Enemy

May 25, 2020

The Invisible Enemy
Since the beginning of this pandemic, the corona virus has been referred to as an “invisible enemy.” The world was warned that the impact of this disease would be devastating should it reach the most vulnerable, our seniors. Those serving seniors in nursing care communities jumped into action in early March to put strict screening protocol in place that would monitor staff and residents for the signs and symptoms that an infected person might display. Proactively screening for symptoms has arguably been the most effective measure of prevention thus far for these communities. Many cases were caught early on and stopped the spread in its tracks.

While this measure has proven to be effective, we are reminded that we are up against an enemy that can hide in plain sight. You see, the corona virus can spread by asymptomatic carriers. These are individuals who feel healthy and have no symptoms, yet test positive for COVID-19. With a shortage of testing supplies in the beginning, it was formerly best practice to reserve testing for those displaying symptoms. All of that has now changed. Governor Greg Abbott announced in early May that anyone who works or lives in a Texas licensed nursing care community will be tested. That’s right, everyone.

Mass testing may result in mass positives
Brace yourselves to see a sudden surge in positive results from otherwise healthy individuals. Before you allow yourself to panic at the thought of a wave of positive cases in your local nursing care community, consider how these cases will be managed. First of all, the staff that test positive may be sent on leave until they are safe to return to work. Some organizations like Methodist Retirement Communities, who operates 12 communities across Texas, will offer paid leave to their staff. Any positive testing residents will each have a care plan built to meet their specific needs. Since they have no symptoms, there will not be discomfort to manage or symptoms to treat. The staff will simply have a new level of awareness that will most certainly inspire the use of best practices. Nursing communities have been effectively caring for infectious diseases for decades. Many industry experts believe that the early horror stories surrounding COVID-19 are largely due to misunderstandings about how the illness spreads and a shortage of PPE (personal protective equipment). With better understanding of the disease and remedied supply chains, experts suggest that many nursing care communities are far better positioned for success than they were 3 months ago. The truth is, this surge of mandatory testing will only give these care communities an understanding of asymptomatic cases for a brief snap shot in time. Only days after the tests are administered, the data is out of date as new unknown exposures may have occurred.

We have our test results…now what?
So…what will change with these results? Well…nothing really. What more can care communities possibly do to offer more prevention than they are already doing? Nursing care communities across Texas are following state mandated infection control measures, reporting requirements, visitation restrictions, admission procedures and resident engagement guidelines that are not always clearly defined and sometimes conflicting but come with a hefty fine when not implemented. Teams are already sanitizing to the point of obsession. Staff is already wearing PPE, every position during every shift. Residents have already been restricted to their rooms and quarantined from their family and friends. They haven’t enjoyed a meal with another person or attended a group activity that didn’t involve sitting in a hallway or participating through a digital screen in nearly 3 months. Even smiles from caregivers are hidden away behind masks. What is left to sanitize? What is left to restrict? What is left to take away in the name of prevention?

New Enemies Emerging
While we fight this “invisible enemy,” those on the front lines of senior care will tell you that new enemies are emerging, bringing their own devastating consequences. Loneliness, hopelessness, depression, boredom and fear. One might argue that these emerging enemies that are plaguing our most vulnerable population are also invisible. However, if you could walk the halls and see the faces behind the masks that they wear, you would know that these enemies are not so invisible after all. It is plain to see, our seniors are hurting.

As we round off yet another month of pandemic restrictions, it is becoming more and more imperative that care communities be allowed to find the right balance between protecting their residents from a virus and also returning to the type of human connection that nurtures their mind and spirit. Countless heroes have offered creative solutions to engage and encourage residents within these new boundaries. It has been truly inspirational. Unfortunately, the most creative idea in the world can never be an adequate substitute for the therapeutic touch of a loved one or the loving kiss from your sweetheart of 50 years. Residents have reported that they have felt well cared for by these heroes and are truly grateful for the extra attention that they have received. However, to ignore the pain that has come alongside these prevention methods as an unintended consequence would shrink the enormity of this pandemic in the lives of a nursing care resident.

So, we brace ourselves for the outcomes of this mandatory testing, knowing that it really doesn’t change much other than infusing just a tiny bit more fear into our hearts, it gives us an extra dose of hopelessness that this pandemic will seemingly never end and it somehow makes the craving for human touch even more unbearable.

We were once warned that the impact of this disease could be devastating if it should reach the most vulnerable. Perhaps the impact has reached them after all.

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