LifeSpire Issues Post-Vaccine Guidance

The LifeSpire community teams are excited to share the COVID-19 vaccination clinics have been successful and work continues to ensure residents and team members are vaccinated. LifeSpire’s team members, families and residents should be tremendously proud of how the communities have rallied together, collaboratively, to fight the worst health crisis in a generation.

The extended LifeSpire family is longing for reconnection, socialization, a new normal and will get there through small steps while being safe and smart in decisions and behaviors. Residents, families and team members have shown an enormous amount of strength, resiliency, dedication, patience and compassion over the last year and for that, the community teams are very grateful.

Like at the beginning of the pandemic and throughout, community teams are consulting with partners—local health departments, advocacy groups, providers of senior care—and regulatory agencies such as the Virginia Department of Health (VDH), Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS) and Department of Social Services (DSS) to understand how to best move forward with services following COVID-19 vaccination.

Vaccination rates amongst independent living residents are at 94% or above in each community, while the rates amongst licensed areas are at 85% or higher. Residents in licensed areas may have had to defer their vaccination due to exposure and/or test results which leads to a slightly lower rate. The vaccines have been shown to decrease the incidence of symptomatic disease, however, it is less clear regarding the effect on transmission and infections without signs/symptoms. Because of this, LifeSpire communities may not see an immediate return to normal to the extent, or as quickly. The clinical teams still need to understand how the vaccine works over time and how it prevents the virus from spreading if a vaccinated individual were to get infected.

The CDC and VDH continue to recommend that even after vaccination, the same infection control practices that have been in place throughout the pandemic remain. Per communication from VDH regarding updates for Virginia long-term care communities dated February 8, the CDC “is working better to understand the effect of vaccines on preventing infection and transmission before modifying recommendations for IPC [infection prevention and control], testing, or quarantine of residents or staff. In addition, the Centers for Medicare and Medicaid Services (CMS) is currently reviewing visitation guidance to determine any changes to visitation once residents and family members are fully vaccinated”. At this time, VDH advises long-term care facilities are required to continue to follow all existing recommendations regarding visitation, testing, use of personal protective equipment and quarantine.

Operations within licensed areas will continue to be based on the presence of positive cases within residents and team members as required per regulations. However, communities will re-engage these areas to the extent possible based on CDC, VDH and CMS requirements while providing ways for residents to socialize and participate in meaningful programs until reopening occurs. Also, with revised guidance from regulatory agencies coming, adjustments will be made so residents can reconnect with others at the highest level and as quickly as possible. Again, the least restrictions are desired so residents can live the highest possible quality of life.

With the high rate of vaccination in the independent living areas, combined with declining county positivity rates, communities will be adjusting service areas and operations within this level of care. Each community will convey specific service and operational changes; however, please expect to see the following for independent living:

  • Visitation to apartments/cottages as resident permits—though visitors may be required to be screened, using current processes, upon entry.
  • Independent living residents may dine with other residents or guests in designated dining venues—this process may already be in place in some communities.
  • Transportation of groups of residents to outings via community vehicles. The size of the group is dependent upon the size of the vehicle.
  • Re-introduction of self-service options such as buffets, beverage stations, dessert stations. Mask use will be required while in self-service lines. Hand sanitizer will be used at food lines. Barriers, like gloves or paper, will be used when touching common utensils. A team member will monitor.
  • Increase in size of gatherings, based on room size, for educational and religious programs.

Because departments work so intricately, team members may experience cases of COVID and/or exposure to COVID which may result in a trickling down effect to other team members. This could result in team members being required to quarantine at home. In a case such as this, departments may need to tweak service delivery on a short-term basis. Communities will communicate any tweaks in service delivery and departments will resume normal service delivery as soon as possible. Please be assured communities are doing everything possible to prevent a situation such as this.

To balance safety with personal choice and social wellbeing, adjustments like the ones listed above, will be made. Communities will continue with interventions already in place to reduce risk:

  • Appropriate cleaning and disinfecting, particularly for common areas, shared spaces and high touch surfaces
  • Monitoring residents’ health and rapid identification/response to signs of illness
  • Wearing facemasks except during dining
  • Frequent handwashing
  • Ongoing education for residents and team members regarding infection control practices and revised services/operations
  • Encouraging/educating residents and team members on the importance of self-reporting any signs of illness and possible exposure to a positive or suspected COVID-19 case.

Recently issued guidance from the CDC and VDH states there are some individuals if fully vaccinated, who are not required to quarantine after having close contact with someone with COVID-19 or suspected of having COVID-19.  This new guidance does not apply to individuals residing in healthcare, assisted living and memory support.

Independent living residents who meet the following criteria are no longer required to quarantine after having close contact with someone with COVID-19:

  • Have had COVID-19 in the past three months as long as they do not develop new symptoms.
  • Have been fully vaccinated for COVID-19 within the past three months.  Fully vaccinated means two weeks or more have passed since receipt of the second dose of a two-dose vaccine.
  • Have no sign/symptoms of COVID-19.

This new guidance states “it is very important that all people who are not required to stay home (quarantine) monitor themselves for symptoms for 14 days after their last exposure and continuing following all recommendations…”.

It is disappointing the new guidance does not apply to the higher levels of care. The guidance states “fully vaccinated residents of healthcare facilities should continue to follow quarantine recommendations after close contact with someone with COVID-19.” The CDC states this “is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings.”

Though life will not return to normal immediately after receiving two doses of the vaccine, the light is at the end of the tunnel. Once cases go down overall in communities at large, more normal activities will resume and if cases don’t go up again, herd immunity has been reached. Contact between two people is safest if both are vaccinated, but please keep in mind that vaccines aren’t 100% effective and that the data is still out on how much the vaccine reduces transmission. Risk mitigation strategies need to remain in place until more people overall are vaccinated and infections decrease in number and remain low.

LifeSpire communities will continue to focus on getting residents and team members vaccinated. Communities will provide further information regarding campus-specific vaccination plans.

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