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Opinion | For Nursing Homes, Complacency Could Be a Killer

Incidentally, many non-coronavirus vaccines are given in a three-dose primary series because that number of exposures has been shown to create a more robust immune response. It looks as though these vaccines may well follow a similar path.

Since this variant will cause breakthroughs in fully vaccinated individuals, it’s important to expand nursing home staff vaccine mandates to include third shots because of the gravity of the threat to the vulnerable population they work with. If staff members are less likely to get infected, they will be less likely to transmit.

The stakes are high enough to request that all visitors should be required to have received boosters, and also do a rapid test right before entering.

Rapid tests are good at detecting people when they are infectious, so workers should receive one before every shift. It’s not a big deal. It can take about 60 seconds, with results in about 15 minutes. Employees should be guaranteed paid sick leave if infected so there would be no excuse for coming to work while sick. (Raising pay would also help make these jobs attractive enough for people to feel more motivated keep them by adhering to the necessary standards.) The costs of all this are far less than the costs of hospitalizations.

Residents should be closely monitored for symptoms and randomly tested. Increasingly, there are therapeutic drugs that can save lives, but most of them need to be administered early in the disease, which makes early detection crucial. Exactly how effective antivirals will be for the most frail remains to be seen, so an ounce of prevention is worth a pound of cure.

Plus, mitigations need to target the means of transmission correctly. The coronavirus is airborne, so stopping its spread requires more focus on ventilation, air filtering and better masks, like N95s or KF94s, or surgical masks, preferably with braces that make them fit better. (Those more protective masks should be mandated for staff members and distributed for free to them.) Air can be filtered with HEPA filters, and opening windows can help when the weather allows. (Plexiglass barriers, however, are not only a waste of money, they can create dead spots with less ventilation, increasing risks.)

All these facilities should have outbreak plans in place. It’s inhumane to simply lock everything down. Social support is crucial at every stage of life, and too often we are both late to react to threats, and slow to relax restrictions.

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