Given that kupuna are at high risk for severe illness from COVID-19, the Centers for Disease Control and Prevention is advising that long-term care facilities: restrict visitors, limit activities within facilities, and regularly check health-care workers and residents for fevers and symptoms.
So far, the protective-bubble approach seems to be effective in Hawaii’s adult care centers, nursing homes and assisted living facilities, with some prohibiting visitors and taking other precautionary measures to shield residents from the coronavirus outbreak.
As Hawaii preps to slowly reopen our shuttered economy, this bubble should stay intact as part of the so-called new normal. In stunning contrast to the mainland — where thousands of long-term care facilities and nursing homes are contending with devastating rapid-fire spreads of the infectious disease — so far, none of the cases in the islands has been linked to the state’s inventory of adult residential care homes, or ARCHs.
As of Tuesday, 169 people over age 60 have been diagnosed with COVID-19, representing 27% of all infections in Hawaii to date. About one-third of the kupuna cases have required hospitalization, according to state Health Department figures. But in the absence of effective COVID-19 treatment and a robust contact tracing effort, a loosening of tough social distancing restrictions would be a dangerous gamble for a state where nearly 1 in 4 residents is at least 60 years old.
Hawaii has made commendable strides in flattening the coronavirus curve — slowing spread so that fewer people need to seek treatment at any given time, thereby not crashing health-care resources, which are in relative short supply. While the state’s population hovers at 1.4 million, there are just 340 intensive care unit beds in medical facilities here.
Moving forward, stepped-up state vigilance of long-term care facilities will be key to avoiding a puncture in the kupuna bubble. Hawaii’s ARCHs lineup includes 438 licensed operators. However, a few years ago, it was estimated that there were also a few hundred unlicensed (illegal) operations.
State law authorizes unannounced Department of Health inspection of facilities reported to be operating without a state-issued license; a license signifies compliance with an extensive list of health and safety requirements, including an “infection control plan.”
In a Manoa case last week, which is now slated for an operator-requested hearing, DOH issued fines totaling $88,100 — based on a $100 penalty for each day of unlicensed operation, plus a fine for knowingly transferring a resident from a licensed care home to an unlicensed one. Such DOH crackdowns are needed, especially amid the heightened importance of keeping tabs on health.
With the oldest of the baby boomers in their mid-70s, the silver tsunami’s demand for long-term care facilities is rising. The state should accelerate — without watering down — the application process for a license, which in recent years has drawn complaints about wait periods spanning several months.
Immediate help in sorting through the flow of CDC guidance, various directives and kupuna-focused services is available through advocacy groups like the AARP. The Hawaii chapter also offers advice on matters such as how to avoid social isolation ruts, and is holding online “town halls” at vekeo.com/aarphawaii. There’s one set for 11:50 a.m. today, with U.S. Sen. Brian Schatz discussing the reach of the CARES Act.
State epidemiologist Sarah Park last week told state lawmakers: “We’re in a marathon, not a sprint” as a COVID-19 vaccine is likely a “long time coming.” While holding that slower-but-steady pace of a long run, Hawaii must continue to prioritize protecting kupuna and others in high-risk brackets.