How Illinois Nursing Homes Can Prevent Flu Outbreaks

flu outbreaks during covid-19 pandemic

COVID-19 Care Failures Should Prepare Illinois Nursing Homes for Influenza Outbreaks

In the last flu season, an estimated 35.5 million people were sick with the illness, 16.5 million people required a health care provider for their treatment, and there were 490,600 influenza hospitalizations and 34,200 deaths, according to the Centers for Disease Control (CDC). Due to the coronavirus pandemic and an estimated 213,000 related deaths and counting, medical communities agree that this year’s influenza burden may magnify one of the deadliest illnesses in the United States, with the elderly residing in nursing homes affected most severely.

Shockingly, U.S. nursing homes have the lowest flu shot rates among health settings, leaving many residents of nursing homes already at a significant risk of becoming infected with COVID-19, now left to battle influenza. And as we have witnessed with the rapid spread of COVID-19, many nursing homes and long-term care facilities are not necessarily prepared to prevent an infectious disease outbreak among residents and staff. The pandemic has brought renewed attention to nursing home quality issues related to infectious diseases, such as:

  • Overexertion due to reduced staffing levels
  • Unsafe patient handling or transfers
  • Lack of prevention programs and control of contagious and infectious diseases
  • Lack of personal protection equipment such as masks, gowns, gloves, respirators, shoe covers, shields and safety masks, cleaning supplies, and hand sanitizer
  • Hiring inexperienced workers and failing to train them
  • Mismanagement of medications
  • Wrongful evictions
  • Abuse and neglect

The flu season is here, while the number of COVID-19 cases and deaths in nursing homes continues to trend throughout Illinois and the country. The situation has sparked CMS to issue expanded guidance about how facilities should respond.

New CDC Recommendations For COVID-19 Include Identifying Flu Symptoms in Nursing Home Residents

In June 2020, the CDC’s recommendations for preventing transmission of influenza viruses and other infectious agents within long-term care facilities now require a multi-faceted approach.

  1. Infection prevention and control measures
  2. Education on signs and symptoms
  3. Influenza vaccination
  4. Influenza testing
  5. Antiviral treatment
  6. Antiviral chemoprophylaxis

The CDC also updated its COVID-19 testing guidelines for nursing homes, advising operators to check for other respiratory ailments — including the more ordinary flu — on top of the novel coronavirus. It is possible to have both well as other respiratory illnesses at the same time. When diagnosed with both COVID-19 and flu illness, older adults residing in nursing homes and people with certain underlying medical conditions become at an elevated risk of severe complications and death.

Coronavirus and Subsequent Flu Outbreaks Become Most Concerning for Nursing Homes

Influenza is one of the leading vaccine-preventable infections in nursing homes, which can also help deter illnesses that account for 80% of flu-related deaths. When you mix COVID-19 and influenza, the outcome is likely to lead to other complications, including:

  • Pneumonia
  • Respiratory failure
  • Acute respiratory distress syndrome (i.e. fluid in lungs)
  • Sepsis
  • Cardiac injury (e.g. heart attacks and stroke)
  • Multiple-organ failure (respiratory failure, kidney failure, shock)
  • Worsening of chronic medical conditions (involving the lungs, heart, nervous system, or diabetes)
  • Inflammation of the heart, brain, or muscle tissues
  • Secondary bacterial infections (i.e. infections that occur in people who have already been infected with flu or COVID-19)

CMS suggests all nursing home facilities have a flu program care strategy and infectious disease outbreak prevention plan carried out by a fully staffed and trained department. If a plan fails due to understaffing or neglect of addressing illness-related complications, families could hold physicians and staff accountable. Nursing homes participating in Medicare and Medicaid programs must offer all residents influenza and pneumococcal vaccines and follow COVID-19 care guidelines. Facilities must also document and report the results.

Know These Flu Symptoms Identified by the CDC

Influenza (flu) can cause mild to severe illness, and at times can lead to death. Flu is different from a cold. Flu usually comes on suddenly. People who have flu often feel some or all of these symptoms:

  • fever or feeling feverish/chills
  • cough
  • sore throat
  • runny or stuffy nose
  • muscle or body aches
  • headaches
  • fatigue (tiredness)
  • some people may have vomiting and diarrhea, though this is more common in children than adults

More severe symptoms of flu in older adults may include:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

It’s important to note that not everyone with flu will have a fever.

Evolving Education of COVID-19 Symptoms Provided by the CDC

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Nursing home staff and family members can look for these emergency warning signs for COVID-19.

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

If someone is showing any of these signs, the staff should seek emergency medical care immediately. Due to the high infection rate of COVID-19 and flu risk, it remains critical that the team follows care policies and quality procedures. Lack of prevention and response will create dangerous outcomes for residents and staff.

Nursing Home Negligence Attorneys in Time of COVID-19 and Influenza

Levin & Perconti has become one of the most widely-known and respected nursing home abuse and neglect law firms in Illinois, achieving large verdicts and settlements for representing those impacted by infectious disease-related injuries and wrongful deaths. If your loved one has sustained a serious illness resulting from neglect or failure in preventative care, they may be entitled to compensation. There is a time limit to file a nursing home neglect case in Illinois, so please contact us now for a free consultation with one of our skilled nursing home attorneys at 312-332-2872.

Also read: Can Nursing Homes Superbugs Be Washed Away?

Sources: Centers for Disease Control and PreventionNational Center for Immunization and Respiratory Diseases

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