Nearly one year to the day after California placed 100,000 elderly people in 1,200 nursing homes on lockdown to protect them from COVID-19, the state has begun the process of reopening the facilities to visitors.
Under new rules unveiled this week by the California Department of Health (CDPH), fully vaccinated residents in San Diego can receive visitors inside their rooms as long as the visitors have tested negative for the COVID-19 within the previous two days. These rules apply to counties in the state’s most restrictive purple tier for COVID-19 case rates.
Once San Diego drops to the less-restrictive red tier, unvaccinated or partially vaccinated residents will be able to welcome visitors into certain other areas of their facility.
There are even fewer restrictions for fully vaccinated visitors of fully vaccinated residents. They are now allowed “brief, limited physical contact” that includes a short hug, hand holding and help with feeding and grooming.
In announcing the change in visitation restrictions, the CDPH conceded the toll the in-room visitation ban has taken on seniors in long-term care communities.
“Residents may feel socially isolated, leading to increased risk for functional decline, depression, anxiety, and other expressions of distress,” wrote Heidi Steinecker, deputy director of CDPH, in a guidance letter to the state’s nursing homes. “Due to these factors and the progression of COVID-19 vaccination in California, CDPH is revising the visitation guidance for LTC (long-term care) facilities to expand opportunities for social interaction and improved quality of life.”
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CDPH is urging nursing homes to slowly lift restrictions while keeping vigilant for breakthrough infections through testing and surveillance.
Advocates for people living in senior care facilities hailed CDPH’s new visitation rules for nursing homes as “life-saving” for some residents.
“It is a milestone,” said Mike Dark, staff lawyer for California Advocates for Nursing Home Reform. “Many of these residents have been waiting a year for contact with family and friends. Many have them have not been getting basic care that some of those visitors used to provide, things like having their hair combed or being bathed or having their medication given to them.”
But Dark also said the requirement of visitors testing negative for COVID-19 two days prior for in-room visitations in purple tier counties like San Diego and Los Angeles may prove to be unrealistic.
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“What’s kind of frustrating about that is if you want to see a resident everyday in a facility, you’re effectively going to have to get tested everyday which is a lot of testing and it’s not necessarily testing that will be provided by the facilities,” Dark said.
CDPH signaled it is open to relaxing more visitation rules as additional information emerges.
“CDPH will continuously review the scientific literature and CDC guidance for updates on vaccine effectiveness in the SNF resident population, how much the vaccines reduce transmission, how long protection lasts, and the efficacy of the vaccines against new SARS-CoV-2 variants,” said Steinecker in her letter to nursing homes.
