Wow, it’s been such a strange couple of weeks! I just started the new school year completely online, and it’s been quite an adjustment. It feels like an awkward stage, between summer and school, because online school just doesn’t feel real. It was also like there was never closure to the previous school year because we ended online. Going through my blog, I know many of my recent posts have been about COVID-19, which I do believe is an important topic to explore, especially with respect to the elderly. However, further past these posts, I came across one about the different types of memories, and this sparked me to search for the opposite: the different types of memory loss.
Amnesia: “a partial or total loss of memory” (please note that this is different from causes of memory loss, which include dementia and Alzheimer’s disease)
Most of the time, amnesia is temporary. However, it is definitely a daunting concept to face. Clive Wearing, as mentioned in Musicophilia by Oliver Sacks, never ceases to inspire me. He’s a musician who, after a brain infection, suffered from devastating anterograde and retrograde amnesia. His memory span is only a few seconds, so he is constantly in a state of confusion about where he is, who he is, and what he’s doing. Every time I come across his story I am both amazed and haunted at the same time because I could never imagine how to live when every moment is like a new moment because I’ve forgotten that a few seconds ago even existed.
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Throughout the United States and across the world, a topic sparking much alarm and urgency is the disproportionate amount of COVID-19 cases in nursing homes and the even larger share of deaths. It breaks my heart to hear the news about these residences being devastated by COVID-19, so I looked into research trying to understand underlying reasons for this. I’ve learned that the inherent characteristics of nursing homes make them more vulnerable: residents likely have underlying medical conditions and the communal setting makes it easier for transmission. Previous research has confirmed that urban location and larger facility size of the nursing home are related to the nursing home having COVID-19 cases. After thinking, this intuitively makes sense: a higher population density makes it harder to social distance, and a larger facility means there’s more traffic of staff in and out of the nursing home. I also watched a webinar hosted by the NIA IMPACT Collaboratory, which affirmed that facilities with COVID-19 cases were likely to be larger, in urban areas, and in states with more cases.
After going through this existing research, I realized most studies are only on nursing homes. What about other types of long term care facilities? Less research has been done on the transmission of COVID-19 in other facilities and comparing the outbreaks to those in nursing homes, although there are many distinctions between the types of facilities, the main one being that nursing homes are more focused on providing medical care for residents. This sparked an idea: I wanted to visualize the different patterns of COVID-19 cases in nursing homes vs other facilities, so I created a map. The map consists of outbreaks in licensed nursing homes and residential care facilities for the elderly (RCFEs; encompass assisted living, memory care, and continuum of care communities) in Los Angeles County, and I also included layers to compare the cases within the racial composition and median income of the area they are located in. The COVID-19 cases are grouped by zip code in order to depict the outbreaks in a community as a whole.
Here is my first map of LA County (the case numbers are not being updated). The nursing home cases are displayed for all of California, while the RCFE cases are only displayed for LA County. To view the legend, click on the arrow button on the top left:
I also recently created a similar map for Austin, TX, with case numbers that are up to date. Here, the exact locations of long term care facilities with cases are displayed: A clear major difference between nursing homes and RCFEs is that there are fewer cases of COVID-19 in RCFEs. I think this could be due to the differences in care and living between nursing homes and RCFEs, like residents being more independent in RCFEs and staff providing less hands-on care. Furthermore, unlike nursing homes, residential care facilities are not federally regulated, but rather states set most regulations, so the quality can greatly vary between facilities. This also means that COVID-19 responses for these facilities can vary greatly between states— yet another factor that could contribute to the presence of COVID-19 cases. Therefore, there may be many more variables to consider with regards to COVID-19 cases in other long term care facilities than in nursing homes. As the extent of the spread of COVID-19 in a community contributes to its transmission into long term care facilities, it is everyone’s responsibility to protect the residents living in them. In order for us to understand this and take necessary precautions, we also need a clear picture of the COVID-19 situation of the long term care facilities in our own communities. Therefore, I believe it’s important to create visualizations of the long term care facility data that are easy and quick to understand and on a local level. This can help the general public to recognize where outbreaks occur, focus appropriate attention and resources, and consciously take action to lessen the spread of COVID-19 to those most vulnerable in the community. Sources
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