The Lowdown
Spring 2023

An Educational Resource for Long-Term Care

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​​​Welcome to the fall issue of The Lowdown, an educational resource focused on promoting resident and healthcare worker health and safety. This edition focuses on the three respiratory threats this fall: respiratory syncytial virus (RSV), influenza (the flu), and COVID-19, as well as why it’s important to be vaccinated. Happy reading!

RSV

Respiratory syncytial virus (RSV) is a common illness that often causes mild, coldlike symptoms, with most people getting better in a week or two. Older adults are more likely to develop severe illness requiring hospitalization. Vaccines can protect older adults from severe RSV. “Monoclonal antibodies” are a kind of drug treatment that mimic the body’s ability to fight the virus and can protect infants and young children from severe RSV.

Adults at the highest risk for severe infection include the elderly, people with chronic heart or lung disease, people with weakened immune systems, and people living in long-term care (LTC) facilities. In the United States, about 60,000–160,000 older adults are hospitalized each year, and 6,000–10,000 die.1

A vaccine is available!
The Centers for Disease Control and Prevention (CDC) recommends that adults age 60 and older receive an RSV vaccine. The decision to vaccinate should be decided between the person and their healthcare provider by evaluating the individual’s risk of severe RSV illness and their characteristics, values, and preferences.1,2

For more information on RSV, visit www.cdc.gov/rsv/clinical/index.html.

Influenza

The flu is a very contagious respiratory illness caused by a virus. It is one of the 10 leading causes of death in the United States when combined with pneumonia. Influenza viruses are unique in their ability to cause both annual epidemics and more serious pandemics. Elderly people; pregnant women; young children; and people with chronic medical conditions, such as diabetes and heart disease, are at higher risk of developing complications from the flu.3

Flu seasons are unpredictable and can be severe depending on which virus strains are circulating. The incubation period is one to four days, but adults are contagious from the day before symptoms begin up to 10 days after the onset of illness. (This is called “shedding virus.”) Children shed virus several days before onset and 10 or more days after symptoms start. Severely immunocompromised people can shed virus for weeks or months.3

Vaccination is the single most effective way of preventing influenza! Vaccination has been shown to lower the risks of getting the flu, hospitalization, and death. It is very important to vaccinate everyone who can be vaccinated. The 2023–2024 quadrivalent vaccine will contain two influenza A viruses, H1N1 and H3N2, and two influenza B viruses, Victoria lineage and Yamagata lineage.3,5

For more information on the vaccine, visit www.fda.gov/vaccines-blood-biologics/lot-release/influenza-vaccine-2023-2024-season.

COVID-19

COVID-19 is caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronaviruses are a family of viruses that cause illnesses such as the common cold, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19).6,7

Vaccination helps to prevent severe COVID-19 illness!
COVID-19 vaccines help your body make antibodies to help protect against developing the disease. You can still become infected following vaccination, but staying up to date on COVID-19 vaccines greatly lowers the risk of severe illness, hospitalization, or dying from COVID-19.6,7 The CDC recommends everyone age 5 years and older get one updated Pfizer- BioNTech, Moderna, or Novavax COVID-19 vaccine, no matter what their original COVID-19 vaccine was. People age 65 and older may get another dose of COVID-19 vaccine four or more months after the first updated COVID-19 vaccine. People who are moderately or severely immunocompromised may get one additional dose of updated COVID-19 vaccine two or more months after the last updated COVID-19 vaccine.10

More information on the vaccine and dosing is available at www.cdc.gov/ coronavirus/2019-ncov/vaccines/stay-up-to-date.html.

Stop the Spread!

These respiratory viruses spread from person to person by droplets released when an infected person coughs, talks, laughs, or sneezes. Touching objects that are contaminated with the virus and then touching your mouth, nose, or eyes may also cause infection.1,4,6

Ways to stay healthy through RSV, flu, and COVID-19 season include:
  • Vaccinate healthcare workers and residents!
  • Use personal protective equipment (PPE) to “break the chain” of transmission.
  • Hand hygiene is the single most important thing you can do to stop spreading germs that can make you and others sick.
  • Remember to use and teach others cough etiquette.
  • Don’t touch your eyes, nose, or mouth.
  • If you are sick with symptoms, stay home and avoid contact with other people, except to get medical care. Stay home for at least 24 hours after your fever is gone without the use of “antipyretics” (medications that lower a fever, such as Tylenol).
  • Clean and disinfect surfaces and objects that may be contaminated with germs.

References

  1. Centers for Disease Control and Prevention. Respiratory Syncytial Virus Infection (RSV). CDC. https:// www.cdc.gov/rsv/index.html. Last reviewed August 4, 2023. Accessed September 14, 2023.
  2. Advisory Committee on Immunization Practices (ACIP). ACIP Shared Clinical Decision-Making Recom- mendations. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/acip/acip- scdm-faqs.html#scdm. Last reviewed September 29, 2023. Accessed September 14, 2023.
  3. Centers for Disease Control and Prevention. Influenza (Flu). https://www.cdc.gov/flu/index.htm. Last reviewed September 29, 2023. Accessed September 14, 2023.
  4. Centers for Disease Control and Prevention. Key Facts About Influenza (Flu). CDC. https://www.cdc. gov/flu/about/keyfacts.htm. Last reviewed October 24, 2022. Accessed September 14, 2023.
  5. U.S. Food and Drug Administration. Influenza Vaccine for the 2023-2024 Season. FDA. https://www. fda.gov/vaccines-blood-biologics/lot-release/influenza-vaccine-2023-2024-season. Published July 3, 2023. Accessed September 14, 2023.
  6. Centers for Disease Control and Prevention. COVID – 19. CDC. https://www.cdc.gov/coronavi- rus/2019-ncov/symptoms-testing/symptoms.html. Updated October 26, 2022. Accessed October 12, 2023.
  7. Mayo Clinic. Coronavirus Disease 2019 (COVID-19). Mayo Clinic. https://www.mayoclinic.org/dis- eases-conditions/coronavirus/symptoms-causes/syc-20479963. Published July 14, 2023. Accessed September 14, 2023.
  8. Washington State Department of Health. What to Do if You Were Potentially Exposed to Someone With COVID-19. Washington State DOH. https://doh.wa.gov/sites/default/files/2022-02/COVIDexposed. pdf. Updated February 8, 2023. Accessed October 12, 2023
  9. Centers for Disease Control and Prevention. COVID-19 Overview and Infection Prevention and Control Priorities in Non-U.S. Healthcare Settings. CDC. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ non-us-settings/overview/index.html#:~:text=The%20droplets%20that%20contain%20the,be%20in- haled%20into%20the%20lungs. Updated December 6, 2021. Accessed October 12, 2023.
  10. Centers for Disease Control and Prevention. Stay Up to Date With COVID-19 Vaccines. CDC. https:// www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Updated October 4, 2023. Ac-cessed October 12, 2023.​