The coronavirus pandemic has been hard on everyone, but for individuals with dementia the impact has been especially great, a confusing, frightening and often lonely experience like none other.
In 2019, the Wisconsin Department of Health Services reported some 113,000 state residents 65 and older had been diagnosed with Alzheimer’s disease, as had over five million adults nationwide. In 2017, 2,428 Wisconsinites died from Alzheimer’s, according to the Alzheimer’s Association, a number that rose dramatically in 2020.
Per a recent analysis of data from the CDC, the Alzheimer’s Association found deaths from dementia increased 13.9% in Wisconsin during the pandemic compared to the five-year average. On a national level, through October over 34,851 more deaths than expected due to Alzheimer’s or another dementia in 2020 were confirmed. The “above average deaths far exceeds other categories reported by the CDC,” the Alzheimer’s Association says.
“Due to the COVID-19 pandemic, we are seeing excess deaths of those living with Alzheimer’s and dementia,” says Michael Bruhn, director of public policy, Alzheimer’s Association Wisconsin Chapter. “Families with a loved one in a facility have been hit hard by the pandemic and COVID-19 is altering normal patterns of mortality. The Alzheimer’s Association is concerned about this alarming trend.”
The Alzheimer’s Association postulates several contributing factors, including the chronic health conditions of many residing in long term care facilities, the shortage of COVID-19 testing early in the pandemic, which may have caused COVID-19 deaths to be inaccurately recorded as deaths due to other causes, including Alzheimer’s disease, and pandemic-related environmental and care changes, such as overburdening of health care systems, reluctance to seek treatment due to fears of being exposed to COVID-19, and the repercussions of increased isolation and limited socialization, particularly face-to-face interactions with loved ones.
Elizabeth Cogbill of geriatrics at Gundersen Health System in La Crosse, who also serves as the medical director for two area long-term care centers and performs rounds at several others, says, “We have seen nationally that deaths in long term care make up a disproportionate number, and a significant portion (of those individuals) have dementia.”
In La Crosse County, 63 COVID-19 deaths had been confirmed as of Friday, the majority attributed to elderly residents of nursing facilities.
“What we have seen is older adults who reside in long term care facilities who have cognitive impairment — which is an umbrella term which includes dementia — (is) cognitive and functional decline, probably in part related to the social isolation of the pandemic,” Cogbill says. “And when a patient with dementia contracts COVID their likelihood of death and long term complications is higher than a younger adult.”
On a local level, Cogbill says facility staff have maintained the same level of care as pre-pandemic, with rounds completed as normal and the same level of interaction and services provided. Staff, she says, have made special efforts to keep schedules as consistent as possible for residents during a time of enormous change, such as serving breakfast at the same time every morning and having the same person assist with bathing each day.
“It’s a heroic effort that they’re making to help people with dementia feel safe and secure in this home environment, trying to really ahere to those things that bring them comfort,” Cogbill says.
However, change was unavoidable due to necessary coronavirus precautions, including the wearing of full PPE by staff, including masks and shields which obscure facial features and expressions, some closures of communal areas, and restrictions placed on visitors, including family members on which residents rely on for comfort, communication, and updates on the world outside facility doors.
While long term care providers have implemented virtual visits and increased phone calls to keep up with connections to family and friends, a screen can’t compete with a hug and holding hands. Chronic disease, Cogbill notes, can be exacerbated by lack of stimulation and socialization.
The effect on morale, Cogbill believes, is “not insignificant,” noting residents with dementia “are not able to tell us a lot of times how that’s affecting them, but I can imagine absolutely it has contributed to a decrease in their spirits. It must feel like a loss to some of these older adults to not see their loved ones. And I know it feels like a loss to the family.”
Of this vulnerable population, Cogbill says “We are trying desperately to protect them both from COVID and from the poor outcomes associated with social isolation among older adults.” A glimmer of hope has materialized in the form of the COVID-19 vaccine, which arrived at La Crosse hospitals Dec. 21 and at long term care facilities the week of Jan. 4. As of Friday Jan. 8, the vaccine had been administered to every willing staff member and resident at all skilled nursing facilities in La Crosse County.
Walgreens gave inoculations of the Moderna vaccine on Friday to Benedictine Living Community employees and residents, a momentous occasion.
“We are both excited and hopeful that this will be a first step to ending this pandemic,” said Leslie Thompson, executive director of Benedictine Living Community. “We want our residents to be able to freely visit with their family and friends and to give and receive hugs. ... Our residents’ health and safety is our priority. All the measures we have implemented over these past months were to safeguard them. It is important for everyone to get vaccinated so these wishes can come true.”
As the vaccine is currently only available to first priority individuals, as determined by federal and state guidelines, it may be several months before the general public has access to the vaccine and viral spread has significantly decreased. As such, long term care facilities will continue to adhere to precautions, including sanitation, PPE usage and visitor constraints. Some facilities currently allow limited visitation.
Of Benedictine Living Community, Thompson says, “We are thankful that this is a start, but we don’t anticipate that the restrictions will change until the number of cases in the broader community start to decrease as well.”
TRAVERSE CITY, Mich. — Enbridge said Tuesday it would defy Michigan’s demand to shut down an oil pipeline that runs through a channel linking two of the Great Lakes, contending that Gov. Gretchen Whitmer’s decision was based on bad information and political posturing.
The Democratic governor in November moved to revoke a 1953 state easement that allowed part of the Canadian company’s Line 5 to be placed along the bottom of the Straits of Mackinac. Saying Enbridge had repeatedly violated the terms and put the lakes at risk, Whitmer gave the company 180 days — until May 12 — to turn off the flow.
Enbridge filed a federal lawsuit challenging the order shortly after it was issued. Vern Yu, president for liquids pipelines, gave a point-by-point-response to the state’s termination notice in a letter Tuesday and said it wouldn’t close Line 5.
“Our dual pipelines in the straits are safe, fit for service and in full compliance with the federal safety standards that govern them,” Yu said.
Mike Koby, vice president of U.S. operations for the Calgary, Alberta-based company, said Whitmer had overstepped her authority. Enbridge has “no intention of shutting down the pipelines based on these unspecified allegations,” Koby said in an interview.
Dan Eichinger, director of the state Department of Natural Resources, described the letter as “Enbridge’s attempt to power-wash the company’s long history of violating the terms of the 1953 easement, and their current non-compliance.”
“Enbridge cannot unilaterally decide when laws and binding agreements apply and when they do not,” Eichinger said. “We stand behind our efforts to protect the Great Lakes, and we stand behind the substance of the November 2020 revocation and termination of the Easement.”
Line 5 is part of Enbridge’s Lakehead network, which carries oil and liquids used in propane from western Canada to refineries in the U.S. and Ontario. The pipeline moves about 23 million gallons (87 million liters) daily between Superior, Wisconsin, and Sarnia, Ontario, traversing parts of northern Michigan and Wisconsin.
The underwater section beneath the Straits of Mackinac, which connects Lake Huron and Lake Michigan, is divided into two pipes that Enbridge says are in good shape and have never leaked.
Whitmer, however, agrees with environmentalists, Native American tribes and other critics who contend they’re vulnerable to a catastrophic spill.
Enbridge reached an agreement with then-Michigan Gov. Rick Snyder, a Republican, in 2018 to replace the underwater portion with a new pipe that would be housed in a tunnel to be drilled beneath the straits.
The company is seeking state and federal permits for the $500 million project, which is not affected by the shutdown order.
Whitmer’s order said granting the easement in a busy shipping lane vulnerable to anchor strikes was a mistake and Enbridge had made things worse, repeatedly violating a requirement that the pipelines rest on the lake bed or have other supports at least every 75 feet (22 meters).
The company also has failed to ensure that protective coating hasn’t worn off and has allowed the pipes to bend excessively in some places, the order said.
In his response, Yu said problems with pipeline supports and coating had been fixed years ago and that Enbridge had taken numerous steps to prevent contact with vessel anchors after one was dragged over the pipelines in April 2018.
The allegation about bending appears to have been based on the state’s flawed reading of data that could have been cleared up if officials hadn’t refused to discuss technical issues over the past two years, he said.
“The governor’s notice is actually based on inaccurate and outdated information that ignores the current condition of the dual pipelines” that federal regulators have described as safe, Koby said. He accused the state of bias, adding that “for the governor this is a political issue, pure and simple.”
Land Stewardship Project has expressed satisfaction with the U.S. Supreme Court’s recent decision to not overturn Winona County’s frac sand ban.
On Monday, the court elected to not hear Minnesota Sands, LLC’s suit, which could have resulted in the ban eventually being uplifted.
Minnesota Sands LLC, citing Southeast Minnesota Property Owners, claimed the ban violates equal protection, due process and private property rights.
It added that silica sand has been mined in the state for over 100 years and that it is unique because it is “extremely” hard and round and made up of quartz, which makes it valuable for use in energy production around the country.
“The Land Stewardship Project is pleased that the court has made the right decision, respecting the people of Winona County’s right to keep their communities safe from this harmful industry,” LSP said in a statement Tuesday morning.
The frac sand ban was passed in 2016 and Minnesota Sands, LLC subsequently sued in an attempt to overturn the decision. The Winona County District Court upheld the decision a year later, as did the Minnesota Court of Appeals in 2018, the Minnesota Supreme Court in 2020 and most recently the U.S. Supreme Court this past Monday.
Back in October when Minnesota Sands, LLC announced it had filed a petition with the U.S. Supreme Court, LSP called the move “disappointing, but unsurprising.”
“The land has inherent value, and the health of the land and of people are interconnected,” LSP said at that time. “All decisions about land use must be made with the needs of the future in mind.”
“The people of Winona County have understood for many years that the frac sand mining, processing, and transport industry offers no benefit to rural communities and is too harmful to be allowed to operate in their communities.”
Winona County staff are working to continue vaccinating people against the deadly COVID-19.
With the help of the Winona Fire Department, 233 doses of Moderna have been distributed by the county as of Tuesday.
The county is continuing to receive new doses each week that will go to the first phase of people in a plan set up starting in October.
The county has distributed doses to community members such as EMS providers, COVID-19 testers, COVID-19 vaccinators and public health nurses.
If an organization has employees who fall under the Phase A1 category, as detailed on the Minnesota Department of Health’s website, sign up at at form.jotform.com/210104400922032.
Excluded from this request to fill out the form is Gundersen Health Systems and Winona Health, because of doses being directly delivered to these organizations.
More information for those who do not qualify for the A1 phase is expected within the upcoming weeks.
If there are questions, email firstname.lastname@example.org.
After a day of a slow increase in COVID-19 cases, Winona County has once again seen a large growth with 26 new cases confirmed by the Minnesota Department of Health Tuesday.
With no new deaths from the disease, the county’s totals are now at 3,789 cases and 45 deaths.
Of the 26 new cases, one is 5 to 9 years old; three are 15 to 19 years old; five are 20 to 24 years old; one is 25 to 29 years old; two are 35 to 39 years old; two are 45 to 49 years old; three are 50 to 54 years old; one is 55 to 59 years old; two are 60 to 64 years old; three are 65 to 69 years old; two are 70 to 74 years old; and one is 80 to 84 years old.
As for Houston County, five COVID-19 cases and no new deaths were announced my MDH Tuesday, raising the county’s total to 1,305 cases with 13 deaths.
In Minnesota, 1,335 new COVID-19 cases were confirmed Tuesday.
The cases bring the state’s total to 438,867, including 34,132 health care workers, with 418,610 patients no longer needing to be isolated.
Statewide, 5,982,456 COVID-19 tests have been completed, with 3,097,074 residents having been tested.
Thirteen new deaths were reported in the state, bringing the total to 5,724.
Of these people, 3,660 resided in long-term care or assisted living facilities.
Statewide, 22,931 people have required hospitalization because of COVID-19, with 4,811 having spent time in an intensive care unit.
For daily Minnesota COVID-19 situation updates, visit the Minnesota Department of Health’s website.