When COVID-19 restrictions loosened in Washington's long-term care facilities, thousands of people got to see Yoshia Uomoto's reaction to seeing her son and niece for the first time in months at the assisted-living facility where the 98-year-old lives.
In a photo shot by a Seattle photographer that was seen around the world and made several media outlets' lists of the best photos of 2021, Uomoto's mouth forms an “O” in surprise and jubilation. The photo symbolized the mix of emotions as families, after months of separation, reunited.
Her son comes to Nikkei Manor, the assisted-living facility in Seattle's Chinatown International District where his mom has lived since 2014, with much less fanfare now. But the visits are still special — even as he has to remind his mom, who has dementia, about the photos.
"Well, isn't that beautiful?" she asks, as she's shown the photo for the second time during a short visit. She has little recollection of having to eat meals in her room, seeing her son through a window and the overarching anxiety among staff about the possibility of COVID spreading among the residents. But all around her, people remember.
"All that we've gone through in the past year, I was just so worried," Mark Uomoto said. Now, he gets to say hello to his mom, watch "The Andy Griffith Show" with her and kiss her hello and goodbye.
Even with worries over the fast spread of the omicron variant, it's a much cheerier time in Washington's long-term care facilities. Christmas is approaching, and unlike last year, residents get to visit with loved ones, provided that either the resident or the visitor is vaccinated. It's a stark contrast to December 2020, when the number of facilities with active outbreaks was at its peak and sites were largely locked down to any visitors.
In the state's nursing homes, which bore the brunt of COVID deaths, nearly 90% of both residents and staff are fully vaccinated. All staff were required to either get vaccinated or receive a medical or religious exemption by October. At least half of nursing-home residents have received booster shots, according to the Centers for Medicare and Medicaid Services, and that number is expected to increase as vaccines become more widely available and more people reach the six-month mark necessary to get the additional shot. Neither CMS nor the state tracks vaccination rates in assisted-living facilities or adult family homes.
In total, 187 long-term care facilities out of about 4,600 in Washington currently have an outbreak of COVID among residents or staff, a number that has been falling steadily since a wave of cases in late August, according to a state Department of Social and Health Services report. There's a concern among health officials that the omicron variant could put an end to that downward trend. At least 400 omicron cases have been confirmed across Washington, according to the state Department of Health.
"The combination of the holidays, a new, highly transmissible variant and indoor gatherings on top of an already-fragile health care system, from a staff perspective, has everyone on edge," said Deb Murphy, president of LeadingAge Washington, which represents nonprofit nursing homes.
For now, visits are still happening, and meals in dining rooms and other activities have resumed. At Nikkei Manor, activities on this weekday included a morning walk, games of rummikub and, in the afternoon, a crafts session. As Bing Crosby Christmas music streamed through a speaker, a dozen residents sat around a table and decorated paper Christmas trees with string and bright-colored beads.
There are still signs that a pandemic is surging outside. The tree decorators and their staff helpers wore masks. Residents' visitors have to reserve times to come by, to reduce the number of people in the building at one time. During a recent weekend, carolers stood under umbrellas and sang outside the main entrance while residents listened inside.
Overall, long-term care facilities seem to be moving in a positive direction, said Patricia Hunter, the state's long-term care ombudsman, but she still hears complaints from residents and their loved ones about restrictions. If a facility has had an outbreak, for example, sites have to limit who comes in and out of a building. Hunter remains concerned about the impact that a lack of visits and touch can have on residents, leaving them vulnerable to the trauma of social isolation.
"It's a dual epidemic," said Hunter, "with the fear of omicron and COVID transmission, but also the real impacts of harm when people are isolated and not getting that surveillance and monitoring with their loved ones. It's very harmful."
Barbara Fujita gets to see her mother, a Nikkei Manor resident, for about an hour during their visits. But that seems to work OK, she said, because her 93-year-old mom tires easily.
"As long as I bring her favorite snack, she is happy," Fujita said. Her favorite snacks: mashed potatoes from KFC and mini corn dogs.
But Fujita and her relatives are cautious about taking her anywhere outside the building. She has an aortic aneurysm, or a bulge in the aorta, the large artery that carries blood from the heart. If she were to contract the coronavirus, it would be incredibly hard on her system.
Back in Yoshia Uomoto's room, she and her son sit on her bed and look at the photos of family members taped to her walls. Mark Uomoto teases her and asks if she likes when he comes to visit. "Of course I like seeing you!" she responds. She's getting tired, so he sets her back in her bed and says goodbye. "Off you go!" she says.
Her son reminds her that he'll visit again, soon.
