Illustration: Aïda Amer/Axios

Caring for older adults was already expensive, emotionally taxing and logistically difficult — and the coronavirus is only making it worse.

Why it matters: People older than 65 have the highest risk of dying from the virus, and outbreaks have been rampant in long-term care facilities. That is creating anxiety for seniors and their families.

The big picture: Most seniors will need at least some long-term care, but the coronavirus has added even more complications to the tough decisions about how to obtain it.

  • Assisted-living and independent-living facilities cost an average of at least $4,000 a month, almost always paid out of pocket.
  • Nursing homes are generally more affordable, but people often have to burn through their savings, pensions and other assets on their way there.
  • Nursing homes also are cramped, understaffed and have poor track records with infection control to begin with — and they've been hotbeds for the spread of the coronavirus.
  • Home care is another option. If a professional worker isn’t available, the task often depends on the charity of a friend or relative, and that's a dicier proposition when those friends or relatives could be carrying the virus — or unemployed, caring for children or otherwise just not able to help.

Where it stands: The pandemic has severely hindered operations across the industry.

  • Senior housing operators have limited tours of rooms and communities to prospective residents and one family member, or they are only providing virtual tours. That limited recruitment, combined with widespread outbreaks and lockdowns, has led to fewer people moving in.
  • The federal government is starting to ease some restrictions at nursing homes, but is saying they "should be among the last to reopen within the community."

Controlling outbreaks depends on facilities stocking up equipment for employees and conducting widespread testing — things the industry hasn't exactly been heralded for.

Between the lines: Seniors who want to avoid the virus-related risks could try to stay and get care at their homes, which more people have done in recent years. Adult children also may try to move their parents closer to their homes.

  • "But not all parents want to do that," said Toby Edelman, a senior policy attorney with the Center for Medicare Advocacy.
  • Home health aides can also be hard to find. Despite the demand, the job pays poverty-level wages.

The bottom line: "Especially with the way [the coronavirus] has spread at these facilities, there's going to be a fear until there's trust that the risks are sufficiently low," said Carri Chan, a health care business professor at Columbia University.

Go deeper: The looming crisis in long-term care

Go deeper

Bryan Walsh, author of Future
Sep 2, 2020 - Health

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Illustration: Annelise Capossela/Axios

America's failures in handling the coronavirus pandemic bode ill for our ability to deal with climate change and other threats that loom on the horizon.

Why it matters: America's ongoing struggles with the coronavirus have caused tremendous human and economic pain. But what should worry us for future disasters that could be far worse is the way the pandemic has exposed deep political divisions and a disinformation ecosystem that muddies even the hardest facts.

CDC requests states ready COVID-19 vaccine distribution by November

CDC director Robert Redfield. Photo: Erin Scott/Pool/AFP via Getty Images

The Centers for Disease Control and Prevention last week "urgently" requested governors to speed up their permit applications so vaccine distribution sites are operational by early November, McClatchy reports.

Why it matters: When a vaccine is ready, distribution is a major challenge the Trump administration is working to address. Supplies will be limited initially, and even if the most at-risk populations are given priority, that group still numbers in the tens of millions.

Colleges drive a new wave of coronavirus hotspots

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Data: The COVID Tracking Project, state health departments; Note: Washington state case count does not include Sept. 1; Map: Andrew Witherspoon, Sara Wise/Axios

America’s brief spurt of progress in containing the coronavirus has stalled out.

Why it matters: We had a nice little run of improvement over the past month or so, but cases are now holding steady at a rate that’s still far too high to consider the outbreak under control.