Could care homes avert the COVID lockdown?

11 October 2020

Could care homes “cure” the COVID lockdown?

Now that we are over six months into the COVID-19 pandemic, the data shows that the virus is unfortunately most life-threatening to those past their 75th birthday. Referring to data provided by the ONS we can see that 75% of all COVID related deaths have been recorded in these age groups (75 to 84 = 32% and 85+ = 42%). With this data it is obvious that within our society, the elderly are at the most vulnerable and require the most protection from this disease.

At the time of writing (October 13th, 2020), the UK is currently considering further lockdown measures to reduce the spread of SARS-CoV-2. Some believe that these measures are extreme when considering the impact that they have on the economy, people’s life prospects as well as their health and mental wellbeing. People ask why are the Government doing this? and the answer is two-fold, firstly to protect the NHS from being overwhelmed and secondly to limit the amount of people that potentially may succumb to the illness.

Why were there so many deaths in care homes due to COVID?

In the early stages of the pandemic (March/April 2020), when testing for COVID-19 was only available in hospitals and guidance on how to protect yourself and others from the virus was limited, care homes bore the brunt of the crisis. Due to the virus’s innate ability to be transmitted asymptomatically, without adequate testing and therefore with no real means to detect it, care homes did not have the necessary tools to be able to identify, contain or prevent the spread of the virus.

Secondly, although AgeCare had stopped admitted new residents at this point, care homes were coerced into accepting elderly residents into their care from hospitals to relieve the NHS but without sufficient testing to advise whether that patient was potentially carrying the virus. Again from the data that the ONS provide, this clearly had a devastating impact on care homes across the country.

As we can see now in the graphs above, the level of “excess” deaths for residents in care homes has reverted below the five year average since June 2020. This correlates with the slowing of the pandemic in the summer months, combined with the adjustments being made within the care sector to combat COVID-19.

Whilst sadly it seems inevitable that there will be a shift in this data over the coming months, it is our firm belief that we will not see the same levels of COVID-related deaths within the care sector as long as providers are able to provide adequate testing within their homes and react appropriately.

How can care homes help in the pandemic?

Now that we have established who is most at risk, we have to ask how can we prevent those most at need from being exposed to the COVID-19?. This is how care homes can be key in the fight against the COVID-19 pandemic as they should be built able to provide a bubble for the most vulnerable. All of AgeCare’s care homes employ the following measures to minimise the risk of infection within the home:

  • Weekly PCR testing of staff for SARS-CoV-2, allowing systematic testing, identifying and isolating of any potential carrier of the virus
  • Restrictions imposed preventing non-essential visitors from entering the building
  • Any person entering or working within the building must adhere to strict infection control standards as well as wearing appropriate PPE during their shift
  • In line with Government guidance, any staff member displaying or suffering symptoms, or live with someone who does is to isolate and not attempt to enter the home
  • New resident admissions to the home must receive a negative test prior to entry, then complete a two week isolation period before joining the communal areas
  • All goods entering the home are sanitised appropriately before use
  • Intensive, regular cleaning of all areas within the home

Whilst these measures are in place, there is still no absolute guarantee that this will keep the care home 100% COVID free. However, it does provide us a robust defense, more so than in most other scenarios such as “at home care” or sheltered housing etc.

Should there be a positive case recorded within a test, the homes are able to act swiftly to minimise the spread of infection with the deployment of the following procedures:

  • Immediate lockdown of the home, restricting all visits to the absolutely essential only
  • All residents required to isolate to their rooms for a period of at least two weeks
  • Enhanced measures of decontamination, fumigation and deep cleaning across the building
  • Increased PPE / Infection control measures implemented
  • Alert made to Public Health England and Local Authority to receive direct support for any potential breakout
  • Higher frequency testing implemented for both staff and residents to monitor the level of infections within the home

Obviously, with such restrictions in place this can become difficult for family members wishing to visit their loved ones. We try to offer as much scope as possible in this regard, either using technology (via virtual meetings, FaceTime and so forth) whilst also allowing face-to-face visits that are held either in the garden, through a window or in a specially designed area within the home that is built specifically to provide meetings that are safe for both resident and relative.

Whilst this may seem restrictive to some, what it allows us is to ensure that we are able to specifically test those who enter the building regularly and react to any potential infections quickly. When we are confident that the home is COVID free (through the regular testing regime), it allows the residents to enjoy the communal areas and more importantly each other’s company whilst they are staying in the home thus improving their mental wellbeing during this difficult time.

The Government are piloting a care home visitor scheme that may allow relatives to under go weekly testing to enable more frequent and less restrictive visits, which if proven successful, we would both welcome and support.

What does this all mean to the COVID-19 pandemic?

From the outset, the Government has insisted that the reason for a national or local lockdown is to both protect the NHS from being overwhelmed and to stop the spread of infection which could ultimately cause an unnecessary and inhumane loss of life within the country.

Whilst we completely agree with this, if we look at the data in regards to hospital admissions based on age it is telling that the majority of admissions occur within the 65+ age bracket (source ONS):

The data shows that, based on population density, the over 85s are the most likely to require hospital admission if they are infected. If we were more able to protect or shield the older generations, perhaps the requirement to lockdown the remainder of society could be reduced. Instead of shutting businesses and spending budget on furloughing millions of people, if the most vulnerable were provided funding for respite placements into care homes when the virus reproduction rate (the R number) increases, we would be more able to protect the elderly whilst allowing the country to return to some form of (socially distanced) normality.

Could care homes help lift and therefore “cure” the COVID-19 lockdown?

With the measures in place as detailed above, we believe that our care homes (and those employing a similar regime) are in the best position to protect and shield those most vulnerable to disease. Whilst we cannot provide an absolute assurance that the virus will not permeate our homes, we feel confident in being able to manage any outbreak and protect our residents from it.

It is our opinion that if more of the most vulnerable, elderly people spent some time within a care setting that has implemented similar protocols, rather than at home and having to rely on visitors or their own means of getting provisions, that ultimately the number of hospital admissions due to COVID-related infections could be reduced and therefore the need for lockdown across the country would similarly be negated.

Remember that a stay in a care home doesn’t necessarily have to be on a permanent basis; most offer respite care facilities that allow you to book a period of time at the home. AgeCare offers respite bookings up to one year in advance of your stay and for durations as long as you require.

If you have any feedback or questions in regards to the above, please do not hesitate to contact us.

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