Public health officials in the UK had proposed plans for a radical lockdown of care homes back in April in an effort to stop the spread of deaths from COVID-19 among the vulnerable residents, but their proposal fell on deaf ears, reports The Guardian.
On 28 April, officials at Public Health England (PHE) submitted to Downing Street an 11-point plan proposing “a further lockdown of care homes” at a time when mortality rates were starting to peak at the facilities, writes the outlet.
In line with the proposed draft, ministers were urged to “use NHS facilities and other temporary accommodation to quarantine and isolate residents”, deploy NHS Nightingale hospitals, and to “consider whether staff can move into the care home for the next four weeks”.
Although recommended as “high impact” by the PHE officials, ministers rejected the live-in proposal, under the belief that not all care homes could offer staff suitable accommodation for living on site.
Care operators were issued government guidance last week that suggested only staff “who proactively choose it should be offered accommodation on site or in hotels”.
Instead of the proposal to “require care home workers to isolate to reduce risk of picking up COVID-19, possibly with higher pay”, the government told care operators to ensure staff “minimise risk of picking up COVID-19 outside of work”.
The PHE proposal to “use NHS facilities and other temporary accommodation to quarantine and isolate residents before returning (them) to their care home” was also declined.
The suggested use of the NHS Nightingale hospitals, erected with the help of the military in the early stages of the pandemic and barely used, was rejected as not suitable for providing care to elderly people.
Government ministers had instructed local councils to “ensure that there is sufficient alternative accommodation as required to quarantine and isolate residents”.
Attempts to follow this advice experienced challenges, as was the case with Somerset county council, which tried to set up a “pop-up” home in Yeovil to house infected care residents. The project was delayed for weeks, reports the outlet, due to commercial insurers declining to underwrite risks.
Health officials had also urged the “very high impact” measure to “stop staff from COVID-19 positive homes being rotated to those which are COVID-19 free”.
This was already being implemented at NHS hospitals, and it was suggested that the measure should be extended to care facilities.
However, the government’s subsequent guidance was that “subject to maintaining safe staffing levels, providers should employ staff to work at a single location”.
Overall, none of the proposals, recommended as “high impact”, were included in a subsequent action plan on dealing with the coronavirus pandemic, announced by the health secretary, Matt Hancock, last week.
By the end of last month, the coronavirus had spread to half of the care homes in areas worst-affected by COVID-19.
Triple Threat
According to official UK statistics, around 16,000 care home residents are confirmed or suspected to have died from COVID-19. These figures cover data from outbreaks in 38 percent of homes in England and 59 percent in Scotland.
Amid the pandemic, the vulnerable residents of care homes have faced a triple threat. Firstly, the virus spread due to coronavirus-positive discharges from hospitals. Secondly, care workers arriving from the wider community on shifts could potentially be carrying the respiratory disease asymptomatically.
And, finally, the layout of the care facilities themselves was not originally designed to aid isolation.
In several care homes, the staff was reported to have moved in on a voluntary basis to protect their residents by reducing transmission rates.
A source from the care industry was quoted as saying: “If there was 24-hour pay, you would have had a flood of applications.”
According to a study released on 28 May by the London School of Economics and cited by The Guardian, 12,597 more people died in care homes in England, Wales and Scotland during the pandemic than the five-year average.
This brings the number of excess deaths in care homes to 27,591. The figure represents over half of all excess mortality.
According to the publication, temporary staff moving between facilities is confirmed to have contributed to the spread of COVID-19 outbreaks in care homes in London between 11-13 April.
A spokesperson for the Department of Health and Social Care was quoted by the outlet as saying that they had worked with care homes to reduce transmission rate and save lives, resulting in almost two-thirds of the facilities registering no outbreaks at all (62% in England to 11 May).
“We announced £600m to help tackle the spread of coronavirus, including by limiting staff movement between care homes, as well as £1.3bn to cover alternative accommodation to isolate residents. We are also testing all care workers and residents, regardless of symptoms, and delivering millions of items of PPE to the frontline,” added the spokesperson for the Department of Health and Social Care.