Did the UK Government Really Throw a Protective Ring Around Care Homes in the COVID-19 Pandemic?

Rajan, Selina; Comas-Herrera, Adelina; McKee, Martin

doi:10.31389/jltc.53

Cited by 46 publications

(39 citation statements)

References 7 publications

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“…Therefore ‘policies designed to prevent hospitals from being overwhelmed had pushed a greater burden onto aged care homes which struggled to get access to tests and protective equipment’ [ 4 ]. Furthermore, aged care homes often found it hard to isolate possible infected residents, especially those with dementia who were ambulant [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 in aged care homes: a comparison of effects initial government policies had in the UK (primarily focussing on England) and Australia during the first wave

Chan

McLaws

Forsyth

2021

International Journal for Quality in Health Care

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Background COVID-19 pandemic has had a major impact globally with older people living in aged care homes suffering high death rates. We aimed to compare the impact of initial government policies on this vulnerable older population between the United Kingdom (UK) and Australia during the first wave of attack. Methods We searched websites of governments in the UK and Australia and media outlets. We examined the key policies including the national lockdown dates and the distribution of some important resources (personal protective equipment and testing); and the effects of these initial policies have had on the mortality rates in the aged care homes during the first wave of attack of COVID-19. Results We found both countries have prioritised resources to hospital over aged care homes during the first wave of attack. Both countries had lower priority for aged care residents in hospitals (e.g. discharging without testing for COVID-19 or discouraging admissions). However, deaths in aged care homes were 270 times higher in the UK than Australia as at 7 May 2020 (despite UK having a population only 2.5 times larger than Australia). The lower fatality in Australia may have been due to the earlier lockdown strategy when the total daily cases were low in Australia (118) compared to the UK (over 1,000), as well as the better community viral testing regime in Australia. Conclusion In conclusion, the public health policy in Australia aimed toward earlier intervention with earlier national lockdown and more viral testing to prevent new cases. This primary prevention could have resulted in more lives saved. In contrast, the initial policy in the UK focussed mainly on protecting resources for hospitals, and there was a delay in national lockdown intervention and lower viral testing rate, resulting in more lives lost in the aged care sector.

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Section: Resultsmentioning

confidence: 99%

COVID-19 in aged care homes: a comparison of effects initial government policies had in the UK (primarily focussing on England) and Australia during the first wave

Chan

McLaws

Forsyth

2021

International Journal for Quality in Health Care

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“…As highlighted by the WHO [ 35 ], an integrated whole-of-society approach is crucial for setting priorities to maintain and improve health among Europe’s citizens, and Vinkers et al [ 36 ] point out poverty, risk of unemployment, and poor access to healthcare and care homes as factors negatively affecting stress and anxiety. Some jobs in these sectors, for example nursing assistants, are low paid and the employment conditions are insecure, which increases the risk of spreading infections to clients and patients, as was seen in the UK [ 37 ]. Other reasons put forward include a highly fragmented healthcare and care services systems with very little sharing of information between the different actors [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Lethin

Kenkmann

Chiatti³

et al. 2021

Healthcare

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The COVID-19 pandemic has affected care workers all over the globe, as older and more vulnerable people face a high risk of developing severe symptoms and dying from the virus infection. The aim of this study was to compare staff experiences of stress and anxiety as well as internal and external organizational support in Sweden, Italy, Germany, and the United Kingdom (UK) in order to determine how care staff were affected by the pandemic. A 29-item online questionnaire was used to collect data from care staff respondents: management (n = 136), nurses (n = 132), nursing assistants (n = 195), and other healthcare staff working in these organizations (n = 132). Stress and anxiety levels were highest in the UK and Germany, with Swedish staff showing the least stress. Internal and external support only partially explain the outcomes. Striking discrepancies between different staff groups’ assessment of organizational support as well as a lack of staff voice in the UK and Germany could be key factors in understanding staff’s stress levels during the pandemic. Structural, political, cultural, and economic factors play a significant role, not only factors within the care organization or in the immediate context.

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“…This assumption reflects limited isolation capacity in many care homes. 13 In the baseline scenario, we assumed that isolation reduced the transmission rate from isolated individuals by an average 75% (47-96%), in addition to the abovementioned reduction across all individuals in care homes with detected outbreaks. Care home resident testing and isolation pathways are further described in Figure S5.…”

Section: Testing and Isolationmentioning

confidence: 99%

Impact of non-pharmaceutical interventions on SARS-CoV-2 outbreaks in English care homes: a modelling study

Roselló

et al. 2021

Preprint

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Background COVID-19 outbreaks are still occurring in English care homes despite the non-pharmaceutical interventions (NPIs) in place. Methods We developed a stochastic compartmental model to simulate the spread of SARS-CoV-2 within an English care home. We quantified the outbreak risk under the NPIs already in place, the role of community prevalence in driving outbreaks, and the relative contribution of all importation routes into the care home. We also considered the potential impact of additional control measures, namely: increasing staff and resident testing frequency, using lateral flow antigen testing (LFD) tests instead of PCR, enhancing infection prevention and control (IPC), increasing the proportion of residents isolated, shortening the delay to isolation, improving the effectiveness of isolation, restricting visitors and limiting staff to working in one care home. Findings The model suggests that importation of SARS-CoV-2 by staff, from the community, is the main driver of outbreaks, that importation by visitors or from hospitals is rare, and that the past testing strategy (monthly testing of residents and daily testing of staff by PCR) likely provides negligible benefit in preventing outbreaks. Daily staff testing by LFD was 39% (95% 18-55%) effective in preventing outbreaks at 30 days compared to no testing. Interpretation Increasing the frequency of testing in staff and enhancing IPC are important to preventing importations to the care home. Further work is needed to understand the impact of vaccination in this population, which is likely to be very effective in preventing outbreaks. Funding The National Institute for Health Research, European Union Horizon 2020, Canadian Institutes of Health Research, French National Research Agency, UK Medical Research Council. The World Health Organisation funded the development of the COS-LTCF Shiny application.

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Did the UK Government Really Throw a Protective Ring Around Care Homes in the COVID-19 Pandemic?

Cited by 46 publications

References 7 publications

COVID-19 in aged care homes: a comparison of effects initial government policies had in the UK (primarily focussing on England) and Australia during the first wave

COVID-19 in aged care homes: a comparison of effects initial government policies had in the UK (primarily focussing on England) and Australia during the first wave

Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Impact of non-pharmaceutical interventions on SARS-CoV-2 outbreaks in English care homes: a modelling study

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