The Times - UK (2020-09-15)

the times | Tuesday September 15 2020 2GM 11

News

Care home leaders have accused minis-

ters of failing to deliver on the promise

to prioritise the sector amid testing

delays and fears that there could be a

rush on PPE before the winter.

In July the government announced

that testing would be rolled out across

the adult social care sector to enable

screening of staff every seven days and

residents every four weeks.

However, industry leaders say that

the failure of couriers to pick up sam-

ples in time and a backlog at testing lab-

oratories has led to a doubling in the

waiting time for results in some areas.

Concerns have also been raised that

testing is not required for government

officials who visit multiple care homes.

Inspectors at the Care Quality Com-

mission (CQC), who carry out detailed

assessments, do not meet government

requirements for routine testing, de-

spite going in and out of different units.

The CQC is pressing ministers to

count their inspectors as frontline

workers prioritised for tests, saying not

testing them makes no sense after the

government said outbreaks in the

spring were spread by agency staff

moving from one home to another.

Martin Green, chief executive of

Care England, told The Times: “We

were promised weekly testing for staff

and 28-day testing for residents. That

has not been delivered. There are de-

lays in the couriers not coming to take

swabs and problems with the labs get-

ting the results back in time.

“It seems that the government makes

an announcement first and then scrab-

bles around to see how it makes it

happen. The testing regime needs a

thorough root and branch review.”

Mr Green questioned why the rapid

lab-free tests that could deliver results

within a couple of hours were not being

deployed to the social care system. He

added: “It is also ridiculous that we have

inspectors coming into care homes

who have not been tested. The whole

infection control model is focused on

people not working in several care

homes — the policy on inspectors is

completely at odds with that.”

Mike Padgham, chairman of the In-

dependent Care Group and managing

director of St Cecilia’s care group, said

that testing delays were “creeping up”.

break rule of six, says minister

5

Restrictions No more than five,

indoors and outdoors, for family

gatherings, children not

included; max ten for organised

activities outdoors such as

walking and cycling, if 1.5m apart

Cases 2,

Death rate 0.

Belgium

6

Restrictions No more than six

indoors and outdoors, children

not included

Cases 6,

Death rate 0.

Netherlands

10

Restrictions Limit of ten

outdoors in Bavaria and

North Rhine-Westphalia, two

of the biggest states; no limit

indoors, providing distancing

is maintained

Cases 9,

Death rate 0.

Germany

10

Restrictions Limit of ten in homes,

including children; church services,

weddings and funerals limited

to 50

Cases 11,

Death rate 1.

South Africa

20

Restrictions Limit of 20, including

children, indoors and outdoors, in

New South Wales

Cases 2,

Death rate 0.

Australia

Restrictions No restrictions;

“avoid crowded places” until

test results are known

Cases 3,

Death rate 0.

Japan

Restrictions No restrictions on

numbers; no standing on public

transport; weddings limited to

one hour

Cases 11,

Death rate 0.

Turkey

Restrictions No restrictions;

“maintain distancing inside and

outside”

Cases 10,

Death rate 0.

Italy

(^3) in a car
Restrictions Only three people
per car, unless from same family;
curfew 1am-6am
Cases 3,
Death rate 0.
Lebanon
Pupils and parents outside the Visconti
high school on the first day of the
reopening in Rome
A pupil has her
temperature
checked as children
return to the
Simonetta Salacone
school in Rome
13.
51.
19.

1. 
   


2. 
   

   *Limit of 20 people for weddings
   and funerals in Scotland. Thirty in
   England and Wales
   News
   Care home bosses
   claim government
   is failing on tests
   He added: “It used to take two days for
   the labs to return results, it is now up to
   four. This will only increase with
   re-opening of schools and universities.
   I’m not sure that the government
   realises how much things are slowing
   on the ground. Another concern is that
   ahead of the second spike everyone will
   start ordering PPE and we could see
   another shortage.”
   Last week the government wrote to
   care home providers in England to
   warn them of a rise in new infections
   within the sector. A letter from the De-
   partment of Health and Social Care
   (DHSC) urged care bosses to take “nec-
   essary action to prevent and limit out-
   breaks”. Cases were mainly among staff
   but risked spreading to residents, it said.
   The Labour Party has warned that
   the government has weeks to imple-
   ment a winter care home plan or risk re-
   peating the mistakes of early in the pan-
   demic. Liz Kendall, the shadow health
   secretary, has written to Matt Hancock,
   the health secretary, urging him to act
   urgently to prevent the deadly spread of
   the virus in care homes. The opposition
   is calling for family members to be
   treated as keyworkers to ensure they
   can safely visit care homes this winter.
   Care home providers are being en-
   couraged to “open up” residential units
   and allow relatives to visit. Visitors are
   also not tested but are required to wear
   PPE and stay away if they have symp-
   toms or have been abroad.
   The government has been criticised
   for how care homes were handled at the
   start of the crisis. Professor John Ed-
   munds, an epidemiologist at the
   London School of Hygiene & Tropical
   Medicine and a member of Sage, the
   government advisory group, called the
   halting of community testing “bonkers”.
   A CQC spokeswoman said: “DHSC
   has advised that CQC inspectors do not
   meet the criteria for regular weekly
   asymptomatic testing, as inspectors are
   not required to undertake ‘hands on’
   close personal contact with people.”
   The Department of Health and
   Social Care said: “We are testing all resi-
   dents and staff, have provided 208 mil-
   lion items of PPE and ringfenced
   £600 million to prevent infections in
   care homes, with a further £3.7 billion
   available to councils to address pres-
   sures caused by the pandemic, includ-
   ing in adult social care.”
   Katie Gibbons, Chris Smyth
   Analysis

   
   

C

oronavirus

cases in

England are

estimated to be

doubling every

seven to eight days and

Sir Mark Walport, a

former chief scientific

adviser, has warned that

the UK is on “the edge

of losing control” (Rhys

Blakely writes).

But as the risk of a

second wave grows,

there are grounds to

think it would differ

from the first. “We don’t

know for certain — this

is all educated

guesswork,” says Paul

Hunter, professor of

medicine at the

University of East

Anglia. “But I don’t

think we will see

anywhere near the same

number of deaths.”

Nothing significant

has changed about the

virus itself. There is no

evidence that it has

mutated into a less

deadly form. What has

changed is our

knowledge: much more

is known about how it

hijacks human cells,

how the immune system

responds and who is

most vulnerable. One

lesson is that if the

elderly are protected,

deaths can be limited.

“America has already

been through two peaks

in cases and, indeed,

through two peaks in

deaths. But although the

second peak was about

twice the number of

cases it had roughly half

the deaths. And the

main reason for that is

that a younger age

group was involved,”

Professor Hunter said.

“The big scandal of

March and April in

Britain was that nothing

was done to protect

people in care homes,”

he added. “I can’t see

that happening again.”

In the spring doctors

knew little about what

drugs to use. There is

still no silver-bullet

treatment and, critically,

no vaccine. But a trial

involving thousands of

NHS patients has shown

that a cheap steroid,

dexamethasone, can

reduce the death rate

among the sickest

Covid-19 patients by as

much as a third.

Another medicine, the

anti-viral remdesivir,

may quicken recovery.

Hospitals have learnt

valuable lessons: tactics

as simple as having

patients lie face down

have helped to save lives.

These incremental gains

may help to explain the

relative stability of

deaths.

The latest European

Centre for Disease

Control weekly analysis

show that case numbers

across the continent

have been rising for 52

days while the death

rate has been stable for

68 days. Unfortunately,

there is one other big

difference between now

and the spring: the first

wave hit just as the NHS

was exiting its peak

winter months — and it

still had to shut key

services to cope.

Summertime made a

lockdown just a little

easier to bear. As the

nights draw in, there are

no grounds for

complacency.