Aged care faces coronavirus crisis as residents transferred

Anastasia Tsirtsakis

28/07/2020 4:45:31 PM

With almost 770 active cases recorded among aged care residents and staff in Melbourne, the Federal Government has gone into crisis mode.

Aged care patient being transferred to hospital.
The Victorian Government has transferred residents out of some affected facilities and into hospitals. (Image: AAP)

As coronavirus clusters grow across aged care facilities in Melbourne, the State Government has intervened, transferring residents out of some affected facilities and into hospitals.
In an effort to free up beds, elective surgeries have been put on hold, with the exception of category one and the most urgent category two procedures.
The response is being coordinated by the Victorian Aged Care Response Centre, headed by former Country Fire Authority chief officer Joe Buffone, who said the top priorities are ensuring care for residents and the aged care workforce, and the prevention of further outbreaks.
Victoria recorded 384 new coronavirus cases on Tuesday, and another six deaths, four of which have been linked to the private aged care sector. It follows the death of five aged care residents on Monday.
There are 80 different outbreaks in aged care facilities, including: 

  • 88 cases linked to Estia Health in Ardeer
  • 86 cases linked to St Basil’s Homes for the Aged in Fawkner
  • 82 cases linked to Epping Gardens Aged Care
  • 76 cases linked to Kirkbrae Presbyterian Homes in Kilsyth
  • 62 cases in Menarock Life aged care in Essendon
  • 53 cases linked to Glendale aged care facility in Werribee
  • 51 cases linked to Baptcare Wyndham Lodge in Werribee
  • 50 cases linked to Estia Health in Heidelberg
  • 40 cases linked to Outlook Gardens aged care in Dandenong North
  • 39 cases linked to Arcare aged care in Craigieburn.
 The majority of St Basil’s residents have been transferred out of the facility, which is currently being investigated by the sector’s watchdog at the request of Federal Health Minister Greg Hunt, after residents were reportedly left lying in soiled sheets and without food.
‘Our role is to make sure all the remaining residents are safe, and the advice that I had as of late last night and early this morning is that the conditions are stable,’ Minister Hunt said.
‘What could have been an extraordinary, catastrophic situation – actions have been taken.’
Victorian Premier Daniel Andrews said he does not have confidence that providers can keep all residents safe.
‘Some of the stories we’ve heard, some of what’s gone on in some of these settings is simply not acceptable and it’s not about blame, it’s not about demarcations and having disputes about who is in charge of what,’ he said.
Those same fears are being felt by staff members themselves.
After six months of the COVID-19 pandemic, more than two thirds of aged care workers still do not feel prepared to deal with a virus outbreak, according to a new national survey released by the United Workers Union.
Of the 1000 aged care workers surveyed, four in 10 do not feel their facility has communicated their infection plan well, while three in 10 say they have received no additional training in coronavirus safety measures or correctly using personal protective equipment (PPE).
This comes as no surprise to Dr Sachin Patel, founder of an aged care GP service.
‘We’ve been communicating to facilities since January about this, and they fall into two groups,’ he told newsGP.  
‘There’s a group who are well-prepared and have taken it seriously. But we’ve also had feedback from some who think we’re alarmist.
‘We’ve had feedback such as, “Don’t tell us about this, we only listen to our head office. Our head office tell us everything’s okay”.’
Dr Patel says this also applies to some GPs.
‘There are still GPs going into aged care only wearing a mask. Not a gown, no gloves, no face shields, no nothing,’ he said.
‘That doesn’t sit right with me.’

Dr Patel has assisted with eight outbreaks in Melbourne since March. He says when a facility has a confirmed case, having the right infection control measures in place can make a world of difference, often resulting in minimal spread.
‘When those methods are employed rigorously, there’s actually no necessity, unless there’s a medical need, to remove residents,’ Dr Patel said.
‘When people are moved, it causes unrest in the resident quite often, because it’s an unfamiliar setting with unfamiliar people, and that does have an impact, which is why I think there’s the rationale for trying to keep people in situ.’
There are currently 769 active cases among aged care residents and staff in Melbourne, with almost three quarters of the deaths recorded in the past three days linked to aged care outbreaks.
Premier Andrews said he believes too many workers are going to work with virus symptoms, fearing the financial impact of foregoing a shift. Nine of 10 aged care workers have the same concerns about their colleagues, due to lack of leave, the United Workers Union survey found.
In response, the Fair Work Commission on Monday decided that aged care workers across Australia will be given paid pandemic leave to encourage them to stay home if they have symptoms.

Pacific-Greg-Hunt-Hero-3.jpgFederal Health Minister Greg Hunt said the Government’s role in responding to the St Basil’s crisis was to ensure all remaining residents were safe. (Image: AAP)
Dr Patel says the matter is multifaceted, from lack of adequate control measures to staffing issues that affect not only the staff and residents, but also families.
Reports have emerged of family members of residents being kept in the dark about outbreaks in facilities.
‘What we’re finding is families just want information,’ Dr Patel said. ‘They’re not asking for a crystal ball, they just want to be informed.
‘That piece, from what we’ve seen, has been really poorly handled everywhere.
‘Because we’re in task mode to get stuff done, the soft side, which is the communication side, can go awry. But that’s actually vital to allow the other pieces to happen smoothly.’

GPs working in aged care homes with outbreaks have also reported feeling left out of the equation.
One Melbourne aged care GP, who chose to remain anonymous, told Today she was ‘horrified’ by the Victorian Health Department’s lack of advice to doctors about the provision of medical care.
‘We need clear guidelines from the Victorian Public Health Unit for the GPs working in aged care. What our role is and who we can get help from,’ she said.
‘It’s like they have given up, they are completely overwhelmed.’
Dr Patel says while this was certainly the case in March, communication with the Victorian Health Department since then has ‘improved significantly’. Though he agrees that GPs have ‘sort of been cut out of everything’.
‘We’re the ones that have the local knowledge medically. And so I would have thought a GP should have some sort of executive role when COVID enters a facility, where a GP is involved in or consulted with about it,’ he said.
‘But I’ll be controversial in that we have a duty as a profession to take responsibility, as well.
‘This is a health crisis, so I don’t think we can only expect to be fed by the department; I think we have to step up.’
He says what the outbreaks do highlight is that general practice in aged care is its own specialisation, and that healthcare for older Australians needs greater attention.
‘General practice and general practice in aged care are different,’ Dr Patel said.
‘The reason we get to enjoy the country and all the trappings of luxury that we have is because these people came before us and worked to create what we have to enjoy. So they need to be looked after and taken care of, and we need to make it a central part of our society.’
The Royal Commission on Aged Care Safety and Quality held hearings earlier this month for the first time since the pandemic began. It is examining funding and investment issues, which are now being linked to COVID-19 outbreaks at residential aged care facilities.
‘If anyone had any doubts about the need for a royal commission [into aged care] hopefully that’s beyond doubt,’ Premier Andrews said.
Prime Minister Scott Morrison cut short his planned tour of Queensland on Tuesday to return to Canberra for urgent discussions workforce shortages in aged care.
The Victorian Government has offered to assist the sector, with registered nurses being sent to help. One aged care home saw Australian Defence Force nurses sent in overnight to address staffing gaps.
In the face of rising cases, Premier Andrews empathised with concerned family members of residents, saying ‘I wouldn’t want my mum in some of those places’.
But Minister Hunt jumped to the defense of aged care staff, and grew emotional while drawing on the experiences of his father, who spent the final months of his life in aged care.
‘The idea that our carers, that our nurses are not providing that care, I think, is a dangerous statement to make,’ he said.
‘They are wonderful human beings and I won’t hear a word against them.’
While vital measures are now being taken at all levels to stop any further spread, Dr Patel believes there is no doubt we will see more deaths in aged care facilities.
‘The question is how many,’ he said.
‘This is one of those situations where … we need to metaphorically all roll up our sleeves and work on this together. It’s not a situation where we can just say, “Oh the government should sort this out”.
‘They need each and every one of us to stand together, step forward and do our bit.’
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A.Prof Ralph Gustav Audehm   29/07/2020 7:22:01 AM

Thank you Mr Hunt for your support of the Aged Care Sector. Many do amazing jobs in difficult circumstances. I am shocked at the rhetoric sometimes aimed generally at the industry. they get minimal recognition. Andrews should apologise to those who work hard and do the right thing.

Dr Janice Faye Sheringham   29/07/2020 12:07:25 PM

While we now all know that the spread of virus in Victoria is “largely if not entirely”due to the breakdown in hotel quarantine management, once the virus started spreading the writing was well and truly on the wall in regard to ACFs! Don’t forget that it was the FEDERAL AGENCY’S CHANGES to staffing levels and qualifications of care staff that has made this situation inevitable, both in the outbreak in NSW at Newmarch House, and now across (apparently exclusively) privately operated ACFs in Victoria! In my long experience as initially a regional centre GP, and more recently as a GP locum in regional and rural Victoria and NSW, I was absolutely disgusted to learn that ACFs only “require” a SINGLE fully trained RN per 30 patients per day/evening shift, and a SINGLE “AVAILABLE” RN overnight(who may be off-site, or even off-shore)! Even in “normal” daily operations, this is functionally inadequate, but in these times, a recipe for the disaster it has become!