Winter is coming

Academics have warned health and social care professionals to prepare for a “particularly challenging winter 2020/21", including for a second wave of COVID-19.

Published by the Academy of Medical Sciences, the report, ‘Preparing for a challenging winter 2020/21’ estimates that in a reasonable worst-case scenario the ‘R’ value' could rise to 1.7 from September 2020, unless lockdown is repeated. Researchers say: “COVID-19 [is] likely to become common again and may be exacerbated by simultaneous transmission of influenza in these settings, as well as transmission between settings.”

Care homes and other community health and social care settings have been told to plan to deliver routine services in parallel with COVID-19, a challenge that should involve continuing use of PPE, minimal use of agency/multi-site staffing and ‘zoned’ working that limits physical overlap and movement between areas of care provision.

And, care homes should heed this advice. A recent Government-commissioned  study has highlighted the need for improved infection control in care homes. In research conducted during May - early in the COVID-19 epidemic - it was found that care workers had the highest risk of testing positive for COVID-19, compared to health and other key workers.

In the care sector, the incidence of COVID-19 infection was 0.71 per cent, compared with health care workers at 0.47 per cent and other key workers at 0.17 per cent.

Compared with non-key workers, care workers’ unadjusted odds of testing positive were 7.7 times higher. In contrast, health care workers reported odds of 5.2.

Explaining the results, the research suggests that one of the most significant risk factors for infection in care homes is contact with people with COVID-19. In fact, the report shows that anyone who had recent contact with a known COVID-19 case was 24 times more likely to test positive than those with no such contacts.

Researchers said: “Care homes and hospitals, even during the period of our study at the end of lockdown, remained an important source of infection.”

Little wonder, perhaps, that new research from care provider Vida Healthcare reveals 76 per cent of adults don’t think it’s currently safe to put a loved one in a care home. A further 53 per cent worry their loved one’s health would deteriorate if they were placed in a home.

A follow-up, upscaled study on how health and social care sectors have coped in the later stages of the pandemic was conducted during June, and this is expected to report shortly. It will shed further insight into the ‘new normal’ environment facing care home providers as we move cautiously through de-escalation.

With Winter approaching, concerns are rising about the complicating effect of flu on care home residents. This puts added pressure on care homes who are already worried about their future in this new post-pandemic world. The research on infections in care homes shines a harsh spotlight on the need for regular testing of residents, pre- and post- admission to care homes, the ongoing need for PPE and operational support for a workforce more likely than any other to need to self-isolate should infection occur.

Academics have called on Government to take this window of opportunity before the flu season kicks in  to work with stakeholders – including care home staff, residents and their families – to design a set of services, guidelines and communications that will work for the whole person – not individual conditions – and which give people options when it comes to their care.

It is clear that for the care sector there is much to think about. Many things about the interaction between health and social care need to change. There are significant and real concerns about the current funding model. Customer confidence in the sector is at an all-time low.

NHS boss Sir Simon Stevens has called on Government to deliver on its promise of a Green Paper for social care within a year. Let’s hope there are providers left in the care business to hear what it has to say.