Care home outbreaks of Covid-like illnesses highest for a month

Outbreaks of Covid-like illnesses in care homes are at their highest levels in a month, data from Public Health England show.

In the week from July 13 to 19 there were 145 outbreaks of ‘acute respiratory infections’ in homes around the country, up from 128 the week before.

An outbreak constitutes two or more people having the same symptoms, such as coughing, wheezing or difficulty breathing.

Not all of the outbreaks are confirmed coronavirus cases because the category includes any types of infections that cause coughing and infections in the airways. But many are likely to be down to Covid-19 because it isn’t flu season.   

There were only 243 breakouts reported overall in that week, meaning that the care home incidents make up 60 per cent of the country’s total figure.   

Outbreaks in care homes are concerning because the elderly are most at risk of dying if they catch coronavirus, and thousands of home residents have died in coronavirus outbreaks in the past four months. 

Of all deaths involving Covid-19 registered up to July 10, 63.5 per cent occurred in hospital and a whopping 29.7 per cent happened in care homes. 

While the remainder occurred in private homes (4.6 per cent) and hospices (1.4 per cent).   

Some care homes have allowed relatives to visit in a drive-through setup but none have been able to let family members inside the homes for fear they would carry Covid-19 in with them (Pictured: Residents receiving outdoor visits at a home in Banbury, Oxfordshire)

The Office for National Statistics is working with the Care Quality Commission and Public Health England to better understand deaths that are occurring in care homes. 

Care homes haven’t seen such a high number of similar incidents since June 15-21, where there were 176 outbreaks. 

Numbers dropped every week in the three weeks after that but saw a spike in the week ending July 19.  

The high figures come amid fears that the Government’s decision to reopen care homes may be too hasty as they house the people who are most vulnerable to coronavirus.   

Health Secretary Matt Hancock gave care homes the green light to start arranging visits on Wednesday, as long as social distancing and protective equipment rules are followed. 

Each resident will only be allowed a single nominated visitor, who can visit regularly as long as they book in advance and wear a mask and extra PPE if required.

The move finally brings England in line with Scotland, Wales and Northern Ireland, where care home visits have been allowed for weeks. 

Local councils and public health officials in England will decide on a case-by-case basis which homes will be able to reopen, depending on levels of coronavirus in the area.

Charities and care providers said the move has been ‘long overdue’ and the lack of contact with families may have already caused irreparable harm to the mental and physical health of frail residents. 

Mr Hancock said: ‘I know how painful it has been for those in care homes not being able to receive visits from their loved ones throughout this period.

‘We are now able to carefully and safely allow visits to care homes, which will be based on local knowledge and circumstances for each care home.

‘It is really important that we don’t undo all of the hard work of care homes over the last few months while ensuring families and friends can be safely reunited so we have put in place guidance that protects everyone.’  

Local public health officials will decide whether visiting should be allowed at homes in their community, in a sign the government is moving away from its top-down approach to the crisis.

Visitors will need to wear a face covering and wash their hands thoroughly before and after putting it on and taking it off.

They will be asked to give up their contact information so they can be tracked down by NHS Test and Trace if someone tests positive in the home.  

If there is a pick-up in community transmission then some visitors may need to wear extra PPE, including gloves and aprons. 

Providers will decide whether visits should take place in a communal garden or outdoor area, where the fresh air and heat make it hard for the virus to spread. 

It is expected care homes will tentatively start relaxing visiting rules, with family members of residents nearing the end of their life taking priority.  

Charities have said the restriction on family visits has had ‘damaging consequences’ on the mental and physical health of residents with dementia.

Care homes in Wales that are virus-free have been allowing visits from relatives since June 1. Scotland followed suit on July 3, while Northern Ireland allowed visitors into its homes on July 13.

All three nations are still only allowing one single nominated visitor, which limits the number of potentially infected people bringing the disease into he homes. 

Lisa Lenton, chair of Care Providers Alliance, said the measures had been ‘long overdue’ in England.

She added: ‘The impact of the Covid-19 pandemic has taken its toll in many ways. The effect of not being able to see friends and family has been very difficult and very upsetting for many – both for the people who access care and support, and for their loved ones who have been isolated.  

‘The Care Provider Alliance welcomes this overdue guidance – the CPA has been calling for Government guidance for many weeks and released its own visitors protocol last month in its absence.

‘People need people and this is such an important step for the wellbeing of individuals and their relatives.’ 

Among the reasons why care homes were so badly hit by coronavirus are:  

• At least 25,000 people were discharged from hospitals into care homes without being tested for the coronavirus in March and April, which bosses say triggered outbreaks;
• The Department of Health did not supply adequate personal protective equipment (PPE) for care staff, according to managers who accused senior officials of overseeing ‘shambolic’, ‘haphazard’ and ‘paltry’ attempts to provide it;
• Routine testing for people living in care homes was not available throughout March and April and only small samples of people living in homes could get tests if there was a suspected outbreak;
• Department of Health did not publicly count the numbers of people dying of Covid-19 in care homes until April 29, by which time there had been more than 3,500 fatalities. Many victims are still uncounted because they never got tested;
• Public Health England’s advice that care homes were not at risk of Covid-19 outbreaks remained in place until March, by which time thousands of people nationwide were infected after the virus came into the country in people returning from February half-term trips to Europe.

Care home bosses were still struggling to source PPE in May, well after the brunt of the pandemic had passed.

One provider even added a £6.47-a-day surcharge on top of £4,000 monthly fees to pay for masks, gowns and gloves for staff. 

And one home in Wales was forced to warn in April that staff may have to resort to wearing bin bags unless they could urgently source PPE.

The report also claimed around 25,000 hospital patients were discharged into care homes during the peak of the pandemic without all being tested for Covid-19.

Critics said the move, ordered to free up beds for an anticipated surge in seriously ill virus patients, was ‘extraordinary’ and showed care homes were an ‘afterthought’.

Mr Johnson’s comments sparked immediate backlash last night, with Vic Rayner, of the National Care Forum, rejecting the criticism and urging the Prime Minister to start ‘turning the dial up on reform and down on blame’.

She added: ‘Mr Johnson’s comments in relation to care homes’ following of procedures are neither accurate nor welcome.

The Independent Care Group’s chairman Mike Padgham said: ‘We should not be getting into the blame game and it is wrong to criticise care and nursing homes at this time.’

He added: ‘Care providers may not have got everything perfect but neither has the Government.

‘For much of this pandemic, providers were operating in the dark over what they ought to do and with one arm behind their backs in terms of the support they were given. In those circumstances, they have worked miracles.’

No 10 last night tried to calm the row, saying Mr Johnson had not been criticising care homes but had merely been highlighting the difficulties they faced.

‘Throughout this crisis care homes have done a brilliant job under very difficult circumstances,’ a spokesman said.

‘The PM was pointing out that nobody knew what the correct procedures were because the extent of asymptomatic transmission was not known at the time.’

It comes after damning figures last week revealed a care home resident died every minute in England and Wales at the peak of the Covid-19 crisis in mid-April.