Care homes are bearing the brunt of Covid, again

The government has missed its target to vaccinate all older care home residents by 24 January. The deadline has now been shifted to 31 January. The delay has been attributed to a variety of factors including confusion over whether GPs should vaccinate in care homes with an ongoing outbreak, changes to the second dose schedule, and early logistical difficulties.

Meanwhile, amid vaccine delays, coronavirus is once again tearing through care homes. A total of 1,705 Covid-19 related deaths were reported in the week up to 22 January, according to data released today by the Care Quality Commission. The grim toll represents a worrying spike in cases, up 32 per cent compared with the previous week and nearly double the number from the week before that. These tragic figures bring the total number of deaths involving Covid-19 in care homes to 23,081 – out of a total of 103,709 deaths involving Covid-19 in the UK.

Disruptions to the vaccination rollout may be a key factor behind this disturbing rise. Notably, five out of the six areas which saw the highest number of Covid-19 related care home deaths last week – Norfolk, Surrey, Kent, Essex, Hampshire, and East Sussex – have lower vaccination rates than much of the rest of the country.

Vaccine distribution to care homes was also initially sluggish due to the Pfizer vaccine having to be stored at very low temperatures and being distributed in batched of 975, far more than the average number of care home residents according to Mike Padgham, Chair of the Independent Care Group. The rollout accelerated in the second half of the month, helped by government pressure and the new easier to distribute AstraZeneca vaccine. Yet as the figures show, by then the spike in care home deaths was already well underway.

Other potential factors behind the spike include the emergence of the new and more infectious strain of coronavirus, and the government’s policy of allowing some patients to be discharged from hospitals into care homes without a negative coronavirus test.

This policy, designed to free up bed space and prevent hospitals from being overwhelmed, was put in place during the first coronavirus wave in March. It proved disastrous, playing a key role in spreading the virus to vulnerable care home residents – who now make up a significant portion of the virus’s total fatalities.

Admittedly, this time around only patients who have been isolated for 14 days can be discharged. However, many care home owners are still extremely concerned about a potential repeat of the tragedy in March – and made these concerns when the policy was introduced in mid-January. Yet two weeks on, and with a number of care homes seeing coronavirus outbreaks, the policy still remains in place.

More generally Padgham thinks that the rise in care home deaths reflects the wider spike in cases across the nation and thinks the government got it wrong when it came to containing the spread. “During the first wave I think we locked down a little too late and reopened too early. I think we’ve seen the same thing this time around. On top of that, confusion over the tiers system and the Christmas mixing doesn’t seem to have helped. The result is increased community transmission which risks infecting the care home staff and from there it can get into care homes.”

In many ways it seems to be the same story as last year all over again. Once again, the virus has spread through the population putting pressure on hospitals. And once again, care homes have picked up the slack. While better prepared than ever before, care homes have not always received the support they were promised from the government.