As Victoria was in the grip of a second wave of Covid-19 that resulted in the death of hundreds of elderly people, Acting Chief Medical Officer Prof. Paul Kelly said federal, state and territorial governments would “redouble our efforts “To ensure that the industry is” fully prepared “for future outbreaks.
On Monday – nine months after the federal government spent $ 9 million to step up Covid readiness exams in nursing homes, and following the Royal Elderly Care Commission’s special report on Covid-19 – employees and residents of the sector in Victoria were again wiped down and banned when the virus was discovered in two houses.
By the end of the week, the most recent outbreaks in elderly care in Victoria appeared to have been contained. However, serious lessons should have been learned from the 655 Covid-related elderly care deaths in Victoria throughout 2020, most of which occurred between July and September during the state’s second wave.
With so many elderly care workers either infected or in close contact and being quarantined at the time, elderly care homes were forced to administer infection control and care while staff were also severely exhausted. It meant that residents had to forego basic services including food, wound care, and bathing.
It could have been disastrous. Those who lost loved ones in elderly care to Covid last year were shocked when elderly care was once again banned.
Liz Beardon, whose parents died after contracting Covid-19 in the Menarock Rosehill house, says, “If what we went through last year wasn’t the catalyst for reform, what will happen then?
“Of course, I am still deeply traumatized and grieve for my parents,” she said. “I’m still trying to prevent this from happening to others, I’ve testified to the royal commission and asked for answers. But for some reason the elderly are still not seen as important and valued members of our society to whom we owe a duty of care. “
The blame game
Why didn’t the Victorian government put stricter infection control procedures in hotel quarantine to prevent it from spreading to the community, which sparked the second wave, and why couldn’t basic questions about who was responsible for the quarantine program be answered? Why did it take so long for the state government to recognize the expansion of jobs in hospitals and care for the elderly or for the mask requirement to be introduced in care facilities for the elderly?
Why has the federal government not done more to protect the elderly care facilities against Covid, and why did there appear to be no Covid-19 infection control plan or staff plan in the event of an outbreak?
A blame game was played out as exhausted geriatric carers and health workers struggled to treat growing numbers of patients.
But as the recent Victorian outbreak spread to elderly care last week, the main problems that led to the spread – a hotel quarantine violation in South Australia that caused the virus to invade Victoria, poor vaccination rates that left those in need of protection exposed and an insecure workforce – everything landed firmly at the feet of the federal government.
It was revealed on Monday that while Victoria was ensuring that all employees of the handful of elderly care facilities she manages no longer work in multiple locations, the federal government, which is responsible for the majority of elderly care homes, abolished the same policy back in November.
Guardian Australia confirmed that federal guidelines were never mandatory, and nothing could be done to prevent employees from working across locations to supplement their income. The only time the federal government makes guidelines mandatory for a workplace is during an outbreak, when the most at risk are already at higher risk.
Geriatric and geriatric care researcher Prof. Joseph Ibrahim says the federal government failed to address the underlying problem.
“And the underlying problem is that you don’t make enough money in geriatric care to work in one place,” says Ibrahim.
“When you’re a manual worker, you have to work multiple shifts in multiple locations to get a viable wage. You don’t solve the problem by saying, ‘You are only allowed to work in one place’. It’s a really very narrow vision. What needs to happen is that elderly care workers need to be better paid for their work with decent wages, and these problems have been known for years and have not really been answered in any way. “
In August, Federal Nursing Minister Richard Colbeck didn’t know how many geriatric nurses had died from the virus, and on Tuesday he didn’t know how many residents or workers in the sector had been vaccinated. Despite the federal government’s promises that the most vulnerable Australians would be vaccinated by Easter, there were 16 nursing homes in Victoria at the end of May where no resident or employee had received a dose.
About a third of the population is not yet fully vaccinated. A government survey of elderly care workers found that only 11% of elderly care workers received a first dose.
The vaccination of geriatric care staff and residents is the responsibility of the federal government.
Dependence on private contractors
But it has outsourced much of the work to private contractors, relying on four companies – Aspen Medical, Healthcare Australia, Sonic Healthcare, and International SOS – to vaccinate elderly care residents in their facilities.
Contractors were paid a total of about $ 76 million, according to Senate estimates, with Department of Health officials eventually revealing full contract values despite declining multiple requests from the Guardian for the same information out of confidence.
Still, there are conflicting statements among contractors about whether they are responsible for vaccinating elderly care workers. Aspen was reported to have declined any contractual obligation to vaccinate employees earlier this week, but later told the Guardian that its contract covered workers. Sonic said it wasn’t hired to vaccinate workers, and HCA first told the Guardian that before clarifying that it was actually contractually bound to vaccinate workers.
Some groups, including the Royal Australian College of General Practitioners, believe that too much trust has been placed in private contractors who have had little experience delivering vaccinations to residential aged carers.
“A dog breakfast”
Ian Yates, the chairman of the board of directors of the Council on the Aging, says he has had staffing concerns for some time.
“We fully understood when Plan A, doing them all together, fell through,” he says. “But it took them a while to get Plan B in place.”
The government also promised to set up special “pop-up” pfizer hubs for younger caregivers who, in turn, rely on contractors.
But the initial April deadline for the pop-up hubs came and went with no further details and the elderly care workers were left in the dark.
The health department later promised to set up 13 pop-up hubs in May. Only three have been launched so far, and all are located in Sydney, which is well served by state mass vaccination centers with Pfizer. Only 1,887 employees were vaccinated through the hubs.
Two elderly care facilities in Melbourne – Arcare Maidstone and Blue Cross Western Gardens – have worked flat out to prevent the spread of Covid-19. Photo: Daniel Pockett / AAP
The government is now calling on geriatric carers to get vaccinated everywhere like the rest of the population.
On Friday, three months after the introduction, a general agreement was reached with the states and territories that makes vaccination compulsory for geriatric carers mandatory.
A senior care director did not hold back when asked about the government’s efforts to vaccinate staff this week.
“It’s a dog breakfast, it’s a bunfight, it’s a shitfight – all of those things,” he said.
State governments must now fill the void and run targeted lightning programs to increase the intake of elderly care workers.
The problem is also not limited to inpatient care for the elderly.
Cath, a Melbourne-based community caregiver, told the Guardian that the vast majority of the frail and elderly Australians she cares for at home have still not been vaccinated.
“I would say out of 50 customers maybe one or two had their first chance,” she says. “I’ve told them every time, part of it is how to get to the doctor, part of it is the hesitation.
“There is no official information or government campaign to promote this.”
Quarantine puzzle
While the Victoria outbreak was due to failures in hotel quarantine in South Australia, a state responsibility, the Australian Medical Association (AMA) has been calling for months on the federal government to fund more suitable, purpose-built hotel quarantine facilities.
The AMA argued that while hotel quarantine made sense as a quick response at the start of the pandemic, there have now been enough violations across the country to show that it is not a long-term solution.
The AMA President Dr. Omar Khorshid said: “In our opinion, the quarantine will be with us for the foreseeable future.
“We can’t see a situation that doesn’t require quarantine,” he told Sky News in May. “Even as we begin to open the borders, even with a vaccinated church. We will still need some form of border control, especially with people who we believe are arriving from high risk areas or where there are new varieties of these viruses. “
While Colbeck has been told to step down over the situation in Victoria, Ibrahim says the failures go beyond a minister.
“This is a national responsibility,” says Ibrahim. “And there is no point in replacing one minister with another if the underlying issues have not been addressed.”