Report reveals how Covid got into rest homes

Staff members and visitors were responsible for the transmission of coronavirus in aged care facilities, a report has revealed.

The report, released yesterday, was commissioned by the director-general of health, Dr Ashley Bloomfield, in April to learn from clusters of Covid-19 in aged residential care (ARC) facilities, so New Zealand can be better placed to manager further occurrences.

The independent review looked at five aged-care facilities – in Christchurch, Auckland and Waikato – which were known to have clusters of the virus, as well as other facilities that were largely unaffected.

The panel report confirmed the infections were introduced to the facilities by staff or visitors.

By May 24, the five ARC clusters had been associated with 153 cases, out of a total of 1504 national cases.

A total of 39 residents were infected, along with 78 health care workers and 36 others associated with health care workers or their close associates.

The five clusters in the agedcare facilities were identified by April 10.

The onset dates of the outbreak clusters ranged from March 11 until March 28, which coincided with the peak in national notifications.

According to the New Zealand Aged Care Association (NZACA), out of more than 36,000 residents in 650-plus facilities around the country, 39 were affected by coronavirus and 16 residents died.

The report found that all initial infections came from outside the facilities, and two were associated with overseas travel. Data showed that three out of the five facilities had staff cases first before residents got infected.

The report also revealed that staff experienced ‘‘considerable stress’’ because of the extra vigilance, longer working hours, misinformation, isolation, reputation and the stigmatisation of the disease.

Staff turnover dropped during the four weeks of lockdown, as did absenteeism and sickness, and communication and resources provided to ASR providers were at times confusing.

Some noted a lack of PPE leading into the pandemic which forced staff to operate without it and ARC facilities that experienced the virus felt there was a ‘‘takeover’’ by public health experts who had little understanding of the work required in an aged-care facility.

The panel noted that before the pandemic, the concept of outbreaks, clusters, probable versus proven cases and other epidemiological terminology were never a part of ARC day-today operations.

The health ministry said the key focus of the review was to improve systems to prevent any future experiences and was not putting any blame on staff.

‘‘No blame is being attributed to any staff involved.’’

‘‘As the review acknowledges, a source of stress for staff was uncertainty around knowing who had the virus, and we repeatedly called for testing of all staff and residents to address this, which was denied by the ministry.’’

NZACA chief executive Simon

Wallace welcomed the findings, particularly the acknowledgement of the work done by their sector managing the virus.

They had been calling for many of the recommendations in the report, including the development of a nationally co-ordinated outbreak management plan, access to supplies of PPE, support for staff and testing. In fact as the review points out, the MoH’s initial focus with the pandemic was on hospitals rather than aged residential care.’’

‘‘A source of stress for staff was uncertainty around knowing who had the virus.’’ Ministry of Health