End the impasse on rest homes
By and large New Zealand’s coronavirus response has been exemplary. On the raw numbers, we are among the best in the world at containing the epidemic, and now appear to be on the brink of attaining the ambitious goal of eliminating the virus.
There have been flaws exposed, such as the distribution of personal protective equipment, the initial testing capacity and contact tracing abilities, but there’s been a largely nimble response to make rapid improvements.
However, there is an emerging area of concern involving some of our most vulnerable citizens where the response seems anything but agile.
It’s the awful limbo experienced by elderly patients hospitalised with non-Covid-19 ailments, who cannot return to their rest homes.
On one side the aged care industry says any such patients must first have a negative Covid test before they can be transferred, even though they are required to do a 14-day isolation period first.
On the other side the Ministry of Health policy is that only those showing symptoms, or with a history of exposure to Covid-19, should be tested before being transferred to aged care facilities.
Stuck in the middle are elderly people who have been unable to return to their rest homes for weeks. People like 90-year-old Mary Kincaid, in Christchurch’s Burwood Hospital. Her family say she is stressed about not seeing them, worsening her condition. The hospital won’t test her because she has no Covid symptoms; her new rest home won’t admit her without a test.
Daughter Cat Kincaid says they are at their wits’ end because, despite the best efforts of hospital staff, her mother is deteriorating. Why, she asks, when community testing has been carried out on those without symptoms at supermarkets, can’t her mother get a test in hospital?
In a similar case in Wellington, involving a 93-year-old woman, hospital authorities backed down and gave her a test after several weeks and repeated inquiries from Stuff. It’s understandable that aged care facilities are cautious, perhaps overcautious, about accepting new and returning residents, given that most of New Zealand’s Covid19 deaths have been from rest homes.
The industry admits its position on testing is not solely science-based, but one of leadership and empathy for families. Presumably that’s to offer reassurance to other residents and their families fearful of outbreaks in such a vulnerable environment.
Director-general of health Ashley Bloomfield says the mandatory isolation period for new and returning residents is designed to keep aged care facilities safe, and the advice from a range of professionals is that random testing is not helpful because it shows only a point in time.
The New Zealand Microbiological Network, representing clinical laboratories, backs the ministry stance. It says a negative test may provide false reassurance and gives no guarantee that infection won’t occur soon after.
Effectively, authorities are saying that isolation and clinical assessments provide a better gauge of Covid-19 risk than a single negative test.
That may be a sound clinical approach, but at a time when random testing is increasingly rolled out around the country, it is jarring that tests cannot be given to elderly people as an extra layer of reassurance, allowing them to return to their rest homes. The impasse has to be resolved soon, to stop more of our most vulnerable citizens being left in the lurch.
When random testing is increasingly rolled out ... it is jarring that tests cannot be given to the elderly.