Aged care worker diagnosed with COVID-19, facilities at risk

The coronavirus COVID-19 is on the march across the globe and appears to be gaining a foothold here in Australia with the news of the third case of person-to-person transmission in NSW.

It has also been reported by the Sydney Morning Herald that a Sydney aged care worker has contracted the virus.

A number of healthcare workers are said to have come in contact with the virus unknowingly and panic is setting in across the nation, with people stripping supermarket shelves of essential goods such as toilet paper.

As of 3 March, there is a total of 90,893 reported cases of COVID-19 globally, and 3110 deaths.

Australia currently has confirmed 29 cases of the virus; 9 in Queensland, 9 in Victoria, 6 in NSW, 3 in SA and 2 in WA.

The first Australian death due to COVID-19 was also announced this week, after 78-year-old James Kwan passed away in the Perth hospital on Sunday. He had been recently airlifted from the Diamond Princess cruise ship docked in Japan after an outbreak occurred. His wife has also contracted the virus and remains in isolation in hospital.

“As the numbers rise the deaths also rise,” Australia’s deputy chief medical officer Paul Kelly told ABC radio on Monday.

“Although, we must remember that over 80 per cent of the people that get this infection, it’s relatively mild.”

Is the aged care sector prepared for a pandemic?

It is becoming increasingly clear that we should be preparing for larger scale outbreak and as usual the elderly and those with prior medical conditions are at risk. It has been reported that an aged care facility in the US experienced six coronavirus cases and many more residents and employees have complained of illness.

The Sydney aged care worker who acquired the virus is reported to be a 50-year-old woman who was working at a facility near Macquarie University in northern Sydney, and health authorities are concerned the nursing home’s residents may have been exposed to the virus.

However, we are yet to hear much from authorities or the aged care sector about the preparedness for an outbreak at a residential aged care facility here in Australia.

This week Federal Health Minister Greg Hunt said aged care will be a coming priority and also said any health and aged-care workers returning from Italy and South Korea must not go to work for two weeks because they could infect vulnerable populations at greatest risk of dying.

“As a healthcare worker, or as a residential aged care worker, you should not attend your regular work for 14 days,” Mr Hunt said.

“That is an additional level of protection which has been advised by the chief health and medical officers and accepted by the Australian government.”

When approached by Aged Care Insite, a department of health spokesperson said: “The Department of Health has written to aged care providers to remind them of the importance of having and maintaining transmission-based precautions to prevent and control infections. Infection prevention and control programs will vary between aged care homes, depending on the nature of the care and services provided, the context and the risk, but should be consistent with the Australian Guidelines for the Prevention and Control of Infection in Healthcare.

“As well as implementing an infection control program, there should be established protocols in place at aged care homes to manage any health emergencies that arise, including service-wide infection outbreaks or broader community epidemics.

“The Department will be engaging with the sector shortly to share information about the virus and support the sector’s preparedness planning.”

Aged Care Insite also approached several aged care providers to hear about any precautions being taken to prevent infection and protocols for a potential outbreak. However, many were reluctant to discuss COVID-19.

One provider, Uniting, through a spokesperson said: “Uniting is concerned about the impact that COVID-19 may have to our residents and clients. We are updating our outbreak management protocol to monitor and manage this appropriately.

“We have robust infection control processes which guide how our team members care for our residents. We have also consulted with the Department of Health on how to appropriately prepare for, and manage, a possible outbreak of COVID-19.

“We know health matters of this nature can be concerning. We encourage any aged care resident or their family members who may have questions to speak to their service manager.”

Pat Gracia, chief executive of Peak Body Catholic Health Australia, said that aged care providers have received advice from the government and already have strict infection control protocols in place such as resident isolation, restrictions on movement and universal infection control precautions, including vigilant hand washing. He is, however, worried about supplies in facilities.

“An issue of concern is the flow of crucial clinical supplies out of China such as masks, gowns, and sanitisers. Some of our facilities have been advised by Chinese companies of potential risks to future supply. This isn’t an immediate issue, but we are monitoring it.”

What do we know?

“I think [aged care facilities] need to be talking about this because they care for our parents and grandparents and there’s certainly, I would have thought, a responsibility to talk to everybody about that,” said associate professor Ian Mackay form the University of Queensland.

Mackay suggests that aged care providers need to be prepared to stop visitors arriving and keep close tabs on the health of staff.

“I know there’s a lot of preparation and planning going on. I don’t know the detail about it, but I know it is happening; essentially, these facilities are going to need to be prepared to, as they do in a bad flu season, stop visitors arriving,” he said.

“They’re going to have to keep an eye on staff who are possibly going to acquire their infection from the community and then bring it in to the healthcare facility. So, that is an issue. I don’t know how you overcome that, but that’s a real risk. I guess as soon as anyone’s ill, they need to be taken away from caring for the aged community.”

As yet there is no widespread person-to-person transmission but vigilance is key, Mackay says.

“Surface cleaning is going to be really important in those sorts of shared communities. So, lots and lots of cleaning; I think more cleaning than would normally occur, and obviously encouraging everyone to wash their hands a lot if they’re caring for people is going to be really important,” said Mackay.

Mackay said that overall, Australia is well placed to tackle the virus and the government is doing everything it can.

“Everything in terms of planning and response that’s going on is fantastic. Australia’s really well placed. And we’ve been doing it all year, since we first found out this thing had a pandemic potential, which scientists knew about early.

“The only thing I would say is [we need] a bit more communication to the community about the specifics, the details of what they can do to feel like they’re in control,” he said.

“The use of words like “Pandemic” and what they really mean. Not speaking too technically to the wider community. So, when we do see people in front of microphones, [we should be] trying to keep it as simple and clear as possible.

“Allowing people to be anxious, but not in any way encouraging panic is a really important message and it’s very subtle and hard to get across, but it’s one that would probably save us some time.”

From the data observed from China’s outbreak, experts believe that those who develop a mild case of the disease do not develop more serious symptoms. But Mackay stresses that the groups that do suffer worse are the older people in the community.

“If this virus goes pandemic, we’ll all experience an infection at some point, the same way we’ve all been infected by flu or by other corona viruses.”

“We’re not all going to get infected and ill. We might get infected, but we may not become ill, and that all still needs to be to teased apart. We know that the people who die are mostly the elderly and those with some sort of underlying cardiac or lung or kidney diseases,” he said.