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It may seem premature to consider a plan to reopen nursing homes to visitors with the daily Covid-19 death toll, which primarily involves nursing home residents, still in double figures, but the industry regulator believes this discussion should start. .
The Health Information and Quality Authority (HIQA), which inspects nursing homes, has raised the issue with Health Minister Simon Harris and the State’s National Public Health Emergency Team (NPHET). HIQA CEO Phelim Quinn is a member of NPHET.
“It is time to start the conversation; we’re not saying it’s happening today or tomorrow, “said Susan Cliff, HIQA’s deputy chief inspector.
The topic has come up during the 93 nursing home regulator on-site assessments since mid-April, reviews aimed at assessing households’ readiness to handle an outbreak.
An HIQA inspector was informed of the cost the lockdown was charging for older residents who had not had a visit in two months.
“The provider said that if they don’t die from Covid, they will die of loneliness. That was a genuine concern,” Cliff said.
There had to be a discussion about “how we are going to open the centers safely to visit, limited as it may be.”
She said that among the solutions being considered was the installation of Perspex glass and “prison-like visitation scenarios.”
“What we want is a consistent approach to this that is risk-assessed, provider-safe, resident-safe, and family-friendly who come to visit,” Cliff said.
Mass testing
The HSE said Sunday that it had completed mass testing of 28,000 residents and 30,000 employees in all 577 nursing homes in the state, and had found suspected or confirmed outbreaks of coronavirus in 371 or 64 percent of nursing homes, far more than previously thought. .
However, the crisis in nursing homes, the most affected sector, seems to have reached its peak; HSE said the number of nursing homes “of great concern” had dropped to 56 from 90 in one week.
During the pandemic, HIQA has raised concerns to HSE crisis management teams about outbreaks and delays in testing (or no testing), along with a shortage of personnel, personal protective equipment (PPE) and oxygen in homes. most affected.
Cliff says HIQA has received “some snipey comments -” too little, too late “is common” – but he could count the criticism on “one hand.”
He heard “panic out there” without having “assets or the ability to solve problems, and can only look to convey the information,” he said.
Cliff spoke about the “blind panic and pandemonium” that gripped some homes as they battled outbreaks and handled multiple deaths after the first Covid nursing home case was reported to HIQA on Monday, March 16.
She believes that the initial response was hampered by the lack of relationship between HSE and 80 percent of privately owned homes.
She said some houses had a higher expectation of how the state would help and that state officials initially viewed the houses as independent legal entities.
However, he emphasized that these residential centers were “homes” and “were never established to function as acute care centers.”
There was “an acceptance” within the HSE, around the beginning of the last week of March, that “the ability was simply not there” to handle the deepening crisis, and recalls a call from a Dublin house that was struggling for facing. .
Significant deaths
“That nursing home was probably the third or fourth in the Dublin area that had significant deaths, but the number of deaths as a proportion of total residents is very high,” he said.
Cliff expressed surprise at the large number of asymptomatic positive Covid-19 cases found in the massive tests, according to anecdotal reports. One house, which it thought was free from Covid, had 27 asymptomatic cases. In another, all but four of the 40 residents were positive and asymptomatic.
Now HIQA believes there must be “an articulated plan” to retest and confirm staff are negative and return to work as nursing homes were still experiencing details to get results.
“We need to move to a situation where centers have the ability to do their own testing, have access to a laboratory to send those tests, and have a consistent way for those tests to return on time, that is, in 24 or 36 hours I don’t mean five or six days, “said Cliff.
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