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On March 14, the chief physician of the Stockholm region writes to the county municipalities about the new guidelines for municipal care activities.
In the previous days, the Swedish Public Health Agency and Infectious Disease Control in Stockholm had found signs of social spread, prompting new routines to protect the elderly.
The sampling would now be aimed at people in hospitals and the elderly in special accommodations. But staff with symptoms would not be tested, instead would go home from work. It was also not obvious that residents with symptoms were evaluated; the decision would be made by the attending physician.
The guidelines thus deviated of the authorities’ recommendations. The cause was the “local epidemiological situation”. At that time, the region had 341 identified cases.
– I found it remarkable that the sampling of residents with symptoms was not something natural, contrary to the guidelines of the Public Health Agency. It was a departure from the recommendations, which was also highlighted, says Marta Szebehely, emeritus professor of social work with a focus on the elderly at Stockholm University, and emphasizes that the Public Health Agency stated that residents and care staff of elders should have priority for testing.
The infection quickly reached most of the county’s nursing homes. As the pandemic entered its second wave, Szebehely says it highlights Stockholm, where now nearly 9 percent of the elderly in nursing homes have died from covid-19, also in Sweden, where the corresponding figure is four percent. .
– Stockholm was infected a lot during sports holidays, but it is also distinguished by the fact that it was infected a lot inside old people’s homes and there was a high proportion of deaths. It should not be ruled out that if the infection has reached a nursing home, it will also know from there so that you can also be infected in society.
In an international comparison Care for the elderly has been hit hard by the pandemic, and here Sweden ends on average: about 46 percent of all those who died with or from COVID-19 have lived in nursing homes.
“I thought it was remarkable that sampling residents with symptoms was not natural, contrary to the guidelines of the Public Health Agency,” says Marta Szebehely.
Photo: Elin Åberg
The spread of covid-19 was initially similar in neighboring Nordic countries, when the 100 infected cases were diagnosed within days of each other, between March 6 and 12 in Finland and the first deaths occurred shortly after.
But countries acted differently. When it came to taking measures such as restrictions, information campaigns and testing strategies, Sweden acted more slowly and with less force, according to the report. Neighboring countries were also quicker to pay attention to elderly care in the authorities’ information.
Even before the pandemic broke out, Finnish and Norwegian authorities sent warning signals to regions and municipalities so that they would not forget about caring for the elderly.
Denmark stands out for testing on a broad front, and it is the only country in the Nordic region that reports how many staff have been tested.
– If you have contracted the infection, you should test everyone regularly, due to an asymptomatic infection and when older people with dementia cannot express themselves.
It is difficult to compare the spread of the infection in addition to the death rate, as all the Nordic countries lack public data on how different nursing homes have been affected by infection and death. A serious knowledge gap, according to Szebehely.
– In Sweden, the information is not public, but it must be. How else can we learn from this?
Countries also differ Regarding staffing in the care of the elderly, Norway stands out with a high proportion of nurses, and Sweden with the highest proportion of salaried workers is at the other end of the scale.
Sweden is also distinguished by the fact that it has largely embraced new public management and introduced business community control models in the public sector, which stands out as an explanation for the fact that emergency stocks have been rationalized. and replaced by just-in-time deliveries.
– The evolution has been clear in Sweden compared to neighboring countries. You haven’t had as much protective gear or testing opportunities because you expected to buy it. Competition has also been trusted to drive quality. In Norway, quality development has taken place in other ways.
Marta Szebehely agrees with the Crown Commission in the sense that the widespread spread of the infection has been decisive in terms of the intensity with which the infection has also affected the care of the elderly.
As the pandemic has now entered its second wave, nursing home deaths account for an even higher proportion of all covid deaths compared to this spring, in Sweden now 55 percent.
– It may be because he has improved in the treatment of those who are out. Unfortunately, I am not ruling out more deaths in nursing homes. They are fragile people and they are a nasty disease.
DN is looking for a representative for the Stockholm Region.
Read more: The main deficiencies in covid care in nursing homes show a review by Ivo
