Category Archives: Care homes

Covid – when should we wear masks?

Two older people wearing medical facemasks and giving a victory signFinally, at long last, masks will be MANDATORY on UK public transport from 15 June. Far too late of course – as is to be expected from this craven, risk-averse, milquetoast, chumocratic apology for a government – but hoo-blinking-ray anyway.

Masks help reduce covid transmission and so protect not only passengers but drivers.

33 bus drivers have died in London to date.

Why has this diktat taken so long?  Well, you see, “masks undermine social distancing. Everyone knows that!” But everyone also knows that when the wind changes, your face stays that way. And eating crusts makes your hair curl.

Things everyone knows are not always true.

This week I challenged Suffolk’s Director of Public Health, Stuart Keeble, to supply the scientific evidence for the whole “masks undermine social distancing” story – which has been peddled in the UK at all levels. I called it an “urban myth”. He denied this. But has yet to come back to me with any scientific evidence whatsoever.

On the other side, Dr Greenhalgh – an Oxford Professor of Primary Care and passionate advocate of  mask-wearing to reduce community transmission – has recently published this peer reviewed paper analysing the evidence behind counter arguments and shows it to be (at best) weak:  Face coverings for the public: Laying straw men to rest //onlinelibrary.wiley.com/doi/10.1111/jep.13415

When I blogged in March (yes, you heard it, MARCH) on how to make your own masks– stating clearly they helped reduce transmission rather than infection and were particularly useful in taking pressure off scanty PPE supplies (and that the pattern was approved by local medics) – o lord, what a fuss there was from local keyboard experts! (A lot of the arguments that were made about this – now far from- controversial idea, are addressed and put to bed in Dr Greenhalgh’s paper.)

Yet it turns out from Suffolk’s latest figures on covid infection in care homes, that the virus must have come in via people from outside: visitors, deliveries, staff.  Care homes were briefed fully on infection control. Transmission was their Achilles heel. Why were they, why were we not alerted to the benefits of wearing masks? The course of the pandemic might have run differently.

Graph showing correlation between mask wearing and infection rates in 4 countries: highest infection per day no masks- UK. Lowest infection and a tradition of masks, Taiwan


Here is an interesting table showing the path of infection in 4 countries – and when each made mask-wearing compulsory. Imagine if everybody in the UK had started wearing facemasks on the day I had blogged – instead of passing on remarks about incorrect usage (really, how hard is it to cover your nose and mouth?),  how they reduced social distancing and so on.

Imagine, if instead of criticising Asia, we in the UK had taken a steer from them, and implemented face covering for all as well as hand washing and social distancing. I would then have not have been receiving emergency masks from anxious friends in China to give to all of us poor Suffolk people they saw as vulnerable and unprotected.Facemasks


 

Suffolk Care Home Outbreaks

EU compliant PPE sent as a gift to Woodbridge from friends in China. The world has worried about us

Suffolk’s LibDem, Green and Independent group have been  regularly quizzing those in charge of the County’s Social Care and Public Health about  the state of Suffolk care homes. We have been increasingly concerned  about the high proportion of Suffolk Care homes with Covid outbreaks (much higher than in Norfolk or Cambridgeshire).

I first raised the issue of peripatetic care staff back in mid-April.  Does county keep records of carers and other staff moving between different care locations?  My concern was that carers and support staff might unwittingly spread infection between these locations.  If you only test people with symptoms (and then only those in hospital), we were clearly likely to miss out on routes of transmission.
The answer? No records were kept:  that infection  control is managed best  through proper use of PPE . It was therefore more effective to monitor use of PPE rather than monitor staff movements, I was told.
But of course the advice to care homes  was to rely on handwashing and professionalism in most situations. Minimal  PPE was required, unless Covid-19 had been diagnosed.  And tests only happened in hospital. So what sort of answer was that?
Again – as with mask usage – it seems that there has been a desire at all levels to confuse the issue of infection and transmission –  and to assert that handwashing and professionalism  is  enough of a defence against coronavirus, no matter where peripatetic staff  may travel in the course of a day.
Now I do not question for one moment the professionalism. I absolutely believe in the handwashing. But there has been an abnormally high  level of outbreak in Suffolk care homes. Clearly we needed more.
Today my group has taken our outrage to the press:
 
“Failing to test patients being discharged from hospital, and then placing these patients into care homes, is irresponsible beyond belief. We are very concerned that this occurred in Suffolk, and that this seems to account for the much higher proportion of Suffolk care homes with outbreaks compared to Norfolk and Cambridge,.”
“Even if this was allowed by national policy, the CCGs did not themselves consider the risks to our care home residents. Their decision to block-book beds in care homes to facilitate the discharge of patients from hospital is equally to blame.
“Care homes have been the hidden crisis of this pandemic. It is shocking  that elderly care home residents, who are in the high-risk category and should have been fiercely protected by the authorities, have instead been exposed to the virus.
The risks to care homes were clear from countries like Italy, and yet this Government failed to learn from their experiences and instead put care homes directly into danger by allowing hospitals to discharge potentially infectious patients.”
In Suffolk we didn’t do nearly enough to stop this.

Dominic Cummings and Staying Home

 


26 May 2020

Dear Dr Coffey,

I wish to express my concern at the clear rift that is emerging between our government’s guidance on lockdown – especially as it gradually eases – and the strangely defensive attitude that senior members of the government are very publicly taking to Mr Dominic Cummings’ breach of this same guidance.
Surely, in a case of pandemic and lockdown, we really are “all in this together”.
As a shielded carer, I have not been able to see my significantly disabled daughter for eight whole weeks. (Since then I have seen her briefly, while masked). My anxiety has been extreme.
My husband, whose mother is in a care home suffering from vascular dementia, has had the triple whammy of only being able to contact her by phone for the whole of the same two months, knowing that she is lonely because his multiple daily calls do not register with her, and fearing for her safety within the home. His anxiety has also been extreme.
However we have both obeyed the governmental rules created (in part) by Mr Cummings because we believe in a common good and are prepared to play our part.
We are one family amongst thousands that you represent. There must be thousands of similar stories in Suffolk Coastal.
Mr Cummings’ behaviour and excuses – but more particularly, the clear desire of many in the government to believe and excuse him, diminishes the sacrifices of us all.
I feel that his attitude makes a mockery of the massive effort that this pandemic requires from the people of Britain. Please could you tell me whether we really are “all in this together,” or whether there are exceptions?
Sincerely
Caroline Page