Of the 1 431 patients discharged to care homes did any cause the outbreaks there?

The Herald, today, report official figures indicating 1 431 patients were discharged out of hospitals into care homes.

Scotland’s MSM and opposition parties are desperate to link the discharges, Scottish Government testing policy and the deaths together but the evidence is not there.

We know that, until mid-April, some were admitted without having been tested. All would, of course, have been assessed by a doctor beforehand for suitability to be discharged. While some may have been infected but asymptomatic, we know that testing of this group is unreliable.

Care homes were expected to isolate new arrivals so symptoms would have had time to emerge before further integration.

Since then, some still awaited the results of a second test when admitted. All had had one negative test.

Tony Banks, owner of multiple care homes claims:

“In at least one of our care homes we can directly attribute the first positive cases of Covid-19 to a new admission from hospital.”

https://news.stv.tv/politics/scottish-government-betrayed-care-homes-during-covid-19

I can find not one single report of a care home resident whose second test result was positive. I can find no reliable report of an outbreak being linked, with evidence, to the arrival of a discharged hospital patient.

Given what we know about the Skye care home case and the evidence from a large Public Health England study, the outbreaks in care homes were due to temporary care workers.

https://www.theguardian.com/world/2020/may/18/agency-staff-were-spreading-covid-19-between-care-homes-phe-found-in-april

13 thoughts on “Of the 1 431 patients discharged to care homes did any cause the outbreaks there?”

  1. “”Given what we know about the Skye care home case and the evidence from a large Public Health England study, the outbreaks in care homes were due to temporary care workers.””

    The evidence does not support such a sweeping statement laying all the blame on the care workers. Certainly the peripatetic nature of the deployment of staff would have carried infection from home to home within a Care Group..
    This movement of staff may have increased as the infection took its toll on staff and staffing levels reductions at a time when a full compliment was required.

    The outbreaks in Care Homes had multiple causes including the possibility of some of the patients from hospital having the virus.

    In the very early stages family visits cannot be discounted as a source of some infections. How many had been on holiday in Italy and Spain in February then went to visit their elderly relatives when they came home?

    Patients were supposed to be isolated for 14 days when transferred. During that period stringent procedures should have been in place to stop cross-infections. The stringency would depend on the staff being adequately trained and present in adequate numbers. Even later when testing of the patients prior to transfer did not make for a foolproof system mainly due to the low specificity and sensitivity of the test used and thus a relatively high rate of false negatives.

    One of the other likely causes is the chronic underfunding of the private care homes because the owners were more interested in profit than adequate levels of staffing and training for them. This may in fact underpin all the other causes

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    1. Thanks, Legerwood, for that informed piece, giving a sense of proportion and perspective.

      The MSM sensationalised this via a ‘leak’ from a ‘whistleblower’ at Gartnavel Hospital in Glasgow, which was reported in lurid terms, as if this had been a cynically calculated clearing out of mainly elderly patients. And, of course, ‘whistleblowers’ always tell the truth and do not have agendas????? (For the record, on balance, I approve of whistleblowing, and, in the main, it is done by decent people for altruistic reasons. However, it is the nature of our partisan media that they will sensationalise it.

      The impression being transmitted was that it was this wholesale clear out that caused the deaths in care homes and, of course, the unionist parties and some left wing commentators seized on this.

      In his interview on Good Morning Scotland on 1, June, Mr Tony Banks actually justified the reasons for the transfer, because the priority at the time was to prevent the NHS being overwhelmed.

      Of course, once things have settled, there will have to be a proper examination of how we as a community, including Government, NHS, Care sector, etc responded to this and identify lessons to be learned for the future. Of course, the MSM will ‘mine’ the findings to find someone to BLAME. And, as we all know, once someone has been blamed , then the problem has been solved. (Irony!!!)

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  2. Perhaps the journos need to be asking who ran the care homes in which excess deaths occurred.
    Were they run by the local authority, by a charity, by a UK registered company, by an off-shore company? Were these actually care homes or were they nursing homes?
    The journos might also like to ask how many discharges were to private/personal residences, how many of those were sheltered housing, what discharge care packages were put in place ( and who delivered these…private provision, private funded provision, social work, community nursing, etc).

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  3. All in all Coronavirus is a very difficult, deadly contagion for public health bodies and governments to deal with as many different countries across the developed world have found. Opting to take different approaches, or to take similar actions at different times may have resulted in more or less successful public health responses – as commonly judged after the event – but probably never without some tragic (and perhaps sadly, inevitable) failures and mistakes.

    International and scientific ‘perspective’ is needed urgently for sober, serious evaluation and learning: it’s certainly needed by opposition politicians and commentators in Scotland

    There is a report in The Guardian today on expert evidence given to a House of Lords Committee investigating Covid-19 and the UK’s response.

    https://www.theguardian.com/world/2020/jun/02/covid-19-spilling-out-of-hospitals-and-care-homes-says-uk-expert

    Professor Neil Ferguson, Imperial College London (former SAGE member) told the Committee this which is of relevance to, among other things, the ‘ground-zero NIKE’ claim:

    “One thing the genetic data is showing us now is most chains of transmission still existing in the UK originated from Spain, to some extent Italy,” He added: “It is clear that before we were even in a position to measure it, before surveillance systems were even set up, there were many hundreds, if not thousands, of individuals coming into the country in late February and early March from that area. And that meant that the epidemic was further ahead than we had anticipated.”

    And on a cautionary, presumably an informed and realistic note regarding test and trace : “…. was not a panacea” because it relied not only on what proportion of people developed symptoms, but what proportion could identify past contacts, how quickly they could be contacted, and how many then abided by the self-isolation rules. He told the hearing that if the system worked perfectly, it might at best reduce R by 0.2 to 0.25, describing that as “significant, but not huge”.’

    The cautionary remarks on test and trace also included this as reported by The Guardian: ‘The tests would be offered to people with symptoms, but since many people were infectious before feeling ill, and many never show symptoms at all, the system would have only limited use, the committee heard.’

    “By the time someone shows symptoms they have probably been infectious for a day or two,” said Adam Kucharski, an associate professor and infectious disease modeller at the London School of Hygiene and Tropical Medicine. “As soon as someone becomes symptomatic, you have a very short time window before their contacts may become infectious and then you’ve got another generation of transmission to deal with.”

    All in all – to repeat – Coronavirus is a very difficult, deadly contagion for public health bodies and governments to deal with …. even now, never mind at the start of the pandemic!

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  4. Whatever the source of infection it was equally applicable to all of the UK as was low testing capabilities, so why the Scotland focus ?
    If memory serves, the UK’s emergency Coronirus legislation spelled out the decanting of elderly patients, with or without tests, whether the patients came from those homes or not, no ifs no buts, period…
    I get the uneasy feeling that the home-care industry is bricking it over being royally sued for negligence, which is what has been driving this, hence trying everything to pass the buck to SG with able assistance from the usual suspects and WM for political reasons….

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    1. Scotland is the focus because the main stream media in Scotland and the unionist parties fear that the SG is being perceived as managing the epidemic pretty well and has gained the trust of the public, including a majority of unionist voters. The performance of the SG stands in marked contrast to the dire performance of the Westminster Government. So, they feel they must attack the SG in any way they can in case too many voters start to think that Scotland CAN run its own affairs.

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      1. The question was tongue in cheek Alasdair, but I very much suspect it has been shouted at media broadcasts across all Scotland (and farther afield) increasingly over the past few months.

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  5. Effectiveness of infection control measures is dependent upon a number of factors and a combination of strategies with the most significant being:
    – Hand hygiene – Access to hand hygiene facilities at the workspace, in addition to use of four or more of the WHO multi-modal strategy generally improve adherence to hand hygiene measures
    – Environmental decontamination – Daily cleaning of most touched surfaces and weekly deep clean
    – Staff rotation – Allocating staff to one facility consistently may reduce spread across several locations
    – Visitors – Restricting visitation to only emergency/critical cases
    – Testing – Creates rapid response in placing added measures to contain and prevent further spread

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    1. For info: HC-One care homes’ own data on Covid-19:

      Source: https://www.hc-one.co.uk/Our-News/Corporate-News/HC-One-COVID-19-cases-and-loss-of-life.aspx

      “As of 1st June 2020:

      5,487 suspected or confirmed cases of COVID-19 to date

      976 Residents who have sadly passed away in our homes with suspected or confirmed COVID-19 to date”

      The source gives the same data for their homes in Scotland:

      “1,116 suspected or confirmed cases of COVID-19 to date

      218 Residents who have sadly passed away in our homes with suspected or confirmed COVID-19 to date”

      All numbers are cumulative since the start of the UK COVID-19 outbreak.

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