Rosewood residents relocated, isolated
Staffing headaches prompt the relocation of some Christchurch rest home residents. David Williams reports
As the third death was announced yesterday from the Rosewood coronavirus cluster, some residents still at the Christchurch rest home were being moved to other facilities.
On Monday of last week, 20 residents of the rest home’s dementia unit were relocated to an isolated part of Burwood Hospital, leaving 44 residents at the facility in Linwood, just east of the central city.
At that point there were 16 confirmed and probable cases among Rosewood residents and staff. By yesterday, that number had risen to 33, with 18 being staff members.
Of the 20 residents who were transferred to Burwood, three have died and 10 are confirmed or probable cases. The director-general of health, Dr Ashley Bloomfield, has warned there may be more deaths or serious illnesses among that group.
Healthcare workers and other people connected to the Rosewood cluster are expected to be tested in the coming days.
Sue Nightingale, Canterbury District Health Board’s Covid-19 incident controller, says while the moves from Rosewood are underway, a precise number of residents still at the facility can’t be given. “None of the residents remaining there has tested positive.”
“The real problem with Rosewood was the fact that they had to isolate virtually all the staff.” – Simon Wallace
Aged Care Association chief executive Simon Wallace is more forthcoming. He says there are 20 “hospital-level” residents still at Rosewood. By yesterday afternoon, six had been moved to other facilities in Christchurch, six more are leaving but haven’t shifted yet, and the other eight will stay.
Twenty-four others he describes as “rest-home-level” residents will also remain at Rosewood.
Nightingale says all relocated residents have been tested for Covid-19 and were negative. For the first 14 days at the new facility, they’ll be isolated, and staff caring for them will wear full protective equipment (PPE).
Wallace says his association’s preference is for people to stay in their home facility but the district health board was between a rock and a hard place.
“The real problem with Rosewood was the fact that they had to isolate virtually all the staff. And they couldn’t find replacement staff from the DHB.”
It’s a sad and tragic situation for the families of the three people who have died, Wallace says, especially because they couldn’t be with their loved ones at the end of their lives.
Three deaths are three too many, he says – but given there are about 35,000 aged care residents across the country “actually we’re not doing a bad job”.
(Nationally, there have been five deaths from Covid-19, with 798 active cases yesterday. Fifteen people are in hospital, with four in intensive care.)
Of the 15 significant Covid-19 clusters, four are rest homes – two of them in Christchurch, the other being George Manning Lifecare and Village in Spreydon.
On Sunday, Bloomfield said: “With the clusters that have broken out, there were some deficiencies in the actual procedures and how those were being implemented.”
Prime Minister Jacinda Ardern said yesterday rest home residents are some of the most vulnerable members of the community. “There are clear expectations on how people should be managing their facilities while we are battling Covid-19, and the Director-General has asked that these specifically be checked to ensure that they are meeting our expectations.”
Wallace defends his sector. “We have a huge amount of admiration and respect for the work that Ashley Bloomfield and the Ministry are doing. And we work very closely with them – but it is a stretch to talk about deficiencies in regard to all rest homes. There aren’t deficiencies.
“We have the very best protection and control procedures, but even with the right use of PPE and all the other precautions that are in place around hygiene, it’s not fail-safe.”
The “fail-safe” reference echoes comments made by Bloomfield yesterday, who was referring to a nurse at Burwood Hospital, caring for the relocated Rosewood residents, who has tested positive for the virus.
Test, test, test
There seems to be a gulf between the Ministry and the aged care sector over testing for Covid-19.
Bloomfield said yesterday there were no specific plans to test particular workers, like those in healthcare or supermarkets, to get a better idea of the spread of the virus.
“The extent of the testing we have got, particularly where we’re getting positivity rates around 1 or 2 percent, it’s not just giving us a picture of whether we have clinical cases, it is giving us quite a good picture of whether there is wider infection in the community.”
Wallace’s association has already called for new rest home residents to be tested before they arrive. Now he says testing should extend to frontline aged care workers – the nurses and caregivers.
“We’re steadfast in our position on that and we’re working hard with the Ministry to get it across the line. Ours is not a science-based or a clinical position; it’s one that’s about reassurance for families, it’s about confidence in what we do, and it’s responding to what our members are saying.
“We don’t think it’s unreasonable given the capacity that there is for testing that’s not being fully utilised.”
The Health Ministry had received advice in recent days about “surveillance testing” – essentially random sampling across communities to give more confidence about the extent of cases. Bloomfield said that is expected to be done over the next week or two.
Committing to a work bubble
Wallace says some rest home staff are showing exceptional dedication during the Covid-19 crisis by leaving their families and choosing to live at their facility with residents.
But, like in many other essential industries, there are huge staffing issues in the aged care sector, beyond having to to self-isolate when an outbreak is identified. Childcare is continuing to disrupt the work of some staff, he says, as issues with public transport.
There’s also quite a number of over-70s in the aged care sector, who can’t enter rest homes because of the risks of the virus to that age group.
“There are staff doing double rosters,” Wallace says. “The DHBs step in and help where they can.”
The Aged Care Association boss says about 30 percent of its workforce, between 5000 and 6000 people, are migrants on some type of work visa. However, conditions of that visa usually tie them to one particular rest home or facility.
“When we get an outbreak we need the ability for those people to be able to move between facilities where the staffing need is greatest. We haven’t got that one over the line with the Government yet.”
Finance Minister Grant Robertson is preparing the country for the coming economic fallout of the pandemic, by saying it’s going to be markedly worse than the global financial crisis. But it’s not as if the newly unemployed can just walk into an aged care facility and start work.
Wallace: “We can’t train tourism people or hospitality people to be caregivers in the space of a few weeks, unfortunately.”
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