Author Topic: Care homes and testing  (Read 783 times)

Zetetic

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Care homes and testing
« on: May 22, 2020, 06:23:18 PM »
Of 33,000 or deaths where COVID-19 appears on the death certificate, in England and Wales in March and April, about 12,500 were care home residents. That's getting on for about 40% of COVID-19 deaths[1] and over 25% of care home deaths from all causes. About 9,000 of those deaths took place in care homes (rather than after admission to hospital).

I don't really understand how testing more would have prevented this, given:
 - Sensitivity of testing is looking increasingly poor, particularly if you're interested in asymptomatic transmission.
 - Anyone who's been discharged from hospital, or who is symptomatic, or who has come into extended contact with people who have it without protection should be assumed to have it for the purposes of isolation etc. regardless of a negative test result.
 - The most a negative result might have done, is get some people back to work slightly sooner, and maybe some residents out of isolation slightly sooner.

What might have reduced this:
 - Rapid and reliable access to PPE.
 - Consistent, understandable advice about preventing cross-infection, including clear advice on who you treat as contagious and for how long.

For context, I don't believe hospitals were discharging to care home because they thought the increased body count would be a laugh, but because they were trying to ensure they had capacity for a higher peak.

Where am I going wrong? What I am misunderstanding?
 1. Noting undercounting in death certification in some parts of the UK.

Al Tha Funkee Homosapien

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Re: Care homes and testing
« Reply #1 on: May 22, 2020, 09:04:03 PM »
It's unfortunate, but going into a care home is a cardinal event (as you obviously know as a far cleverer person than me), the average life span of those going into a care home is between 1.3-2 years (from a quick google research). I'm not sure much more could have been done for these people. They had a statistically high chance of dying within the next 12 months, its just that they've all died within the space of a few weeks.

I've been in a few care homes recently that have been absolutely devastated by COVID-19, and the staff seemed completely broken by the experience. Whereas some have had very few to no cases at all. I couldn't honestly say what separated the two groups.

Re: Care homes and testing
« Reply #2 on: May 22, 2020, 09:05:53 PM »
It's unfortunate, but going into a care home is a cardinal event (as you obviously know as a far cleverer person than me), the average life span of those going into a care home is between 1.3-2 years (from a quick google research). I'm not sure much more could have been done for these people. They had a statistically high chance of dying within the next 12 months, its just that they've all died within the space of a few weeks.

I've been in a few care homes recently that have been absolutely devastated by COVID-19, and the staff seemed completely broken by the experience. Whereas some have had very few to no cases at all. I couldn't honestly say what separated the two groups.

Region?

Al Tha Funkee Homosapien

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Re: Care homes and testing
« Reply #3 on: May 22, 2020, 09:07:44 PM »
Region?

Somewhere in the South of England.

Mr Eggs

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Re: Care homes and testing
« Reply #4 on: May 23, 2020, 02:36:09 PM »
Of 33,000 or deaths where COVID-19 appears on the death certificate,

We're getting people coming into the crematorium with POSSIBLE COVID written on the notes we receive from the funeral directors.

I think everything is a bit shaky at the moment.

Zetetic

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Re: Care homes and testing
« Reply #5 on: May 23, 2020, 03:44:01 PM »
I'd imagine you're treating most corpses with a degree of suspicion right now.

shiftwork2

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Re: Care homes and testing
« Reply #6 on: May 23, 2020, 03:47:00 PM »
Did you lose your girlfriend to an Englishman?

Zetetic

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Re: Care homes and testing
« Reply #7 on: May 23, 2020, 03:52:02 PM »
Wrong thread?

When I say "corpses", I don't just mean English corpses to be clear[1]
 1. Although an English corpse is more likely to be COVID-19-riddled, I believe.

shiftwork2

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Re: Care homes and testing
« Reply #8 on: May 23, 2020, 03:53:11 PM »
We're getting people coming into the crematorium with POSSIBLE COVID written on the notes we receive from the funeral directors.

I think everything is a bit shaky at the moment.

Around half of our inpatients are suspected hot at the moment.  It's a clinical call.  We get them for lung ventilation scans and they're all clinically positive (short of breath, well, yes they would be) and swab negative.  So it's visors and gowns and FFP3 and while it's a precaution, most of it is needless.

Mr Eggs

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Re: Care homes and testing
« Reply #9 on: May 23, 2020, 04:30:31 PM »
I'd imagine you're treating most corpses with a degree of suspicion right now.

Had an old bloke in called Adolph the other day.

Around half of our inpatients are suspected hot at the moment.  It's a clinical call.  We get them for lung ventilation scans and they're all clinically positive (short of breath, well, yes they would be) and swab negative.  So it's visors and gowns and FFP3 and while it's a precaution, most of it is needless.

If the paperwork has a care home address on it, we assume its a covid. 

shiftwork2

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Re: Care homes and testing
« Reply #10 on: May 23, 2020, 04:42:45 PM »
Would you mind telling us how you're treating them and the cremated remains differently?  Are you in full hazmat?

Mr Eggs

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Re: Care homes and testing
« Reply #11 on: May 23, 2020, 05:56:31 PM »
We are doing what we can. Bear in mind one of us is front of house in a suit to meet the casket and the funeral directors on entry to the Chapel. He wears black latex gloves.

With dimples on them.

Birdie

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Re: Care homes and testing
« Reply #12 on: May 25, 2020, 09:03:23 AM »
We are doing what we can. Bear in mind one of us is front of house in a suit to meet the casket and the funeral directors on entry to the Chapel. He wears black latex gloves.

With dimples on them.

Awww, like Shirley Temple. Cute.

Re: Care homes and testing
« Reply #13 on: May 28, 2020, 07:11:33 PM »
https://www.itv.com/news/2020-05-28/itv-news-reveals-plans-to-discharge-covid-19-patients-into-care-homes-nhs-coronavirus/

Quote
In response to a question from former health secretary Jeremy Hunt, Boris Johnson said he did not get any advice that discharging hospital patients into care homes could spread coronavirus.

That's alright then.

It's only a pandemic Boris, I'm sure it'll be fine. They're only the most vulnerable group in society.

Re: Care homes and testing
« Reply #14 on: May 28, 2020, 07:38:25 PM »
This is no change in policy to the genocide they've already committed.

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