The ABC’s Q&A continues the national conversation about aged care. How did it go so wrong?
Australia’s national broadcaster has once again shone the spotlight on aged care, illuminating the longstanding problems in the sector that have contributed to the current crisis unfolding in Victoria, and delivering on-the-ground insights from clinical experts.
The panel on Monday’s Q&A consisted of two GPs, a respiratory specialist and a registered nurse.
Lucy Morgan, a respiratory physician at Nepean Hospital, said the healthcare workforce has been “decimated” by COVID-19.
A total of 1,195 healthcare workers have now contracted the virus, with 706 cases still active. Eleven per cent of COVID-19 cases across Australia are healthcare workers in Victoria.
Dr Morgan said she is seeing her COVID-19 patients experience a “post-viral syndrome”, suffering ongoing fatigue, depression, anxiety, joint pain and headaches that can mean they are away from work for “a very long time”.
“If you’re a nurse or a nurse’s aid or any sort of clinician, any healthcare worker who catches the infection, you are out of the workplace, off the front line, for a very long time.”
“If you have been in intensive care, it is weeks and weeks and weeks and weeks before you would feel well enough (to return to work),” she said.
The post viral syndrome is “so significant, that returning to the workplace is almost impossible,” Dr Morgan said.
Precautionary responses should be have been taken
The panel also heard from two guests, both of whom had mothers who contracted COVID-19 while living in residential aged care. Tragically, Spiros Vasilakis’s mother died. Christine Golding’s mother was moved out of St Basil’s and into a different aged care facility, where she is doing better.
Ms Golding asked the panel why there was no overarching plan to protect aged care residents considering what was known about the danger in aged care facilities from the experiences overseas.
Kerryn Phelps, Former AMA President, GP and City of Sydney councillor, said a “precautionary” response should have been taken in aged care homes.
“There should have been a preparedness audit of aged care homes as soon as we knew there was a COVID-19 outbreak in Australia because it was so predictable that aged care would be a vulnerable sector, and indeed it has been,” Dr Phelps said.
Training in infection control should have been undertaken and PPE provided. “Yet it didn’t happen,” she said.
“It should have been something that the aged care sector should have taken on right from the start,” Dr Phelps said.
Lessons were learnt from Newmarch
Despite claims that more should have been learnt from earlier outbreaks in aged care homes, Dr Morgan said “important lessons” were learned from the Newmarch outbreak in Sydney.
One lesson was that outbreaks in aged care facilities can be contained, she said. The time from the first case to the last case was 18 days, Dr Morgan said, which was “pretty amazing”.
There were issues around PPE, but there was also a “major outbreak” among staff, she said.
Staff were “unwittingly, absolutely unwittingly” spreading COVID-19 between each other, not in the delivery of care, but before work, in their lunch breaks, and after work.
“When they took their PPE off, they shared a meal, or they shared public transport going home. They shared a drink to recover from the day’s trauma,” Dr Morgan said.
“Lots of patients died, and that’s very very sad, but lots of patients recovered and some of those who recovered were well into their 90s,” she said.
Intractable workforce problems in aged care remain
The panel turned its attention to Professor John Pollaers’s aged care workforce report, from which none of the 14 recommendations have been implemented by the government.
Ged Kearney, Shadow Assistant Minister for Aged Care, said the aged care workforce is “completely disempowered”. Aged care workers have no voice, their work is unstable and insecure, and they often have to work across facilities to make ends meet.
She said it is well known the aged care workforce is understaffed, inadequately skilled and does not receive enough support from doctors, nurses or allied health workers.
Ms Kearney also said there is a lack of accountability and transparency for the $20 billion worth of government funding that goes into aged care.
“The public… has a right to know that every single cent goes on care,” she said.
Where to from here?
Dr Morgan said COVID-19 means we can’t live the life we used to, and that is a “confronting” truth.
She said there is a certain amount of ‘COVID-19 fatigue’ that comes from thinking about the virus “constantly”, and that is affecting “all Australians, even our kids”.
“Yes, it’s confronting. Yes, it’s never going to be the same,” she said.
Image: aetb, iStock.