Staffing ‘crisis’ could see exposed aged care employees return to work

Staffing ‘crisis’ could see exposed aged care employees return to work

01/02/2022

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Aged care workers who are close contacts of COVID-19 cases could be rostered back at work with no isolation period as families express frustration that rising case numbers will leave loved ones in endless facility lockdowns.

Federal government data shows there are more than 1180 COVID-positive aged care residents across Australia, including more than 550 each in NSW and Victoria.

The aged care industry says rising COVID-19 cases have presented a staffing ‘crisis’.Credit:Virginia Star

On Saturday, the federal health authorities published interim guidance on managing aged care workforce shortages caused by high rates of COVID-19 in the community.

The framework, approved by federal Chief Medical Officer Paul Kelly, recommends aged care facilities return workers who are close contacts of a COVID-19 case to work with no isolation period when staff shortages cause a “high impact” on services.

A similar policy was announced for NSW Health staff identified as close contacts on Friday evening, after more than 2000 healthcare workers were furloughed by virus exposures.

Under the framework, aged care workers would return to facilities while close contacts must still self-isolate when not at work. They must have a PCR test followed by rapid antigen tests every 72 hours during work periods, and will wear additional personal protection equipment.

The same measures can be applied to staff exposed in an outbreak within a facility, provided there is a high impact on services. Aged care facilities usually rely on agency staff when large numbers of permanent staff are furloughed in an outbreak.

However, individual jurisdictions may implement additional requirements above the recommendations and it is ultimately local public health units which determine how individual aged care outbreaks are managed.

In NSW, aged care staff, who are required to have received two doses of a COVID-19 vaccine to work, must not return to work for 14 days if identified as a close contact. Victoria currently requires fully vaccinated staff to stay away from aged care facilities for seven days after a COVID-19 exposure.

In a statement, NSW Health said it was “working with the Commonwealth to ensure consistency and clarity of guidelines for workers in NSW residential aged care facilities who have been exposed to COVID-19”. The Victorian Department of Health were contacted for comment.

Paul Sadler, CEO of Aged and Community Services Australia, said there was currently a “staffing crisis” in the sector with staff furloughed due to COVID-19 and it was “sad but necessary” to keep staff who had potentially been exposed to the virus at work.

“It is probably not ideal, but the reality with the staff coverage aged care has at the moment is we need to provide continuity of care to residents,” he said.

“We need to keep risks to a minimum but you don’t want a situation like at St Basil’s [Homes for the Aged during Melbourne’s 2020 wave] where all staff have been furloughed and the available workforce is not really trained to the needs of the residents.”

The industry group is calling for national cabinet to adopt a universal approach to furloughing staff when it meets this Wednesday.

Meanwhile, families of aged care residents say providers need to respond to COVID-19 exposures with measures other than facility lockdowns as cases soar across the country, increasing the likelihood that someone recently on site will have had the virus.

Daniel Virgili flew from London to Sydney to spent time with his 91-year-old mother, who has end-of-life lung disease and has suffered multiple strokes.

He had been visiting her daily but on December 27 he learnt her aged care home had been shut for a week because a staff member had caught COVID-19 in the community.

Mr Virgili said his mother had also spent Christmas 2020 shut inside, and he was frustrated that the system seemed worse for residents and families than in the UK, where millions more cases have been recorded.

“They just lock these places down here,” he said.

The daughter of a Melbourne aged care resident, who did not want her name published because it was a small facility, said her mother had been in lockdown several times since restrictions were eased for the rest of the community.

In her facility’s first exposure, two staff members tested positive and there was onward transmission to residents. However, subsequent lockdowns were triggered when contractors who had been on-site tested positive, although this did not lead to cases in residents.

“It really is taking a toll on these older people,” she said. “[My mother] is pretty resilient, she’s a pretty alert lady – but still I think she’s not quite as good after each bout.”

She said there needed to be a more nuanced approach to lockdowns, noting her mother and most other residents were triple vaccinated.

“What’s the point of locking families out, when there are still staff and contractors who are bringing it in?”

In mid-December more than 100 Australian aged care facilities had active outbreaks. Mr Sadler said “everything would suggest” that figure had increased significantly, but federal authorities had not issued a more recent weekly report.

Mr Sadler said he understood the frustrations of families but often facilitating safe visits during high periods of community transmission, which could involve requirements including rapid antigen testing and personal protection equipment, required significant staff involvement and there was a need to protect the vulnerable from the virus.

In NSW over the past week, six aged care residents have died with COVID-19, including two at the large Lilian Wells North Parramatta outbreak, where cases have been genomically sequenced as having the Omicron variant.

The number of people hospitalised with COVID-19 in NSW reached 1066 on Sunday, including 83 people in intensive care.

Although the hospitalisation rate of the state’s Omicron wave is lower than in the Delta wave, the number of beds is fast approaching the state’s peak of 1266 virus hospitalisations in mid-September.

There were 18,278 new cases reported in the state, with about one in five PCR tests processed in the 24 hours to 8pm Saturday returning a positive result indicating a significant number of cases are not being caught by testing.

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