If there is one message I have taken away from meeting care home owners, nurses and support staff this week it is that they are desperate for coronavirus tests.
Without tests, nursing homes have no idea who has coronavirus and who has not. And this unknown is proving deadly.
The virus is now spreading through nursing homes like wild fire and killing the most frail in its wake.
Earlier this weekend, I spent 12 hours in a care home where COVID-19 is rife. In just two weeks, upwards of 40 residents have caught the virus. Eight have sadly died. One nurse said this was just the beginning.
Staff had flimsy plastic aprons and unsuitable masks. They were worried.
On Sunday, Health Secretary Matt Hancock was upbeat in his assessment of how the NHS is coping. But his optimism is not shared by those in social care.
And to understand why care homes matter, you have to understand how they fit into the healthcare chain.
An awful lot of care homes act as overflows for hospitals.
When hospital wards get full, nursing homes get paid to provide beds to take the strain.
These beds are called ‘intermediate care’ beds and the NHS can’t fill them quickly enough at the moment.
In fact, earlier this month the NHS contacted some of the biggest care providers and told them to block book all of their intermediate care beds for the next 12 weeks – effectively extending the usual period covering the annual winter crisis well into the spring in case COVID-19 was as bad as feared.
That might not be a problem if care managers knew whether those coming from hospital had COVID-19 or not. But that’s not always the case.
Care home managers have told me that more and more patients are coming to them from hospitals without having been tested for COVID-19 and that is contributing to increased infection rates among staff and residents.
Residents need more care while staff sickness rates sky rocket and that’s a deadly combination.
Pam Banwait is a director at Strong Life Care, a care home provider with sites in Yorkshire and Nottinghamshire.
The company currently looks after 200 elderly residents that require residential and dementia care and employs 250 staff.
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Residents are displaying symptoms of COVID-19 but the company has no tests, and so can’t say for sure who needs protecting.
Ms Banwait said: “We need to test. I cannot reinforce that enough. We need to know if they have got the virus and we can only do that with tests. They need to be made as available as possible.
“Even though we’ve been in lockdown for three weeks, we run the risk of importing COVID-19 into our homes without us knowing it and that could ultimately cost lives.”
Another care manager, who wanted to remain anonymous, said: “They are not routinely testing patients before they are discharged to a care home. I have been personally informed it is not required.
“I have also been informed that residents will not be admitted to hospital.
“They are being given what can only be described as a death sentence.”
Another care worker emailed: “I work in a care home and they’ve just had a resident sent home from hospital without being tested for COVID-19 and told to isolate the person.
“We can’t test to see if the carers have it so we can’t make informed decisions about who should be protected. They’ve run out of hand gel as well as PPE.”
At the moment, some patients leaving hospital are tested.
For example, if they’ve been in a critical care ward or have been treated for pneumonia. But the vast majority of patients are not tested.
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I asked the health secretary if he could guarantee across the board that tests would be made available.
He said: “I can. They are coming. Last week we were able to open up testing to staff in care homes.
“Some of the most vulnerable live in care homes and especially nursing homes and therefore getting this right is so important.”
As each day passes, the numbers of staff and residents getting infected with COVID-19 are steadily rising.
Many more elderly and frail will die and it is likely that those caring for them may also lose their lives to this virus.
The big problem for the government is that it cannot get its hands on enough testing kits. They are in short supply.
The truth is, they’ll be handed out to those who need them the most.
And the elderly run the risk of ending up at the back of the queue.