ScotGov - Testing Shambles
CORONAVIRUS
Staff were ‘likely source’ of Covid in Scottish care homes
Asymptomatic staff were more likely to have brought coronavirus into care homes than hospital discharges, Public Health Scotland says - Photo EDDIE KEOGH/REUTERS
Care home staff are more likely to have unwittingly caused the huge wave of deaths of elderly residents in April than patients transferred from hospital, government statisticians have found.
A long-awaited report into care home deaths by Public Health Scotland, the Scottish government agency, found “no statistical evidence that hospital discharges were associated with care home outbreaks”.
Staff and professional visitors, such as GPs and external contractors, were more likely to have been the source of infection, Public Health Scotland said.
Care home staff only became eligible for routine testing in mid-May, three weeks after routine testing of hospital patients being discharged into care homes began.
Nicola Sturgeon stressed that staff should not be “blamed” for bringing coronavirus into care homes as they would not have known they were infected without tests. The first minister has yet to deliver on a pledge to test all care home visitors.
Care home visiting was restricted to professional visitors only, so families would not have been the source of infection in March and April.
Nearly half of the 4,482 deaths in Scotland have taken place in care homes. Deaths are rising again, with one fifth of the 226 deaths recorded in the past four weeks taking place in care homes.
The Public Health Scotland report states: “The analysis does not find statistical evidence that hospital discharges of any kind were associated with care home outbreaks.
“We lack consistent data on positive tests from staff working in care homes. This is primarily a result of changing practice in terms of testing. In March and early April, tests were only performed on those being admitted to hospital and testing of care home staff in the community was rare. We therefore have minimal staff data in the period when most outbreaks started, and therefore did not include staff testing in the analysis.
“Although care home size is the strongest predictor of care home outbreaks, we do not have data to explore why this is so. Care home size is a marker for the number of non-residents coming into the care home.
“During Covid-19, this includes staff and professional visitors coming into care homes.”
Ms Sturgeon said she only became aware that people without symptoms could infect others shortly before hospital patient testing was introduced on April 22.
The Times analysed minutes of the Scottish government Covid-19 advisory group, the UK government’s Scientific Advisory Group for Emergencies (Sage) and the World Health Organisation and found a wealth of evidence about asymptomatic transmission from March onwards.
The latest Public Health Scotland report corroborates international findings that about one in five people who tested positive for Covid-19 was asymptomatic.
There were 4,807 patients discharged from care homes between March 1 and May 31. Ages ranged from 19 to 105 years old, with the average being 81.
Three quarters of patients — or 3,599 — were discharged before mandatory testing was introduced. Only one in five was tested for Covid-19 before that date.
More than one in ten patients that did receive a test — 78 out of 650 — was found to have Covid-19. After April 22 the proportion of patients testing positive prior to discharge rose to one in five — 278 out of 1,215.
An NHS source confirmed patients with coronavirus symptoms were “highly unlikely” to have been eligible for discharge. Most of these positive patients — 233 out of 278 — subsequently tested negative prior to discharge after a follow-up test.
Speaking at her daily briefing, the first minister said: “The most significant factor in outbreaks was the size of care home. That is not blaming care homes and it is not blaming staff. It is simply recognising that in bigger care homes there are perhaps more interactions, there’s perhaps more of a risk of community transmission getting into the care home, so we have to think and about how we work with and support larger care homes to better mitigate that.”
She added: “We now do routine weekly testing of care home staff and we plan now to extend that testing to designated visitors to care home and to a wider range of professionals who enter care homes regularly.”
Care Home Testing Shambles (12/10/20)
The Labour MSP Neil Findlay gets to the heart of the matter in this BBC report by highlighting the fact that it took six full days for a care home in West Lothian to be tested for Covid-19.
An incredible 28 staff were still waiting on results of their tests, some of which had been carried out nine days earlier, leaving care home residents and fellow workers vulnerable to infection.
The health minister Jeanne Freeman is reported as saying that the Scottish Government will investigate any issues with testing.
But the issues are staring the Scottish Government in the face - test results are taking far to long to process and not enough priority is being given to protecting the most vulnerable from the threat of Covid-19.
https://www.bbc.com/news/uk-scotland-edinburgh-east-fife-54456819
Covid in Scotland: Test 'shambles' at West Lothian care home
Testing for Covid-19 at a care home hit with an outbreak of the virus is a "shambles", an MSP has claimed.
Labour's Neil Findlay said the first case was detected at Redmill Care Home in West Lothian on 25 September, but it took six days for a whole home testing regime to be organised.
He said 28 staff and 20 residents were awaiting results from tests, some of which were carried out nine days ago.
The health secretary promised to investigate any issues with testing.
The Redmill Care Home in East Whitburn is one of two in the NHS Lothian area currently dealing with Covid clusters.
At Redmill, which is run by HC-One, 55 residents and staff have tested positive, while at Milford House in Edinburgh there have been 31 positive test results.
The health board has said a "small number" of people have died but will not give precise figures because of patient confidentiality.
Worried relatives
Lothians MSP Mr Findlay told Holyrood he had been contacted by both staff and relatives of families at Redmill.
He said: "Today 28 staff are still waiting on results, six staff are waiting on a test.
"Some tests couldn't be given because labels didn't come with kits. Twenty residents are awaiting results, some people have not had results despite being tested on September 28, nine days ago.
"One staff member received three sets of results, one received someone else's results and 20 results were returned negative, but with no information with them as to whom they belonged to."
Mr Findlay continued: "I really hope the same has not happened at Milford House because staff and residents deserve so much better than what appears to be a shambles with the testing regime."
Health Secretary Jeane Freeman gave a breakdown of the cases, saying 37 staff and 18 residents at Redmill Care Home had tested positive while at Milford House 18 staff and 13 residents had received positive test results.
She said Mr Findlay had raised "serious issues", but that this did not tie up with the information she had received about the homes, and she promised to investigate further.
A spokeswoman from HC One said: "We have experienced several challenges with the testing programme at Redmill Care Home, including delays and erroneous results being returned, and detailed this to Mr Findlay earlier today.
"We are very grateful for Mr Findlay's support and the immediate action he has taken to help us resolve these challenges.
"Our priority is to work with all interested parties to make sure that testing is completed in a timely and accurate fashion and that we can collectively tackle this outbreak for the benefit of residents and colleagues."
Nearly half of those who have died with coronavirus in Scotland have died in care homes, according to official figures.
Scottish Government - Testing Shambles (19/10/20)
The Scottish Government tried to pull a fast one on Twitter yesterday by blaming the latest testing shambles on the UK Government Lighthouse network - see tweet below.
Scottish Government @scotgov
Today’s testing data does not represent the total daily number of tests and cases as there has been a processing delay as a result of a capacity issue with the UK Government Lighthouse network, including Glasgow. For more information
https://bit.ly/35d5NKj
ScotGov and Care Homes (29/10/20)
Scottish Ministers are vehemently denying any link between the policy of rapidly discharging hospital patients into Scotland's care homes at the beginning of the Covid epidemic back in March 2020.
The conclusion of a long awaited report (from NHS Scotland) is that there is no statistical evidence to link the rise in care home cases to the discharge of hospital patients.
Yet common sense would tell any reasonable person that welcoming new residents into a care home without knowing that they had tested positive for Covid-19 was a 'disaster waiting to happen'.
Between 1 March and 21 April 2020 only 650 out of the 3,599 hospital patients discharged were actually tested - only 18% of the total - and 78 (12%) of the 650 tested positive for Covid-19.
Between 22 April and 31 May 2020 the situation improved - 1493 out of 1,605 discharges were tested (93%), yet 45 patients were still discharged from hospital into care homes without testing negative for Covid-19 - which sounds like civil servant speak that they were still Covid positive.
See post below dated 28/10/20 and the official NHS Scotland press release.
So all in all a sorry tale and the most amazing thing is that the Scottish Government denies any link to its discharge policy when, in the first wave, a mere 18% of discharged patients were actually tested.
To add insult to injury the Scottish Government is now suggesting that care home staff and professional visitors, such as GPs and external contractors, were more likely to have been the source of infection - yet no statistical evidence whatsoever has produced to back up this theory.
More to follow.
Coronavirus Scotland: Nicola Sturgeon under fire for care home transfers
By David Bol - The Herald
First Minister Nicola Sturgeon
DEMANDS have been made for an urgent public inquiry into the Scottish Government’s “reckless” decision to transfer more than 100 positive coronavirus patients into care homes – with one official admitting that it is “likely that hospital discharges were the source of introduction of infection in a small number of cases”.
Nicola Sturgeon has been told that it is “essential that lessons are urgently learned” after a stark report from Public Health Scotland revealed that 113 people who had tested positive for Covid-19 were discharged from hospitals into care homes between March and May without first receiving a negative result.
