Vaccine victory won’t quell care conundrum

In normal times, care homes are occasionally forced to shut their doors to visitors. Every winter, when the flu season comes around, children, siblings and partners patiently wait to see their loved ones again, comforted by the knowledge that brief isolation is the best way of containing the virus and preventing excessive deaths.

In 2020, lockdowns have been anything but brief. Many of the care homes that closed their doors in March have still not yet reopened, as the government works to shield society’s most vulnerable from Covid-19. The illness triggered by the SARS-CoV-2 virus causes more devastating symptoms in the elderly and unwell than the young and healthy. Just under 20,000 of the 58,000 Britons reported to have died with Covid-19 this year were living in care homes.

These figures support the idea that protection of care home residents is a crucial step to controlling the pandemic in the UK. But they fail to depict the loneliness of a care home in lockdown. “My 88-year-old mum has dementia and is fading away from lack of family contact,” reads one comment on a campaign lobbying the government to remove blanket bans on care home visits. “The denial of basic human rights to care home residents is an immoral scandal,” says another.

The nation’s elderly (many of whom have dementia) and mentally ill do not understand why their families have stopped visiting them. Shielding them from the dangers of coronavirus by excluding them from society completely is not a long-term solution. That is why the government has stepped up its efforts to regularly and rapidly test care home residents and staff in order to “allow visits in all care homes by Christmas”.

Novacyt (NCYT) is one of the companies working on rapid testing kits for care homes. In an update this week, the company’s directors said that 98 per cent of the 4,000 samples in a study were processed and reported within one day. Omega Diagnostics (ODX) is also flying the flag for the UK’s smaller companies with its diagnostics kit which is said to be able to deliver results within 10 minutes. A team running a trial at the University of Nottingham has called rapid testing “a game changer” for vulnerable people – if care home staff can carry out accurate tests themselves, it will make it easier for relatives to visit care home residents isolated during the pandemic.

Despite broad concerns about the accuracy of existing Covid tests, there is no denying that testing has come a long way since the first outbreak of coronavirus when “there was a lot of confusion from policy makers on how care was going to be affected”, according to John Ivers, chief operating officer of CareTech (CTCH). The listed company, which runs adult and children’s care services and employs 10,000 staff members, has now completed 11,000 staff tests. “We’re benefiting from more available testing,” says Mr Ivers, who is confident that the company is now able to identify and isolate coronavirus rapidly.

But testing is still only an interim solution and to quash the levels of circulating virus, vaccination is currently perceived to be the biggest hope. US group Moderna (US:MRNA) recently reported positive vaccine trial results, while Pfizer (US:PFE) has added to its strong initial findings with the announcement that its vaccine is 94 per cent effective in adults over the age of 65. Both studies will continue reporting over the coming months, but global governments are already stocking up. In the UK, the department for business said that it had secured 5m doses of Moderna’s vaccine, to add to the 350m doses of vaccine being developed by other companies, including Pfizer, AstraZeneca (AZN) and Johnson & Johnson (US:JNJ).

Mr Ivers is confident that “there is going to be a process for the vaccination”, meaning care homes will probably be at the front of the queue. CareTech is building a strategy to make sure as many of its staff and residents as possible can be vaccinated when a product is approved. But there is still a long way to go until that time comes. Neither Pfizer or Moderna’s vaccine has yet been tested in vulnerable populations – those who most need protecting from the virus. Indeed, vaccines don’t tend to work especially well in populations with compromised immune systems.

While the care sector is being propped up by surplus government funding (£3.2bn of extra cash has been available through local councils this year) and goodwill among citizens, care providers are managing to keep their heads above water. But the sector was in difficultly before coronavirus arrived – strained budgets and repeated spikes of a deadly virus darken the outlook even more. Vaccination is not a silver bullet and nor is shielding or testing. The nation’s care sector needs a more radical tonic to survive in a Covid-world.