Care home owner fears second Covid-19 surge because test results are too slow

Glyn Williams, outside the Gwyddfor Residential Home which has a three-stage decontamination unit

A worried care home owner fears a failure to ensure that coronavirus test results are available quickly enough will lead to a deadly second surge of the disease.

According to Glyn Williams, the owner of the Gwyddfor Care Home in Bodedern on Anglesey, critical time is being lost because test results are still taking too long to turnround.

Experts say it is vital for test and trace procedures to be completed within 48 hours otherwise it is ineffective but Mr Williams revealed it took nearly 70 hours for the result of a test on a member of his staff to come through last week.

Anglesey was the only county in the north of Wales to be selected to trial the Welsh Government’s Test, Trace and Protect strategy, which involves testing people for coronavirus and then tracing the people they have been in contact with, in a bid to stem the spread of the disease.

Ministers believe effective use of the strategy will be critical to protecting the lives of thousands of people across Wales in the weeks and months ahead.

But care providers say the test and trace system cannot possibly work because all too often tests results were not being returned within 24 or even 48 hours, leaving no time for tracers to do their job.

 

‘Isolate’

As it turned out, Mr Williams revealed the result of the test on his member of staff at Gwyddfor was thankfully negative.

“If it had been a positive there is no way that it would have been possible to break the chain of infection, it would have been far too late to break the chain of infection. To do that you need to trace every contact within 48 hours,” explained Glynn, 57, a former RAF engineer who runs the home with his wife Mary.

“I listened to the evidence of the UK Parliament Health and Social Care Select Committee, chaired by MP Jeremy Hunt, last week. He had a number of professionals giving evidence who explained in simple terms how fast the test and trace system needs to work for it to be effective.

“The scientists tell us it takes 48 hours from when a person becomes symptomatic for that person’s  contacts to pass the infection on to somebody else.

“If we can get the test turned around within 24 hours that leaves the contact tracers with another 24 hours to contact everyone who is a potential contact of that person and get their agreement to isolate. One thing that doesn’t help in North Wales is that the majority of tests from the region have to be couriered to Cardiff.

“My experience in Wales is that not very many of them are turned around within 24 hours. I referred a member of my staff on Tuesday afternoon at 3.30pm for a test. It finally came through at 11.02am on Friday – that’s nearly 70 hours.

“There’s absolutely no chance the tracers could trace all her contacts within 48 hours because we are beyond that timeframe already, even before the test result has come back.

“I’m in touch with colleagues across Wales and there are tests coming back within 24 hours but the average appears to be between three and six days.

“I’m no expert but I have serious concerns we will have a second peak or another uncontrollable outbreak unless we get the Test, Trace and Protect system running within that golden 48-hour period.”

In his desperation for assurances, Mr Williams tweeted MS Vaughan Gething, Minister for Health and Social Services, asking him to produce data to confirm tests were being turned around within 24 hours but is yet to receive any response.

Mario Kraft at Prince Philip Hospital, Llanelli. Photo by Hywel Williams and licensed under CC BY-SA 2.0

‘Vital’

Care Forum Wales (CFW), which represents more than 450 social care providers across Wales, has consistently warned ministers of the consequences of inadequate testing and says the current Test, Trace and Protect scheme will fail to achieve its purpose if the results are not available quickly enough.

Mario Kreft MBE, CFW Chair, said: “We launched our campaign to Shield Social Care and Save lives back in February and testing was one of the vital components of that campaign.

“It was vital for a number of reasons including the safe discharge of patients from hospitals into care homes, for staff so they could return to the front line and vital for residents in care homes so you could control the spread. This  has not changed.

“It’s imperative that people in care homes – residents and staff – can be tested and the results delivered so that any outbreaks can be contained.

“We now need to learn the lessons of these past few months to ensure we don’t repeat the same mistakes, particularly if we are going to experience a second wave of Covid-19 later in the year.

“That’s why Care Forum Wales has campaigned so vigorously from the outset for an effective testing regime to be implemented.”

It was a sentiment echoed by Sanjiv Joshi, Director of the Caron Group, which owns 14 homes across South and Mid-Wales.

He said there were huge variations in testing returns across the group’s homes from 24 hours to five days and also highlighted other problems with the current system.

“There needs to be proper consultation with care providers before these policies are put into practice because it can be very disruptive for the care system,” he said.

“The current policy from Public Health Wales is that a home has to be incident-free for 28 days before you can admit new clients as you are considered high-risk. The problem is you are recorded as an “open incident” even if you have simply asked for someone to be tested – it doesn’t mean you have a positive result.

“It does not differentiate between a precautionary test and a suspected case. At one of our homes, for example, we are recruiting new staff and we want them to be tested before they start work as a precaution. The minute we asked for these tests the home became an ‘open incident’ which is disruptive and counterproductive.

“We need to assess what is practical and find a solution that works and is effective.”

‘Concerned’

So far at Gwyddfor, Mr Williams has managed to keep the home Covid-19 free through extensive infection control procedures which include a self-designed decontamination unit based on his training in nuclear, chemical and biological warfare when he was in the RAF.

But he fears lifting of the lockdown restrictions in England is undermining his efforts.

“I’m very concerned about the way we are proceeding with the lockdown requirements,” he said

“We’re seeing a relaxation of the measures in England and people in north Wales are thinking why should England release restrictions and not Wales? As a result, we’re now seeing a peak in infections.

“It’s very much an economically-driven strategy. They’re not giving any consideration to care homes. They didn’t give us any when we went into this pandemic and they’re not giving us any now coming out of it.

“We’re collateral damage again, this time collateral damage in the battle to recover the economy. It’s so scary.”

Mr Williams said the ideal solution would be a quick 20-minute ‘point of care’ test which could deliver a rapid result. Instead, he claimed the current system is long-winded and this is hampering the speed at which results can be returned.

“I can’t understand why they can’t leave us with a stock of swabs so if we get a spike in temperature we can instantly swab and send it direct to the lab?” he added.

“It would be an enormous help until the quick point-of-care test was available.

Gwyddfor is currently full but Mr Williams said the financial situation was still precarious and warned he would only have to lose four residents to be operating at a loss.

Although the home has received some financial compensation and welcomes the support it has received from Betsi Cadwaladr University Health Board, Mr Williams said none of the original £40m rescue package from the Welsh Government is available for self-funded residents, only those funded by the local authority.

“What does the Government want us to do? They want providers to pass these extra Covid-19 costs on to self-funders which is absolutely ludicrous.

“Covid-19 has made care home residents prisoners, not being allowed outside their homes, or even rooms in some cases, and the Welsh Government is making self-funding residents pay to be prisoners. Meanwhile, funded residents are being funded for a lower food allowance than prisoners.

“Care Forum Wales has been saying for years a perfect storm is brewing, well it just turned into a Category 5 hurricane. God only knows how we’re going to get out of it. A massive investment of money is the only way to put the social care system right.”

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