You can check out any time you like but …

We’re linking you through to a news report from California which reveals frustration and anger over the way nursing homes were managed there through the Covid-19 crisis.

In its June 28 report “As Coronavirus raged through nursing homes, inspectors found nothing wrong”, The Los Angeles Times claims the main problem was that state inspectors reported “No deficiencies” in places where infection was taking hold.

Advocates argue that in each case infection control protocols were not in place, even though the nursing home got a tick of approval from authorities.

It’s all very troubling. Last week I was part of a few discussions about nursing homes and Covid-19 infection. Some people I spoke to thought it was better to lock the elderly in with other elderly people who are infected, taking risks for them, to stop the spread to the rest of the community.

It’s an argument that says by containing the infection in this cohort that the rest of the community is protected. It’s fuelled by awareness that many old people who contract Covid-19 might have been going to die of the ordinary flu or another minor infection that would have wiped them out anyway.

You can see why the argument is made, especially when our image of nursing homes is that everyone who lives there is severely impaired and has no quality of life.

But to counter that, what about the following:

  • Many people living in nursing homes, both in Australia and elsewhere, are fit and happy, despite images to the contrary. Some are even surprisingly young.
  • The practical reality is that it’s not the residents themselves who bring the infection in. The main vectors so far, in most countries where there have been outbreaks in nursing homes, are the staff. It is true, they quickly pass it to the residents and other staff, so the nursing home is the place where the infection brews, once it’s taken hold. But the nursing home residents, locked in by either poor mobility or policies are the sitting, or stationary targets, not the original vectors.
  • Because larger numbers of the elderly get so sick and so quickly, it looks as though the largest number of infections are among them. In fact they are not, even though they have the largest number of deaths.
  • And there’s a pattern which needs more scrutiny, all over the world. That is, the bigger the shortage of nursing home staff, the more likely poorly trained and poorly psychologically equipped people will be pulled in to cover for them in a staff shortage. And shortages will keep occurring because it is such lowly paid work. The bigger the shortage of carers, the bigger the risk in nursing homes.

So this exposes a truth we aren’t quite able to deal with: in order to protect older people, we need a completely new attitude to training and remunerating the people who look after them. But that at a time when our economies are taking a severe battering, a time when traditionally, the elderly always become a low priority.

There will be a lot of human suffering before we all work out how to deal with this conundrum.

But in the meantime, even if we don’t look at the elderly as vulnerable and in need of protection, there is another point to consider. While ever the virus is endemic in nursing homes, or in any other hotspot, it is ready to breakout into the broader community.

And we are only as strong as our weakest link.

For more on Canada’s crisis, where 81 per cent of Covid-19 deaths have been in nursing homes, go to:

and also:

To see an Australian case where infection control has been questioned, go to:

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