Editorial | Protection of elderly now in question
The outbreak of COVID-19 at the Government’s Golden Age Home in Kingston demands not only a healthcare response at that facility, but a full and ongoing monitoring of the coronavirus protocols at all old people’s care homes.
At the same time, the Government has to frankly ask whether it has been robust enough in protecting this most vulnerable in-care cohort. Based on what has happened at the Golden Age Home at Vineyard Town, on the eastern side of Kingston, there are big question marks over the matter.
The Golden Age Home, according to the authorities, has 428 residents, the majority of whom are over 60, a high-risk group for the novel coronavirus. There are also 162 workers at the facility. Up to Wednesday, the health ministry reported, 43, or 10 per cent of the residents, had tested positive for COVID-19, following the confirmation of the first case a week earlier. Three staff members, nearly two per cent of the workers, had also contracted the virus.
That, however, is not necessarily the extent of the crisis. At the time of the health ministry’s report, only 72, or 12 per cent of the 590 combined residents and staff, had been tested for COVID-19. Sixty-one were residents, and 43 of them had the virus. That is a positivity rate of 70.5 per cent. Yet, the number of residents tested represented only 14 per cent of those who live at the home. With regard to staff, seven per cent were tested.
If the other test outcomes for all the residents and staff followed the same trajectory as those for which there are already results, just over 300 of the residents and 44 (27 per cent) of employees will have COVID-19. Hopefully, it does not come to that. We are optimistic that the health ministry’s intervention, including the isolation of the housing cluster where the outbreak was identified, was early enough to significantly contain the spread.
NUMBER OF ISSUES
However, there are a number of issues relating to the management of this case, as well as the regime for the protection of old people who live in similar facilities, that need clarification. For instance, Dr Christopher Tufton, the health minister, explained that the first case at the Golden Age Home was a 73-year-old who became “symptomatic on October 5”. His symptoms included “a productive cough and fever”.
At that age, a patient with those symptoms, even without underlying health conditions, would be at high risk of contracting COVID-19, and in the cohort that accounts for over half the deaths from the disease in Jamaica and the one that, globally, is 10 times more likely to die from the virus than young people. Yet, it was more than a week (eight days) before that patient was admitted to hospital, and a further two days before he received a positive test result. That was all of 10 days between a vulnerable patient, at a state-owned and run home for the poor and elderly, showing serious symptoms for COVID-19 and receiving a test result. Further, it was another two days, on October 17, that the authorities, according to Dr Tufton, initiated “enhanced surveillance” at the home, concentrating on the residential cluster where the patient lived.
Without further and better particulars, neither Dr Tufton, Desmond McKenzie, the local government minister who has responsibility for such care facilities, nor the management of the Golden Age Home should be offended if either a reasonable man or officious bystander concluded that action at the home took inordinately long to get into gear. Some might even claim that the authorities dilly-dallied.
Such a perception might be considered unfair if people did not assume – especially since a case COVID-19 was confirmed in an employee at the St Ann Infirmary in May – that a robust system was in place to prevent the coronavirus from entering care facilities, and, if it happened, there would be a quick response. If such a system existed, it has seemingly gone wobbly.
The developments at the Golden Age Home, therefore, demand that one is (re)built and that there be periodic testing of residents and staff of long-term care homes for COVID-19, as well as the stress-testing of their mechanisms to prevent the virus arriving, and if it arrives, to quickly respond to it.