Care home coronavirus outbreaks cast doubt on official PHE data

The UK’s largest care home provider has had Covid outbreaks in 70 of its facilities, prompting questions about whether official figures on the virus’s return to social care may be too low.

As care leaders issued fresh warnings about testing delays, HC-One said it had closed one in five of its 329 homes because of outbreaks and that 20 homes had seen new outbreaks in the last fortnight.

Bupa also told the Guardian that in the last 28 days people had tested positive at 21 of its homes – almost one in six of its 130 locations – while Care UK has had positive tests at 19 of its 110 homes.

Public Health England (PHE) records outbreaks when they are reported by care homes. It confirmed 134 new reports of possible or confirmed Covid outbreaks in English care homes in the week to 21 September. The government has told care operators to report even single cases to local health protection teams but research from earlier in the pandemic suggests a significant minority of outbreaks may not have been reported.

In one week in September, HC-One recorded new outbreaks in a dozen homes – equivalent to 4% of its facilities. By contrast, PHE recorded new outbreaks over the same period at just 1% of all homes. Outbreaks are defined as two or more people at a home testing positive, including staff.

“It is essential that we have a full and accurate picture of care home infections and it is worrying that one of the country’s major care home providers has reported rates that seem to be considerably higher than those of official figures,” said the Labour MP Liz Kendall, the shadow care minister.

“It looks like they are [underestimating],” said Judy Downey, chair of the Relatives and Residents Association. “The system seems to be riddled with inconsistencies.”

PHE was approached for comment. An official stressed the figures relied on outbreaks being reported to its local health protection officials.

Barchester, another major chain, said residents were infected at nine homes. Four Seasons Health Care said 39 of its staff and residents were Covid-positive.

Care operators stress that despite rises in infections the death toll has not yet started accelerating again. Eight residents died of Covid between 20 July and 17 August at Four Seasons Health Care, which operates 185 homes. No one had died of the virus in more than a month since, it said. Bupa said all of those infected in its homes were “doing well”.

While infection rates in care homes remain far lower than earlier in the year when 18,000 UK care home residents died from confirmed or suspected Covid-19, providers told the Guardian that testing problems were hindering infection control, with some tests taking more than a week to come back.

“Infections are going up, there is no doubt about it,” said Nadra Ahmed, the executive chairman of the National Care Association, which represents smaller providers. “It is among staff more than residents, but that’s because they are being tested more than residents. That’s a challenge for us because we won’t find out about residents until it is too late.”

Since early September, ministers have promised care home staff weekly tests and residents monthly tests under the test-and-trace system. But frequent delays of more than a week in getting results mean infected staff could be spreading the virus.

HC-One said that between 19 and 25 September, tests of more than 1,000 staff at 12 of its homes took more than a week to come back. It means the results are close to useless because after seven days the workers are due to be tested again. More than 700 of the tests carried out that week were also returned void, the chain said.

“HC-One has long highlighted the importance and value of routine testing for colleagues and residents as testing is absolutely key in mitigating the risk of the virus spreading into care homes,” a spokesperson said. “It is only through regular staff and resident testing, alongside wider infection control measures, that we can help keep care homes safe and identify asymptomatic carriers at the earliest opportunity.”

Problems with testing were creating “fear and anxiety” among staff, said Ahmed. Some had recently raised concerns about how to handle the risk of cross-infection from family members returning from university at weekends. “Waiting four days is no good for us,” she said. “It needs to be in a 48-hour period, then you have a better chance of mitigating the risk. It is causing huge frustration.”

A Department of Health and Social Care spokesperson said: “We continue to prioritise care homes for repeat re-testing, and any care home resident or member of staff with symptoms is able to immediately access a free test with more than 120,000 sent out every day.

“Between 3 and 16 September, more than 700,000 tests were carried out at care homes with the average time for results less than four days.”


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