We were warned on aged care

Victoria starts this week with almost 700 active cases of COVID-19 linked to staff and residents in aged care. State Chief Health Officer Brett Sutton has pointed out what we already knew: that Europe’s experience showed rapid spread of the virus and high mortality in aged-care facilities. These were deaths in circumstances of great suffering and emotional pain, including for extended families, with infection risk denying a proper farewell. Amid the rapidly shifting uncertainties of the pandemic, this serious risk to unwell and often lonely old people in institutions has been widely understood for months. On Saturday, federal Health Minister Greg Hunt announced a new multi-agency Victorian Aged Care Response Centre. Is this a hurried corrective following a sustained failure to take effective preventive measures not only by both levels of government but by the aged-care sector? That’s the question, and Scott Morrison’s response on Monday — “we’ve been taking action on this for weeks now, for weeks and weeks” — sounds confident but lacks convincing detail.

A central justification for the eye-watering cost, job losses and social pain of shutting down the economy and restricting movement was to protect elderly and chronically ill residents in aged care and to suppress community transmission more widely so as to reduce the risk of asymptomatic staff turning up for work in those facilities. To what degree have these sacrifices been wasted through the failure of those responsible in government, regulatory bodies and industry to seize the opportunity of lockdown to fortify aged care against the risk they so rightly and repeatedly broadcast to the community?

The full answer is not yet clear and requires more detailed news reporting under difficult conditions of garbled information and official platitudes. One key question is how much was learned from April’s virus outbreak at Newmarch House in western Sydney that led to 19 deaths. The response following the first infection reportedly was slow and inadequate, and it’s obvious infection control was not successful. Anglicare Sydney, which was in charge, waited six days before taking up a federal offer of fresh staff from a private company. Things reached a point where the regulator had to threaten to take away the facility’s licence to operate before there was decisive action.

Now, three months deeper into the pandemic, commonwealth teams have stepped in to try to control Victoria’s worst aged-care outbreak at St Basil’s in Melbourne, which is linked to more than 80 infections. It took until the middle of this month for the federal and Victorian governments to announce measures to reduce cross-infection between facilities by limiting staff to shifts at a single aged-care facility. It’s up to politicians and industry leaders to rebut the presumption they had not put in a serious enough effort to prepare for this long foreseen risk to the elderly.

Nobody is saying the job would have been easy. Although some visa restrictions have been relaxed, skilled staff were difficult to find even before the pandemic. Governments have not lived up to promises of more personal protective equipment for staff, according to industry figures. Access to testing and hospital admission arrangements have been inconsistent. The aged-care component of the commonwealth’s $289bn COVID response is $743m, with much of it opaque funding for bureaucracy.

In the thick of the immediate crisis, some commentators have spun an opportunistic narrative that COVID-19 is simply the latest proof that the profit motive is the true disease in aged care, and one curable only by a multibillion-dollar public buyout of the sector. There’s no doubt aged care has shortcomings and needs reform. This is a global problem, especially in affluent ageing nations, and goes well beyond the funding model to psychological and cultural dilemmas. But these are complex questions for a post-pandemic future. And everyone knew the nature and state of aged care when we went into lockdown. It was the duty of all involved to take that flawed reality into account when doing their utmost to COVID-proof the sector. Will the record show this was done diligently enough? That is the question.