Coronavirus Victoria: Grim toll as unskilled staff put Melbourne aged-care homes at risk

Seventeen of 29 deaths have been aged-care residents amid concerns 70 per cent of workers only get six weeks’ training.

ADF personnel and police on patrol along the Yarra in Melbourne on day one of the city’s mandatory mask-wearing. Those exercising are exempt. Picture: David Crosling

Seventeen of the 29 fatalities in Victoria’s COVID-19 second wave have been aged-care residents, sources have told The Australian, amid concerns up to 70 per cent of nursing home care workers trying to manage the outbreak have Certificate 3 qualifications that require six weeks’ training.

The state’s grim aged-care death toll is expected to rapidly escalate in coming weeks, even if the new wave is brought under ­control.

An anticipated 35-40 per cent case fatality rate for nursing home residents with coronavirus means 80-85 of the 213 Victorian aged-care residents infected as of Thursday are likely to die.

And more cases are being reported daily.

The worrying trajectory in aged care comes as Victoria recorded its third highest overall daily case count, 403, on Thursday. Premier Dan Andrews also confirmed there had been five new deaths, taking the total in the state to 49 since the pandemic began.

New restrictions in the lockdown areas of metropolitan Melbourne and the Mitchell Shire also came into force as people were required to wear masks in public or risk a $200 fine.

With one of the more contentious loopholes being an exemption for joggers, police and members of the Australian Defence Force patrolled Melbourne’s iconic running track The Tan around the city’s Botanical Gardens, ensuring runners kept up the pace.

The Australian understands the three new deaths reported on Thursday are all from the St Basil’s Home for the Aged in the northern Melbourne suburb of Fawkner, bringing the total deaths from the facility to four.

With 48 of its 117 residents COVID-positive, a figure expected to rise, St Basil’s threatens to become Victoria’s Newmarch House.

Even on the current numbers, projected deaths at St Basil’s would outstrip the 17 suffered at Newmarch House in Sydney’s far west through April and May.

Other nursing homes in Victoria also have growing numbers. Estia Ardeer in Melbourne’s western outskirts, one of the 21 facilities with COVID-positive residents, has 36 cases as at Thursday.

So what has gone so horribly wrong so quickly in Victoria’s nursing homes? With Newmarch House a template for what not to do, why couldn’t an outbreak among this most vulnerable group be avoided in Victoria?

 

Joseph Ibrahim, head of the health, law and ageing research unit at Monash University’s forensic medicine department, said too much was being asked of underqualified and inadequately trained care staff to cope with such a virulent outbreak.

“Seventy per cent of aged-care workers are only qualified with a Certificate III, which is six weeks of training,” Professor Ibrahim said. “That doesn’t prepare you to be meticulous with infection control. It requires multiple steps. Donning and doffing PPE is a motor skill, like driving. You don’t learn to drive watching a video, you practise over and over.

“I don’t believe the majority of aged-care providers have sufficient infection control nurses on staff or on hand to oversee carers,” he said.

Aged-care advocate Sarah Russell said she had heard from many Victorian nursing home residents and their families during the pandemic concerned about staffing standards, qualifications and numbers. “They have written to (Aged Care Minister) Richard Colbeck about dangerously low staffing numbers, inadequately trained staff and the lack of PPE and are furious he has seemingly ignored these concerns,” she said.

Dr Russell said she had also heard from many care workers who had been asked to supply their own masks at work. “Some aged-care companies prioritise profits over care. They employ casual workers, including those on 457 visas. These workers are poorly paid and not entitled to paid leave. And now the chickens have come home to roost.”

There has been recognition at government level that casual carers working in multiple locations may have been the catalyst for the outbreak, with a new scheme introduced to ensure staff to work only at one location.

Mr Andrews said the new outbreak was “almost exclusively a private sector aged-care issue”, and new data from the Aged Care Quality and Safety Commission backs him up. State-owned nursing homes comprise about 200 of the 750 in Victoria, but of the 66 residential aged-care facilities that have reported a COVID case since June, just six are state-government run, the ACQSC said.

Kathy Eagar, director of the Australian Health Services Research Institute, said the reason state-owned facilities were less ­affected was because “they have mandated nursing staff ratios and better access to PPE”.

“They simply have better trained staff and more nursing expertise. And the private providers were until recently required to provide their own PPE,” she said.

ACQSC head Janet Anderson told The Australian the nature of the virus made it difficult to screen for, as care workers could have no symptoms yet be contagious.

“A single infected staff member with no symptoms and no reason to suspect they have the virus may provide hands-on care to a number of residents across a number of shifts,” she said.

“Even where they pay close attention to infection prevention and control requirements, their positive viral status (not yet detected) still poses a heightened risk to others in the facility. This situation is well understood by aged-care providers, which is why they are on high alert, exercising strong vigilance and working hard to keep residents safe by minimising all the risks they can.”