Covid-19: care homes show the failures in UK’s response

The successful mitigation of covid-19 in a healthcare setting, as described by Liu and colleagues for four hospitals in Wuhan, China,1 contrasts with the experiences of care homes across the UK.

One care home manager describes feeling abandoned by almost everyone.2 They were left to try to make do with limited resources. Nine residents died. Staff were left traumatised. We must learn from these experiences.

Care homes need a programme of surveillance to detect infection early. Contact tracing, using local skilled practitioners, needs to happen at pace in response to any new cases, recognising that asymptomatic or mildly symptomatic infection is common. Quarantining all exposed staff is impractical; risk can be managed through regular targeted testing of staff and residents in the incubation period after exposure. These are complex outbreaks and management requires continuity of support from infection specialists. This also provides important psychological support to care home staff. Care homes need practical support to deliver an effective infection control response.

Care homes show the failures in the UK’s initial public health response to covid-19. As we teeter on the brink of a second wave of infections, we must act urgently to learn from these lessons. The announcement of widespread testing in care homes might be cautiously welcomed, but this must happen at speed and in conjunction with local, skilled contact tracing.