Coronavirus: More stringent testing needed for nursing home staff, new residents

Several residents at nursing homes and shelters for the vulnerable have been infected by the coronavirus - a matter of particular concern that needs to be addressed urgently.

On Monday, 12 more residents and two employees at Acacia Home, a sheltered home for the destitute, were diagnosed with Covid-19. They were tested after a 62-year-old resident was found to have the disease on Saturday night.

This is a worrying trend.

The first nursing home to report Covid-19 infections was the Lee Ah Mooi Old Age Home in Thomson Lane on April 1.

Among the 16 people infected on its premises was Singapore's oldest patient, aged 102 years. At least two residents from the home, both women aged 86, have died.

Following this outbreak, on April 2, visitors were no longer allowed in nursing homes, and large homes with more than 200 beds had to introduce split zones.

But this has not stopped five more nursing homes, and now the Acacia Home in Admiralty, from being hit by outbreaks among their residents and staff.

Residents at such homes are among the most vulnerable people in the country.

They tend to be old - and generally in the case of Covid-19, the seriousness of the illness and the risk of death rise with age.

They also tend to be frail or suffer from other medical conditions. These also worsen their risk profile.

In fact, almost all the 14 people who have died here from Covid-19 were seniors with underlying medical conditions.

The youngest was 64 years old.

Twelve more residents and two employees at Acacia Home were found to have Covid-19, after a resident was diagnosed earlier. ST PHOTO: CHONG JUN LIANG
Twelve more residents and two employees at Acacia Home were found to have Covid-19, after a resident was diagnosed earlier. ST PHOTO: CHONG JUN LIANG

In contrast, while more than 12,000 foreign workers living in dormitories have been infected, they are younger and stronger, and none has needed intensive care.

Nursing home residents are another story.

They need to be kept safe.

Covid-19 had already found its way into six of the 77 nursing homes here, infecting more than 20 residents and staff. Add the 15 from Acacia, and that is more than 35 - the majority of whom are residents.

These residents do not venture into the community, so they can never be faulted for picking up an infection. They are the victims, infected by someone bringing the virus from the community into the home they live in.

The simple way to keep them safe is not to allow anyone infected with the disease to get near them.

It may not be easy, but it must be done to save their lives.

Health Minister Gan Kim Yong said on Monday that testing for the coronavirus has been ramped up, including testing "staff of institutions such as nursing homes, where there is close contact with our seniors".

In fact, they should have been given priority right from the start, or at least from two months ago, when it was known that seniors were at far greater risk than younger and healthier people.

While it is good to test people working in nursing homes, a negative result does not guarantee that the person will not test positive a few days later.

So, the only way to be sure is for everyone working in nursing homes to subject themselves to the swab test every time they report for work.

Another option is for such homes to provide staff with on-site accommodation.

This would be the surest way to prevent staff from catching the disease from the community and spreading it to residents.

It is certainly not ideal for the staff, so perhaps it could be done on a rotation basis - with several days off after a period of staying in.

They should also be tested daily when they return to work because people who have no symptoms can still transmit the virus.

Another possible route for the virus to breach these defences is new residents to a home. Not only should they be tested on arrival, but they should also be kept in isolation until it can be confirmed that they are not infected.

Staff caring for them should take extra precautions to avoid getting infected and passing the disease to others.

These measures might seem draconian. But when the stakes are so high - we are talking about lives - then no effort should be spared in ensuring the safety of residents.

Residents in nursing homes are there for the best possible care in their twilight years.

It would be tragic if instead of offering them protection, such homes turn into death traps as clusters form, when that could have been prevented.

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A version of this article appeared in the print edition of The Straits Times on April 29, 2020, with the headline More stringent testing needed for nursing home staff, new residents. Subscribe