Dr MARTIN SCURR: Why the care home watchdog should be taken to task

While many mysteries remain about the coronavirus, one thing we know for sure is that older people are at greater risk of serious complications, or even death, should they be infected.

And where do we have a high proportion of older people? Why, in care homes, of course.

So you would think, would you not, that the Care Quality Commission (CQC) — the regulatory body that oversees the standard of care provided in care homes, and indeed collates the number of deaths among residents — would have been shouting from the rooftops about what is needed to protect the most vulnerable sector of our society.

You might think it would be calling for testing of staff and residents, as well as asking for suitable equipment for workers.

While many mysteries remain about the coronavirus, one thing we know for sure is that older people are at greater risk of serious complications, or even death, should they be infected

But, actually, the silence from the CQC has been deafening.

Only now are care-home staff finally receiving the attention and support they need. And the responsibility for the long delay, which in turn has allowed the escalating death rate, must lie, at least in part, at the door of the CQC and NHS England, which appears to be weeks behind in its response to the dangers of Covid-19 within the social care sector.

We are told that UK care-home inspectors did not ask managers about the number of Covid-19 deaths until two-and-a-half weeks after the UK went into lockdown — one month after the World Health Organisation declared a global pandemic.

Some claim the CQC is guilty of dragging its feet — I’ll say.

The consequence of this inaction is an escalation of deaths in care homes. Many people who are discharged from hospital following treatment are now admitted to care homes and no doubt act as vectors of the virus. Every entrant must be tested before access, there is no other argument.

When I was chairman of the Independent Doctors Federation, I was asked to report to the offices of the regulatory body that was eventually renamed the CQC. I was summoned to discuss its proposals for inspection of general practice in the private sector. This was years ago — the agency had decided to cut its teeth with us before spreading out to create chaos in NHS general practice.

When I arrived at an impressive glass tower block that would not look out of place in a Hollywood film, I was told the executives would not see me until I produced my passport to prove my identity.

Once I had managed to convince security of my status, I was allowed to take a high-speed elevator to the CQC offices. However, its glass doors failed, and I eventually arrived via the fire escape.

I was then interviewed, prior to discussion of the agenda, by two young arts or social science graduates who were wearing jeans and T-shirts; they would have been unlikely to have been employed in my practice as reception staff, so great was their ignorance and naivety about healthcare.

I’m afraid to say things don’t appear to have improved.

DON’T KID YOURSELF THAT A VACCINE IS CLOSE

There is so much still to learn about the coronavirus, not least what kind of immunity is conferred by infection.

When you have chickenpox, for example, you recover because you have developed immunity, part of which is the production of proteins called antibodies. When you next meet the virus, the antibodies enable you to shrug off the infection and you do not experience a second attack.

But the virus has not gone from your body, it is locked down in nerve tissue, and sometimes, later in life when your immunity is compromised for some reason, the virus can escape. It becomes reactivated, and travels down nerve pathways to cause a painful blistering eruption called shingles.

Many teams are working on potential vaccines for the coronavirus and there is hope, but it will be a long time coming — maybe not five years, but probably at least one

An attack of measles results in lifelong immunity. But on rare occasions the virus remains dormant in the brain, only to return years later to cause subacute sclerosing panencephalitis, a progressive neurological disorder that leads to inflammation of the brain, which can be fatal.

When finally a measles vaccine was developed in 1972, it was after years and years spent in development. The last new vaccine to be created and used on a wide scale was against Ebola. It took five years, a measure of the complexity of creating an effective, and safe, vaccine.

Many teams are working on potential vaccines for the coronavirus and there is hope, but it will be a long time coming — maybe not five years, but probably at least one.

Politicians and scientists must not suggest this stands a hope of being available sooner. A virus is a complex enemy to which there is no quick fix.

Source: Daily Mail | Health News