Q+A: 'catastrophic' Covid-19 outbreaks in aged care could have been prevented, doctors say

The deaths and Covid-19 outbreaks in Victoria’s private aged care “could have been prevented 10 years ago”, according to doctors on the frontline.

On Monday the ABC’s Q+A program heard from a Melbourne resident, Spiro Vasilakis, whose mother Maria died in St Basil’s aged care facility, and Christine Golding, whose mother was evacuated from St Basil’s to hospital.

Golding said the scene was “catastrophic” and residents were dehydrated and malnourished when her mother was evacuated. She asked why the federal government, which manages private aged care, had not prevented outbreaks in Victoria that have lead to dozens of deaths and hundreds of infections, given that there had been an outbreak in New South Wales’s Newmarch House aged care home months earlier.

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Vasilakis asked why a mandatory requirement for aged care staff to wear personal protective equipment was not brought in until 13 July.

A clinical nurse specialist, Abbey Fistrovic, said the outbreaks were “preventable”, and neglect of the aged care sector had created “a perfect storm” over a decade.

“This was preventable because we could have prevented it 10 years ago,” she said. “ I worked as a personal care attendant during my undergraduate of nursing 13 years ago. And the problems then are still the same as the problems now.

“There are no mandatory requirements for personal care attendants with the amount of residents they look after. Sometimes you have one registered nurse for a facility with 100 residents. And when you have a casualised workforce that is paid too little, that work across multiple services in order to bring money into their homes and put food on the table, we have created this perfect storm which has ended in tragedy for people with families in aged care.”

The Coalition MP Andrew Laming, a former doctor, was asked why the federal government had not done more to prevent the outbreaks in aged care. Q+A’s host, Hamish Macdonald, asked him why a 2018 report into aged care, written by Prof John Polares, had not received a detailed response from the government.

“There has to be a response,” he said. “And it has to be given to the professor. But on the ground, the greater concern is the training and the reinforcement of those requirements around Covid-19 in every aged facility around the country.”

Laming said: “The focus is probably right now on the frontline.” He added: “For most of this crisis so far we’ve had no certainty supply of PPE and we’ve had to work extremely hard through a taskforce to fill the national stockpile.”

The Labor MP Ged Kearney, a former registered nurse whose father-in-law died of Covid-19, said: “The Morrison government has failed aged care.”

Fistrovic and other doctors on the panel also said they were “struggling” as more and more frontline health workers contracted Covid-19.

“Morale is quite low at the moment … not just the huge numbers we’re seeing, but also the facts that my friends, colleagues and healthcare workers all over Victoria are now testing positive,” she said.

“We are struggling on the frontline now. I think more so ever than we have been. And I think the community does need to be aware of that fact.

“Compared to the first wave, we are seeing a significant amount of people who are not following the rules which is making our job a lot harder.”

Dr Lucy Morgan, a respiratory physician at Sydney’s Nepean hospital, said “a shame game” was not the answer.

“Anybody that’s breaching those protocols is putting our community at risk and that’s very frustrating,” she said. “But I’m not sure that I think a shame game is very constructive. I think in general principles educating and supporting people, to make sure that people understand the right things to do, where there is a more constructive way around it.”

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Dr Vyom Sharma, a Melbourne GP, agreed and said a broader view was needed to understand why people may have not been following isolation rules.

“We have to look at the systems approach here,” he said. “Why aren’t people doing this? Could it be because people are waiting long periods of time for their test results to come back? Could be because we had no paid pandemic leave until very recently.”

A former MP and president of the Australian Medical Association, Dr Kerryn Phelps, said “we need to head towards” masks being compulsory in Sydney and New South Wales in indoor places.

Later in the program, Golding told the panel that the situation at St Basil’s had been “a catastrophic failure” when her mother was being evacuated.

Vasilakis said “it wouldn’t have hurt anyone” to introduce mandatory PPE earlier than 13 July, but “the consequences of not wearing it have caused a disaster”.

“Why wouldn’t aged care providers implement the wearing of PPE mandatory for all staff much earlier?” he asked. “Off their own initiative, given they were dealing with such a vulnerable group? … Why would they not act in a preventive and a proactive way?”