At the time of writing, it is known that the Delta variant of coronavirus is approximately 40% more transmissible than other strains. Whilst a startling figure, the latest data available indicates that only 2% of the people who have been hospitalised in England as a result of the Delta variant had received both doses of a vaccine.
Coupled with the fact that Public Health England’s estimation that 13,200 deaths have been averted in people aged 60 years or older in England (up to 13th May 2021) as a direct effect of being vaccinated, this suggests that vaccines are having their desired effect. Despite this, in areas worst affected by the Delta variant, namely Bolton, Blackburn and Bedford, the Health and Social Care Secretary has not ruled out re-introducing local lockdowns. What might the impact be of re-introducing such measures?
Local lockdown limits
The effectiveness of local lockdowns has been scrutinised since the introduction of the three-tier system in England last October. The Guardian reported in September 2020 that COVID-19 cases doubled in most major English towns and cities where long-term lockdowns were in place. In the case of care homes and their residents, there are clear limitations to re-introducing local lockdowns. Healthwatch UK outlines five key examples drawn from provider experiences – confusing Government guidance, additional costs associated with PPE, reduced admissions and covering staff absences, removing access to face-to-face healthcare appointments, increased delays in conducting routine assessments and revised access for visiting residents. Government must step up and provide adequate guidance and support to care providers.
Mental health concerns
There are clear lessons to be learned from the last 12 months. Extended periods of isolation in residents’ own rooms, limited opportunities to interact socially with staff and other residents, and removing access to visits from friends and relatives have all contributed to widespread feelings of loneliness, boredom and distress. The impact of visiting restrictions has been particularly pertinent in the reported decline of residents’ mental health during lockdown. Visits from friends and family are integral to life in a care home and should local lockdowns be re-introduced, suitable provisions must be put in place to facilitate social contact of this kind, wherever it is safe to do so. Whilst the use of technology, such as making a video call, has served as a compromise for some homes in the last 12 months, many have suffered from poor internet connection and residents with sensory and/or cognitive impairments have struggled to get to grips with this method of communication.
Don’t forget the staff
For many care home staff, especially those providing end of life care to residents and their families, typical working days can provoke feelings of sadness and stress, and this is without the lingering threat of COVID-19 to contend with. Since the beginning of the pandemic and subsequent lockdowns, care home staff have had to endure a rapid increase in the volume and intensity of their workloads, all whilst balancing evolving guidance and protocols from Government. Circling back to visiting restrictions as a fundamental consequence of re-introducing local lockdowns, it is understood that care home staff have, in some cases, had to carry out additional caring responsibilities that may have previously been undertaken by visiting relatives. In addition, it has not been unheard of for staff to take up temporary residence in the care home, out of fear of spreading the virus to their loved ones. Often leading to round-the-clock working, residential care providers must be supported to introduce initiatives designed to protect the physical and mental wellbeing of their staff should the Delta variant continue to pose a threat to the lifting of restrictions in England.