The Public Health Agency plays a key role in tackling COVID-19 in care homes in Northern Ireland. To view our complete series of COVID-19 blogs, click here.
Monitoring outbreaks
We have long-established, well-trusted and robust systems in place to monitor infectious diseases and provide direct advice and support to manage outbreaks and limit onward spread. These arrangements are being actively implemented in tackling COVID-19.
An important example of this is the work we are doing with nursing and residential care homes in the independent sector. While a lot of this work goes on behind the scenes we have well-rehearsed links with these facilities. Whenever there is evidence of two or more cases of either COVID-19 or respiratory illness in a home the PHA will work to try to limit spread.
Working with the service provider to identify risks
When the PHA receives a notification of an issue of acute respiratory infection in a trust or non-trust care home setting our health protection team investigates and supports the provider in managing the outbreak. We are here to support all settings, regardless of whether they are HSC or not.
The work undertaken with these facilities is what we do with a range of infectious diseases week-in, week-out, and the same processes are being followed to deal with COVID-19.
Managing the risk
A comprehensive risk assessment is completed for each nursing or care home outbreak, which includes an assessment of each individual resident and the environment, and an ongoing assessment of the severity, spread and context of the incident.
Advice specific to COVID-19 is given regarding isolation, containment, and infection prevention and control practice, including cleaning, testing information, how to manage symptoms, and when to request additional medical advice or personal protective equipment (PPE).
When a nursing or residential care home outbreak is over, a thorough clean of the facility is undertaken. The PHA’s health protection team will guide the facility through this process, and following this a final outbreak summary report is produced.
Providing reassurance and direct action
We recognise there is understandable concern in the community about care homes, but throughout this process the PHA have been working very closely with care facilities and providing the practical advice and support to deal with emerging issues locally.
We have seen an increase in the prevalence of COVID-19 in care facilities, and anticipate that this will continue. There remains a risk of a very high number of outbreaks in care homes over coming weeks and months, and there is close collaboration between social care, infection control and public health staff to do all that we can to reduce this risk.
It can often be difficult to identify the symptoms of COVID-19 in some older people. The PHA are therefore testing more individuals in care homes. When COVID-19 is identified in a facility, all residents and staff are now tested, and work continues on how this can be extended further as testing capacity in Northern Ireland increases.
Ongoing surveillance
Another key role of the PHA is to undertake surveillance of the situation on an ongoing basis. A range of methods are in place to monitor the course of COVID-19 in care homes and other settings where accommodation is shared. The data collated by the PHA is aimed at monitoring the situation as closely as we can and considering what actions can be taken to protect those who are most vulnerable. It is not designed for public audiences and we are always aware of the need to protect patient confidentiality.
The PHA are taking a precautionary approach to all cases that we hear about, and individuals may be treated as potential COVID-19 patients regardless of whether tests have been conducted or have produced a positive result. This mirrors the approach that has been taken in wider society, where individuals displaying even mild symptoms are asked to self-isolate.
In conclusion, we recognise that we need to do all that we can to protect those who live in shared accommodation, such as a care home. Many of us have friends and family in these settings and we owe it to them to do what we can to help shield them from infection.
Professor Hugo Van Woerden, PHA Director of Public Health
To view our complete series of COVID-19 blogs, click here.