“Biosecurity” strategies can prevent spread of COVID-19 in enclosed group gatherings. Care homes, nursing homes, long-term care facilities, and more fall under the umbrella of enclosed group homes.

Care workers are the enforcers of biosecurity. Global Ageing Network Board Member Vic Rayner, executive director of the National Care Forum in the UK, was recently quoted in the Byline Times saying “Care homes are good at infection control” because “staff have training in pandemic protocols and infection control.” Staff are reliable and dutifully showing up to work at a time when others can stay home.

Issues that care workers are facing seem universal:  lack of PPE and the inability to obtain tests.  Testing feels nonexistent in the UK, in places in the USA, and other countries. In the UK, if testing is non-existent for frontline workers through the NHS, “virtually no care home or domiciliary staff or carers have been tested.” In Scottish care homes, the “crisis within the crisis” is that care home staff cannot obtain tests. If testing were widespread, many care home staff could get out of quarantine and back to work. Instead, they are falling ill, and the majority who do not have COVID-19 carry the work load including the mental strain of being in the midst of the pandemic.

Some issues care workers are facing, like low wages, were all too familiar before the pandemic. The Financial Times points out that the UK provides non-essential employees up to 80% of their wages while on furlough. Those non-essential workers at home now often bring in higher wages than healthcare workers who risk their lives at their jobs.  Due to low wages and shortage of staff, what was an industry problem prior is now on the radar of the general public through the lens of a heightened crisis. The Times further reported some of the most crucial staff were the lowest paid. “Key workers” and “Essential workers” are playing the most important roles across the world and are valued the least. The serious global reform we can institute in response to the pandemic could also heal this growing wound that started years prior.

For example, care workers are now getting the well-deserved title of “hero.” They are not lifting cars with one hand or running into an explosion. They are doing their job while trying to stay healthy. Our job now is to develop strategies support them. Global Ageing Network member,  LeadingAge, in the United States developed a community site for strategies to support the workforce, based on what U.S. providers are doing. Examples from the U.S. and other countries follow:

• Increase staff wages- A number of staff will work in multiple settings to increase their overall earnings. By offering increased wages, staff are incentivized to work only in one setting to reduce the risk of cross-contamination.
• Compensation Funds- For workers stricken with COVID-19, New York is in the process of creating a COVID-19 Compensation Fund for those who are ill. The fund will cover support for healthcare and other frontline workers, as well as their family members, who contract COVID-19.
• Support care workers by offering safe child care – Providers are offering temporary childcare services for essential workers.
• Separate a changing area for staff. Securing uniforms, encouraging fellow staff not to wear uniforms on public transportation, and changing clothes upon entering and leaving work can decrease transmission.
• Virtual support systems – Professor John Ashton, former director of public health told the Byline times: “In 2006/7, when I was public health director in Cumbria, we divided the county into six districts and found GP leaders for each district to work with care homes and across the health and care system. Four of us, myself as public health director, a GP, a pediatrician and a hospital director, shared the medical director role for the county and, every week, we ran a virtual round across all the hospitals, care homes and GPs This gave proper GP oversight of care homes and this is what we need now.”
• Expand Telehealth Services– Where possible, telehealth can offer care alternatives where appropriate. Global Ageing Network member, LASA, welcomed Australia’s $1.1 billion investment that included investment in telehealth services. Telehealth can prevent spread among care workers, as well as offer care workers mental health services around the clock.
• Provide complementary food and/or grocery shopping for workers – One U.S. care home is offering complimentary staple food to their staff. By offering this food as a collective, there is a greater chance individual workers may be able to make fewer trips to the grocery stores.
• Share Data– French nursing homes have run into technical difficulties sharing data that reveals grave statistics on deaths in nursing homes. But if lessons can be learned from one response, lives can be saved in another. Advanced data collection could allow quicker deployment of resources. South Korea learned from the MERS crisis that transparency can lead to quicker action for COVID-19. South Korea now poses as one of the world leaders in their first wave response to COVID-19.
• Cultural Competency – Migrant workers are disproportionately the group on the front lines in the healthcare crisis. The UK previously deemed migrant health workers as “low-skilled”. But just two months later during this pandemic, the UK relabeled the same health workers as “key” workers. Healthcare migration poses ethical questions, such as to what extent countries gaining medical workers are depriving those workers home countries of medical resources? The Center for Global Development recommended policymakers build rapid transport systems for multi-national healthcare workers to respond to countries hardest hit as they hit their peak needs. To do this, we need flexible visa issuance and worker support, which the Open Society Foundation is now piloting.

One LeadingAge member in New York remarked that properly biosecured care homes are more safe than social isolation in one’s own home for months on end. There is more of this pandemic ahead of us, but with precautionary measures we can get through until there is a vaccine.

By Beth Brodsky