May 18, 2020

How did nurse with COVID-19 continue working in nursing home?

 

The Queensland health minister has launched an independent inquiry into how a nurse continued to work at a Rockhampton nursing home while infected with COVID-19.

“A lot of people have asked me over the last few days how a nurse could be working at a nursing home while she was positive with coronavirus,” the minister, Steven Miles, said.

“Central Queensland Hospital and Health Service is currently investigating exactly what happened and we’re launching an independent, external inquiry to get to the bottom of this.”

It is believed the aged care worker who contracted the virus was an enrolled nurse working in the front office, not in direct contact with residents but in contact with many within the facility, Mr Miles said.

It is believed she may have been contagious as far back as 3 May, but she continued coming to work. Her symptoms were mild.

Mr Miles said the fact the person was ill and yet continued to work at an aged care facility was “disappointing”. “It’s not acceptable,” he said.

The EN remains in quarantine.

Questions also remain over whether the EN’s temperature was being checked every day, which is compulsory in all Queensland healthcare facilities.

Residents moved out 

On Saturday, 35 residents of North Rockhampton Nursing Centre were moved into nearby private hospitals to allow the remaining residents better conditions for self-isolation.

The relocations will mean the remaining residents have private rooms with their own bathroom, and can be more spread out throughout the facility.

Ambulance officers were brought in to assist with the move, which was mainly of lower-acuity residents. 

Central Queensland Hospital and Health Service chief executive, Steve Williamson, said the move was “temporary” and would “ensure the best possible long-term care.”

No further cases

Since the case was first identified, last Thursday, all 114 residents have been tested for COVID-19 and thankfully all have tested negative. In total, 193 residents, staff and other contacts have been tested in relation to the case and all have returned negative results. 

The results were “the best we could have hoped for,” Mr Miles said.

However, more than 40 nurses are still in isolation and will remain so for two weeks in case they begin to show symptoms and have to be tested again.

North Rockhampton Nursing Centre remains in lockdown.

Come forward to be tested

Queensland’s chief health officer, Dr Jeannette Young, encourages anyone who feels any symptoms to come forward and be tested.

She said the state has adequate testing capacity, and now that restrictions are being eased, it’s important to use that capacity.

Those infected with COVID-19 can be contagious for up to 48 hours before they show symptoms, she said, so it is important to be tested as soon as you begin to feel unwell.

“This (case) has been the ultimate reminder to stay home if you’re sick, and get tested even if you have the mildest of symptoms,” Mr Miles said.

There are 13 active COVID-19 cases in Queensland, five in hospital, and three are in intensive care.

Union checked in to ensure safe conditions

Queensland Nurses and Midwives Union secretary, Beth Mohle, said a number of its members had been tested as part of the response to the Rockhampton case.

The QNMU contacted members working at the facility to ensure conditions are safe, and that protocols and PPE are in place to prevent further infection.

“This incident highlights the high risk environment our members can sometimes work in,” Ms Mohle said. “They are on the frontline of this COVID-19 health emergency.”

“Our members are professional health workers and would never knowingly or deliberately put the health and safety of their patients, residents, colleagues or the wider community at risk,” Ms Mohle said.

Government Health Services ran the response

The Central Queensland HHS has orchestrated the multifaceted response to the Rockhampton aged care case. The measures it has enacted since last Thursday include:

  • Locking down the facility,
  • Enacting a local disaster management plan,
  • Isolating the primary case, the EN,
  • Providing “rapid response support”, which included flying a senior public health medical officer to the facility,
  • Interviewing the primary case,
  • Contact tracing,
  • Testing and quarantining all contacts,
  • Putting a communications plan in place, including for communication with residents and relatives,
  • Expanding fever clinic capacity, including opening a new clinic, and
  • Expanding community messaging about the need for testing.

The identification of a COVID-19 case in a nursing home is enough to send shivers down the spine of anyone who has followed the stories of Newmarch House or Dorothy Henderson Lodge in Australia, not to mention the horrific death rates in care homes in Europe and the United States.

The fact that no new cases have been confirmed at this point is encouraging, but questions still remain. How did a member of staff in an aged care home continue working while infected? Could the investigation provide some answers as to how the spread of infection was prevented in this case, where it has proven so catastrophic in others?

Image: kzenon, iStock.

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