As the pandemic surges into its third year, concerns for the health and wellbeing of aged care residents have returned to the fore amid an ominous rise in the number of aged care facilities experiencing outbreaks.
There were 1862 active cases of COVID-19 in aged care facilities across Australia as of Thursday, up from 213 two weeks ago, including more than 714 in Victoria alone.
Although the federal government has not released its weekly breakdown on outbreaks in aged care facilities since December 23, Ballarat Health Services (BHS) said yesterday there were no active cases in Ballarat aged care facilities at present.
Reports of outbreaks in both BHS and private administered aged care facilities in Ballarat have, however, since emerged. Those reports are yet to be verified.
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The alarming rise in COVID-infected nursing homes comes as the federal government confirmed just under half of all aged care facilities were yet to receive a visit from an in-reach booster clinic; notwithstanding the decision to prioritise aged care when the booster program launched in early November.
Some reports suggest as few as one in three aged care residents have received their booster vaccine.
Aged care advocates - desperate to avoid a sequel to the horrific waves of infection and death that marked aged care two years ago - have since called on the federal government to urgently ramp up the rollout of booster vaccines to nursing homes.
Paul Sadler, chief executive of Aged and Community Services Australia (ACSA), said booster shots were essential to protecting residents from the firestorm of Omicron infections sweeping the community, which he said would inevitably lead to more outbreaks in aged care.
"We're on the horns of a dilemma here because when there's so much community transmission, it's very difficult to stop it from impacting aged care services," Mr Sadler said.
"It's really vital for the protection of older people that we really do push to complete the roll-out of in-reach [booster] clinics to all aged care facilities."
Recent studies on vaccine durability have consistently found two jabs of AstraZeneca offers little in the way of protection against Omicron infection, while two jabs of Pfizer fares only marginally better.
A Pfizer booster shot, however, restores immunity against symptomatic disease to between 70 and 75 per cent - whether the person's primary course was AstraZeneca or Pfizer - and provides up to 85 per cent protection against severe illness.
James Trauer, head of epidemiological modelling at the Monash University school of public health, said the waning immunity of older people - as the first cohort to be vaccinated - coupled with their known vulnerability to serious outcomes with COVID, made it "absolutely critical" that they be prioritised for the remainder of the booster program.
"We're seeing a really explosive and out-of-control epidemic," Associate Professor Trauer said.
"It's critically important that the booster program target elderly residents in aged care, particularly because we vaccinated many older people over the age of 60 with AstraZeneca."
Though BHS acute operations executive director Ben Kelly confirmed all eligible residents in Grampians Health aged care facilities had received their booster shot, he said the process was still ongoing in many private-run facilities within the region.
"We're doing what we can do to support those private residential facilities to ensure that their residents have boosters," he said. "We've been reaching out to them in the last few days [in particular]."
Mr Kelly added that nearly all BHS staff were also receiving booster shots as and when they became eligible.
"Our staff uptake of vaccination had been fantastic from the outset," he said. "First dose, second dose and now boosters."
Citing the risk of compromised care created by chronic understaffing when COVID-impacted workers were furloughed, ACSA said it was important to ensure staff were also prioritised in the booster program.
"The [current outbreak] is already resulting in a serious increase in staff who become COVID positive or must isolate at home because they're a close contact," Mr Sadler said.
"So, we really need to make sure staff receive their booster shot because that will help protect residents."
Boosters for staff, however, aren't mandatory.
This week, the Australian Aged Care Collaboration (AACC) - an alliance of aged care providers and advocates, including the ACSA, Anglicare Australia and UnitingCare Australia - called for a nationally consistent approach to staff furloughing within the sector, labelling the current outbreak "an emergency situation."
"The kind of tragedy that can eventuate from large numbers of [aged care] workers being furloughed during the pandemic cannot be repeated," AACC said in a statement.
The AACC's intervention follows the release of revised guidelines from federal health authorities recommending close contacts be permitted to return to work in circumstances where their absence would materially impact services.
But Mr Kelly said Ballarat Health Services would continue to follow Victorian government health advice, which provides staff must isolate for seven days after a COVID-19 exposure.
"The Victorian department of health has the best interests of the Victorian community as its number one priority, and [BHS is] no different," Mr Kelly said.
"What we're doing is responding to the directions we receive from the department of health in Victoria and, at the end of the day, that [advice has] stood us in good stead."
The AACC has also sought national guidelines on how to balance infection control measures with the mental health impact of continuous internal lockdowns and visitor restrictions when outbreaks occur.
Though the Omicron wave has not yet prompted a change to visitor arrangements in BHS-regulated aged care facilities, Mr Kelly said BHS would continue to closely monitor the situation.
"Depending on the circumstances, we would clearly change visiting arrangements [if required], communicating that widely with all those impacted."
Meanwhile, some private providers in Ballarat have already re-introduced stricter visiting requirements in the past week, including Calvary (formerly Japara) aged care.
But ACSA's Mr Sadler said that if all eligible residents and staff had received their booster shots, there was no reason to reintroduce strict limitations on visiting.
"What we don't want is to go back to the days when people weren't allowed visitors and were kept in their rooms and not allowed to walk around the facility," he said.
"When everyone's been fully vaccinated and the boosters rolled out, the risk of serious illness [from COVID-19 infection] is clearly vastly reduced."
The federal government said it would look to completing the booster program in the aged care sector by the end of the month.
So far, nearly 1000 people in Commonwealth-regulated aged care homes have died from COVID-19, with 80 lives lost in the past two months alone.
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