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Thursday, December 7, 2023

What does the arrival of the newest strain of COVID-19 mean for the aged care sector?

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The new COVID-19 strain, B.1.1.529 or ‘Omicron’, has breached the Australian border, with cases detected in New South Wales and Northern Territory over the weekend.

So, what does its arrival mean for aged care?

Sean Rooney, chief executive officer of Leading Aged Services Association (LASA), tells Aged Care News that tight standards of infection control will remain as RACFs stand by for health department advice.

“Aged care providers need to remain vigilant to ensure the health and wellbeing of the older Australians in their care,” Rooney says.

“Residential aged care facilities are still required to screen all visitors on entry and to adhere to density requirements, as well as take into account the wishes of their residents when considering how to conduct visits safely and responsibly. 

“The intent being to ensure the risk of COVID-19 transmission is managed effectively.

“This means that providers maintain strict infection protocols and use of PPE to protect residents and staff.”

Are lockdowns back on the cards?

There has been ongoing concern from RACF residents and their families regarding visitation restrictions during COVID-19 outbreaks, many claiming they have had a detrimental impact on residents’ mental and physical wellbeing.

While relaxation of visiting restrictions recognises the progress made with vaccination rates, aged care providers remain very alert to the risks posed to residents where there is still a high level of community transmission and when made aware of new strains of concern,” Rooney says.

“Notwithstanding the high vaccination rates of residents and the mandatory vaccination of the workforce, we call on the community to acknowledge the need to minimise any risk of transmission and ‘visit responsibly’.”

A new industry code for visitation emphasises the right of RACF residents to nominate one ‘essential visitor’ who will ‘always be allowed to visit [daily]… regardless of outbreak status’.

However, there is some likelihood these daily visitation rights could be denied under a “code red scenario”, with the code reading:

“During Code Red (an outbreak in an aged care home) some restrictions may occur. For example the total number of people onsite, including visitors, is likely to be limited in accordance with outbreak procedures, which may mean not all Essential Visitors can visit daily.”

A spokesperson from the NSW department of health tells Aged Care News that whilst the department does not wish to speculate as to what containment measures could be re-implemented, “the health and safety of the people of NSW is our foremost priority and we never hesitate to act to protect it”.

Will vaccination, booster shots, hold up against Omicron?

According to latest federal health department data, just over 97 per cent of Australians aged 70 and over have received two doses of the vaccine, with immunocompromised and residential aged care residents now receiving a third, booster-dose.

Professor Jaya Dantas from the School of Population Health, Curtin University, says that it is too early at this stage to accurately predict the impact of the omicron variant.

“We know that all variants can cause severe disease and death especially among the vulnerable,” she says.

“New modelling will be required to adjust the predictions and modelling to the new variant.”

Dr Deborah Cromer, a research fellow at the Kirby Institute UNSW, speaks to how this new modelling will be undertaken.  

“Scientists will now need to quickly use established laboratory methods to determine how much immunity blood from vaccinated people has against Omicron.

“We will then be able to use the established relationship between immunity and vaccine efficacy to predict how existing vaccines will perform against Omicron, and therefore how much impact this new variant may have on the inroads we have made in the fight against COVID-19 disease.”

Cromer, alongside other experts, emphasises the roll of booster shots in minimising the risk posed by new variants.

“What we have seen is that higher levels of immunity are required to combat new variants (both to protect against any infection and severe disease).

“Therefore, boosting immunity overall will help in combating disease from emerging variants.”

Dantas also notes that new protocols surrounding booster timeframes are also on the cards, pending further research from experts.

“The Federal Minister of Health has given ATAGI a brief to review booster timeframes (reducing this from six months) in regards to immunity, rules of timings on when to give the booster, who will get boosters (from what ages).”

Federal chief medical officer, Professor Paul Kelly, told ABC News Breakfast that whilst “there’s no sign that [Omicron] is more severe at the moment,” vaccine manufacturers are prepared to tweak boosters if necessary.

“We’ve already heard from several of the vaccine manufacturers… that they’re working on that,” Kelly said.

“It is one of the major technological and scientific advantages that has happened from this pandemic, that mRNA platform can be changed very quickly.

“But I would stress at the moment, there’s is no evidence that that would actually be necessary.”

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