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From the start of the coronavirus disease 2019 (COVID‐19) pandemic, it was clear that older people, particularly those in residential aged care facilities (RACFs), were at greatest risk of contracting and dying from the disease. People in RACFs have frequent close contact with their carers, who can unwittingly introduce and spread pathogens; further, older people are more vulnerable to severe infection because of immuno‐senescence and increasing comorbidity.

Community transmission is the strongest predictor of COVID‐19 outbreaks in RACFs. In 2020, the incidence of COVID‐19 in Australia was lower than in most comparable countries. In the context of systemic deficiencies in aged care, many RACFs were unprepared for the major wave of community transmission in Victoria during July–September 2020 and smaller pandemic waves in other states. Decisive action contained many RACF outbreaks, but delayed or inadequate control measures allowed catastrophic spread in others. When suitably trained workers were unavailable to replace the large numbers of staff on medical leave, many residents suffered shocking neglect. In some instances, 60–80% were infected with the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), and many died; hospitals, many themselves overwhelmed by the pandemic, were often unwilling to care for them. Only 7% of COVID‐19 cases in 2020 were in RACFs, but 75% of COVID‐19‐related deaths were of RACF residents; the mean case fatality rate was 33%.

This MJA editorials shares more. 

Learning Outcomes

1. Explain key components of the editorials
2. List main findings
3. Recommend steps to avoid deadly virus transmission in aged care residents.

Details

Author: Gwendolyn L Gilbert

Article Type: Editorials