Covid 19 coronavirus: Dangerous testing gaps not rest home's fault, says Aged Care Association

Testing gaps that allowed Covid-19 infections within a rest home to go undetected weren't the fault of the facility, the Aged Care Association says.

"All rest homes that had outbreaks asked for testing of all residents and staff and questions as to why they were not tested should be put to the DHBs," said Simon Wallace, the chief executive of the association, which represents most aged-care organisations and companies.

The association had consistently called for greater testing in rest homes throughout the Covid-19 crisis, Wallace said, but the Ministry of Health (MOH)had "held on to their case definition and would not test".

"It is my understanding that DHBs were following direction from the MOH case definition to only test those people that were symptomatic.

"I am aware that it has been only through the sheer determination and insistence from providers that wider testing has been done at some care homes."

Wallace was responding to Herald reporting that revealed residents at CHT St Margaret's aged-care home in Te Atatu were only all swabbed 11 days after a staffer tested positive - turning up undetected cases that health authorities say could have led to a "catastrophe".

A worker at the rest home was confirmed as having Covid-19 on April 4, beginning an outbreak that would infect both staff and vulnerable residents and result in three deaths.

Only staff and residents with symptoms were tested, as per advice including from Auckland Regional Public Health Service (ARPHS).

However, on April 15 it was decided to swab everyone - and three more residents were found to have the highly contagious disease, two of whom would die soon after being moved to hospital.

Simon Wallace, chief executive of the NZ Aged Care Association. Photo / George Novak

Waitematā DHB has said its decision to swab all residents "averted a potentially catastrophic situation" as, if left undetected, the positive cases would likely have quickly spread within the facility.

The decision to test all residents was made in consultation with the ministry and northern region health co-ordination centre, a DHB spokesman said, "even though the case definition at the time was that only symptomatic people should be swabbed".

CHT chief executive Max Robins declined to comment, but DHB "situation reports" obtained by the Herald under the Official Information Act reveal frustration with communication: "Facility has noted that they are not getting clear clinical information about swabbing and classification of cases and noted that they have received differing advice," an April 8 document notes.

"Facility confirmed they do not have the capacity to swab large numbers of residents if this is agreed approach," a report from the next day noted. "Decision to treat symptomatic residents - facility to manage."

Six rest homes have had Covid-19 cases, and some successfully ended transmission quickly. Director general of health Dr Ashley Bloomfield noted the differing results when announcing a review into "what has worked well, and what could be improved".

That report is now with Bloomfield and set to be released in the coming weeks.

The ministry has also ordered all DHBs to audit aged-care facilities to make sure infection control and other processes are up to scratch.

Dr Debbie Holdsworth, director of funding for Auckland and Waitematā DHBs, told a recent Auckland DHB board meeting that the auditing done after Covid-19 had "highlighted the standards need to be improved, and there have been lots of learnings that have come out of it".

"We will see a change to the standard, which will lift the infection-control requirements that are set by the Ministry of Health."