Feature: Protecting care homes from the variant identified in India

Clusters of the variant of Covid-19 identified in India have been recorded in care homes in England.

The latest data on the B1.617.2 variant shows the number of cases across the UK has risen to 2,967 cases. Most cases remain predominantly in the North West of England, with some in London.

Leaked Public Health England (PHE) documents, seen by the Guardian, revealed that 15 cases of the B1.617.2 variant were found in one London care home where residents had their second doses of the Oxford/AstraZeneca vaccine in the week prior to the outbreak. Four of the cases were hospitalised with non-severe illness, and there were no deaths.

PHE found that at least 122 people brought the Indian variant to the UK from New Dehli and Mumbai between late March and the end of April.

They were allowed to self-isolate at home when they arrived in the UK instead of completing a hotel quarantine because the country was not on the red list.

The strain is believed to be more transmittable than the Kent variant which caused Covid-19 cases to spike at the start of the year but health bosses say there is no evidence that this variant has a greater impact on the severity of disease or evades the vaccine

When asked what measure it is putting in place to protect care home residents a spokesman for the Department of Health and Social Care told Social Care Today it has been working to make the vaccination accessible to people living and working in care homes.

It has visited every eligible care home in England, offered vaccines to all staff, and continues to work closely with the care sector, independent healthcare providers and local leaders to maximise vaccination numbers.

The spokesperson said: ‘Protecting people in adult social care has been and remains a key priority throughout the pandemic and the social care sector has done a brilliant job of caring for those most at risk during this incredibly challenging time.

‘We have provided almost £1.8bn in specific funding for adult social care including infection prevention and control measures to support providers to pay staff who are self-isolating and limit the movement of staff where possible.

‘We’ve also provided free PPE for Covid-19 purposes and additional testing as well as prioritising health and care workers and residents for the vaccine, with over 95% of care home residents now vaccinated.’

The right action at the right time

DHSC said additional surge testing, tracing and isolation support measures are being deployed at pace across Bedford, Hounslow, Burnley, Leicester, Kirklees and North Tyneside.

The government is working in close partnership with local authorities to ensure the right action is taken at the right time, and to boost uptake of the approved vaccines for those eligible in these areas.

Care providers say they hope DHSC will ‘keep them in the loop’ as measures to combat the variant are put in place.

Professor Martin Green, CEO, Care England said: ‘As with any developments, we would hope that care homes will be kept in the loop in order that they can plan accordingly.

‘I want to pay tribute to the hard work that care home staff have done, day in day out, to look after those in their care.’

Public Health England said it is actively monitoring the impact of this variant and its severity and is taking all appropriate public health actions to limit the spread.

Cases and clusters are being rapidly investigated to identify close contacts of those who test positive, encourage testing uptake and to ensure that people self-isolate when required.

PHE said these measures, implemented by PHE health protection teams, NHS Test and Trace and local authorities, are the most effective way of breaking the chains of transmission.

Additional control measures, including targeted case finding, will be implemented where there is evidence of increased spread and investigations are underway in specific settings to investigate clusters and outbreaks

A community-led approach

PHE said, across the North West, significant work is underway with local councils and partners in specific areas where variant cases have been identified. In Bolton, mobile testing units have been deployed and door-to-door PCR testing has been offered to 22,000 residents.

A vaccine bus has been established in the heart of the community to increase vaccine uptake as part of a wider drive. In London, PHE is working in close partnership across the health system and with borough councils in parts of the city where cases have been identified.

PCR testing, whole genome sequencing and enhanced contact tracing are being used throughout the city to target the many small dispersed clusters. Taking this community-led approach has already proved effective in reducing transmission of variants in London to date.

Dr Susan Hopkins, Covid-19 strategic response director at PHE, said: ‘Cases of this variant are rising in the community and we are continuously monitoring its spread and severity to ensure we take rapid public health action.

‘We need to act collectively and responsibly to ensure that variants do not impact on the progress we have all made to drive down levels of Covid-19 and the increased freedom that brings.

‘That means you should pay attention to and act on the local health advice in your area. Testing and isolating when required not only limits spread, it helps us to better understand how the variant behaves in the community which is vital to taking effective and proportionate action moving forward.

‘If you’re asked to take a test please do. The way to limit the spread of all variants is the same. Keep your distance, wash your hands regularly and thoroughly, cover your nose and mouth when inside, keep buildings well ventilated and meet people from other households outside.’

Photo Credit – Manny Becerra