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Monthly testing in care homes is not enough – daily monitoring is required

Last week the Government announced that it will introduce monthly testing for all care home residents in the UK and weekly tests for staff.

Sector Leaders such as Care England’s Professor Martin Green were quite right to welcome this news as a “step in the right direction,” however, if it is to have real impact then we believe the Government must go further.

An article in The British Medical Journal recently discussed how the rapid deterioration of some Covid-19 patients means that hospital admissions often come too late for effective treatment. This suggests that cases need to be identified much earlier and so, while monthly testing is better than the very little testing we have seen so far, it’s still only going to catch a fraction of the people who become infected and who are at risk of complications. 

In its announcement, the Government cited the higher prevalence of Covid-19 in care homes as the reason for its increased

testing capacity. Alongside that higher prevalence we also know that Covid-19 poses a bigger risk to the typical care home population of people over the age of 70, many of whom have comorbidities. Add to those points that many care home residents may also be less able to verbalise their illness and the stark reality of the risk of letting so many cases continue to go unchecked becomes even more apparent.

The authors of the BMJ article, who hailed from the Universities of Oxford and Edinburgh, recommended the introduction of proactive telemonitoring for people in the community to avoid overwhelming hospitals and to enable earlier detection of Covid-19. 

Data from Covid-19 studies suggest that symptoms such as high temperature, low blood oxygen and a fast heart rate can all be predictors of a poor outcome from Covid-19 and these vital signs are increasingly easily measured by simple-to-use technologies that could be incorporated into the care home setting.

The academics in the BMJ comment suggested that once or twice daily remote monitoring of those most at risk of severe disease would make a real difference to outcomes in the general population. We believe those improvements would be even more significant in the care home setting.

Remote patient monitoring has been proven to be effective in many settings when it comes to improving patient health outcomes, reducing time patients spend in hospital and saving healthcare providers money. The cases of Covid-19 that vital signs monitoring identifies might not be as clear cut as those uncovered through an official test, but it might just be the next best thing in the current circumstances.

Professor Martin Green said in his recent statement that “regular and routine testing is absolutely critical if we are to garner a better understanding and keep at bay this dreadful virus. Testing is not a one off actiright now.

Dr Jas Saini is the CEO of Vtuls and an expert in remote healthcare monitoring technology.

Sources:

  1. https://www.gov.uk/government/news/regular-retesting-rolled-out-for-care-home-staff-and-residents
  2. https://www.carehome.co.uk/news/article.cfm/id/1628842/social-care-chiefs-welcome-coronavirus-testing-in-care-homes
  3. https://blogs.bmj.com/bmj/2020/07/01/the-place-of-telemonitoring-in-covid-19/

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