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Symptom checking of care home visitors should be a reopening requirement

This week the Government announced that families and friends will be reunited with loved ones in care homes as visits restart. (1)

This is wonderful news for the mental wellbeing of residents – and their families. The damaging consequences of the enforced separation was said to be causing significant deterioration among some residents, according to expert charities like Dementia UK and the Alzheimer’s Society (2), so this is a welcome development.

As would be expected, safety precautions will be required, with visitors encouraged to maintain social distancing, wear a mask and wash their hands thoroughly beforehand. However, there is one glaring omission in the recommendations and that is the lack of any kind of symptom or infection testing procedure before admitting people into the care home environment.

Increased testing capacity not going far enough

It was recently announced that the Government is to step-up its Covid-19 testing programme for care home residents to one test each month. (3) However, with studies showing that the rapid deterioration of some Covid-19 patients means that hospital admissions often come too late for effective treatment (4), many would argue that this still isn’t regular enough. That means it’s even more important that the often talked-about “protective ring” around care homes becomes a reality. As well as this increased testing capacity there should be daily symptom monitoring for care home residents to uncover early warning signs, so that they can be quickly isolated and treated. Furthermore, visitors to care homes should be turned away if they present any of the common Covid-19 symptoms, in order to reduce the possibility of bringing the infection into this vulnerable environment.

Digital symptom checking is quick and easy

Modern digital health technology enables Covid-19 symptom checking to be carried quickly and easily. Relevant objective measures such as temperature checks and blood oxygen levels can be easily captured through an appropriate medical device. For example, the Vtuls Biosensor device simply requires the user to hold it in the palm of their hand for 20 seconds, after which it presents readings for five vital signs that can be acted on there and then and uploaded to the cloud if required. Modern technology also enables the easy capture of subjective self-reported measures too. In Vtuls’ case we have a ready-made app-based questionnaire, where visitors can be asked if they have experienced a range of symptoms including continuous cough or loss of taste, for example.

The process is simple enough for the results to be acted on there and then in the case of visitors being admitted or turned away or, for resident monitoring, a platform can be used to easily track and measure the vital signs of all residents in a care home on a daily basis.

Reassurance of being symptom-free

Earlier in the pandemic it was widely reported that families were removing their relatives from care homes in order to protect them from the risk of Covid-19 infection. (5) This – together with a myriad of other challenges – has placed a large financial strain on the care sector.

A powerful letter by Professor Martin Green, OBE, the Chief Executive of Care England and Avnish Goyal, the Chairman of Care England and Hallmark Care Homes, welcomed the Government’s relief-funding for the care sector, but pointed out that it is taking too long to reach the front line. (6)

In order to survive, the care sector must be supported to introduce measures that provide an extra level of reassurance to residents and their families. It is natural to want to ensure that your loved one will be at least as safe – if not safer – being in a care home than in any other environment, and so it’s that level of reassurance that care homes need to aim for.

The introduction of daily symptom monitoring for residents – and for visitors before admission – would enable care homes to declare themselves “symptom-free” on a particular day. Introducing this as a process would prevent potentially infected individuals from entering the care home, encourage everyone to stop and think more before taking a risk, provide peace of mind for families and loved ones and uncover Covid-19 cases earlier, to enable faster treatment and isolation. Most importantly, it would protect the physical and mental health of residents and provide families with reassurance that they – and their selected care home – are doing everything they can in these difficult circumstances. That is all that anyone can really ask.

Dr Jas Saini is the CEO of Vtuls and an expert in using health technology to monitor vital signs and symptoms.

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