Protecting care home residents and staff during the pandemic

During the COVID-19 pandemic UCL research informed key decisions around care homes, prioritising staff testing and limiting their movement between homes, helping protect both residents and staff. 

Professor Laura Shallcross is a researcher in UCL’s Institute of Health Informatics and is co-director of a major research programme to tackle antimicrobial resistance. As part of this programme, she analysed data from care homes to identify new ways to avoid over-use of antibiotics, and mapped the frequency, patterns and risks for prescriptions of these drugs to residents.  

At the outset of the global SARS-CoV-2 pandemic in March 2020, this unique expertise put Professor Shallcross at the helm of a major research study of COVID-19 infection and deaths in elderly residents and staff across 179 care homes.  

The importance of testing and isolating  

Findings showed that those care homes with fewer staff and higher occupancy were at greater risk of infection and that actual rates of infection were likely to be considerably higher than national estimates. This highlighted the need for regular widespread testing in care homes.  

From May 2020, Professor Shallcross led a follow-on Public Health England/DHSC surveillance study in care homes in England. Those care homes that paid sickness pay, did not employ agency staff, and were able to isolate residents to protect them from infection had a much lower likelihood of outbreaks of COVID-19, the study findings revealed. 

Directly informing policy  

As the COVID-19 crisis unfolded, these findings gave insights into what was driving the first wave of the pandemic, directly informing decision-makers in the government’s Scientific Advisory Group for Emergencies (SAGE) and 10 Downing Street. 

Critically, it supported the government’s decision to establish the Infection Control Fund, topping up workers’ sick pay to ensure that they self-isolated when unwell, and halting movement of care workers between different residential homes. It also informed the government’s decision to roll out weekly mass-testing testing to all care homes. 

Saving lives through vaccination 

Realising the potential of the surveillance data, Professor Shallcross was instrumental in the decision to set up an interactive dashboard for the Department of Health and Social Care (DHSC) to monitor infection levels across care homes, explore the causes of outbreaks and deaths, and keep ministers and other policy-makers informed. 

This has directly influenced the UK Joint Committee on Vaccination and Immunization (JCVI)’s recommendation to prioritise vaccination of care home residents and staff above everyone else, saving many lives. 

Links

• Professor Laura Shallcross’ academic profile  
• UCL Institute of Health Informatics 
• UCL Faculty of Population Health Sciences 
• UCL Faculty of Population Health Sciences REF 2021

Image 

• Image credit: Image by Russell Tate. Submitted for United Nations Global Call Out To Creatives - help stop the spread of COVID-19.