COVID tragedy looms!

Health and Wellness Minister Dr Christopher Tufton says he has ordered the Standards and Regulation Unit in his ministry to contact all nursing homes across the country and provide them with a protocol of operation on learning that only 35 of the 185 meet the requirements for registration.

“My big worry is that if we have an outbreak of COVID-19 in a nursing home or an infirmary, or somewhere like that, the consequences are likely to be dire,” Dr Tufton told the Jamaica Observer yesterday.

“I dread the likelihood of COVID-19 spreading within any or multiple facilities of this kind because they represent a weak point, because the people in these homes are older persons — persons with multiple comorbid conditions. And the history of the disease, even in our limited context with those who have died, suggests that the people who are most affected are the people who meet that criteria,” Tufton added.

“So what I’ve asked the Standards and Regulation Unit to do is not only to look at the longer term, but in the short term we need to reach out to all of them, even the ones not registered, and provide them with the sort of best practices that are necessary,” he said.

Clinicians and scientists studying the novel coronavirus disease have repeatedly emphasised that older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. The United Nations put the fatality rate among people over 80 at five times the global average.

Last Saturday, the Health and Wellness Ministry reported that Jamaica had 463 confirmed cases of the virus. Of that number, 217 are related to the Alorica call centre in Portmore, St Catherine, which has been shuttered.

The ages of all confirmed cases range from two months to 87 years. The island has recorded eight COVID-19 deaths so far.

Yesterday, Tufton said Jamaica has been lucky so far in that, in a strange way, the cases at Alorica are young people who don’t have underlying conditions, are largely asymptomatic, and therefore don’t represent the kind of risk associated with elderly people.

“But if Alorica was a nursing home, you would have a lot more deaths, and the reality is that we have had, for a long time, these nursing homes around the country that fail to meet the standards of registration,” he said.

Representatives of the Standards and Regulation Unit, he said, have already made contact with some of the nursing homes.

Asked why the unregistered homes were allowed to continue operating, Tufton said: “The reality is that many of these pop up over time and offer services that are needed without offering all the appropriate standards. It’s been a long-standing issue, and it’s an issue that we have to deal with. I am only recognising that the problem exists, and I am concerned enough to want to do something about it in the immediate circumstances of COVID-19, while we try to deal with longer-term challenges which, I accept, exist and need to be addressed.”

He said there are 242 health facilities on record, including dialysis units, ambulatory medical surgical facilities, and hospitals.

The Standards and Regulation Unit, he explained, conducted 164 monitoring inspections and 118 registration assessment inspections in 2020. “So there’s a lot of work, and part of the way forward has to be to review and revise the standards and regulation agency as part of the new normal.”

Pointing out that the Nursing Home Registration Act and Regulations of 1934 governs the registration and operation of nursing homes and other facilities, Tufton said many years ago, before his time as minister, the Attorney General’s office had advised that the Act should also regulate hospitals.

“One of the things that COVID-19 has done, it has brought into sharp focus how antiquated many of our public health laws are, and it requires a response that should bring these laws into modern times,” Tufton said.

“Part of living with COVID-19, I think, is going to be to facilitate that this happens in the near future, not in the distant future, and I’m committed to working on that, which involves the Public Health Act, Quarantine Act, and several others, many of which are frankly speaking outdated,” he said.

Returning to the issue of the many unregulated nursing homes he said: “Right now, unfortunately, the issue is not so much about registration, as it is about just offering or upgrading or ensuring standards of proper care and observation at nursing homes to prevent bringing in the virus, and to prevent spreading the virus if it comes in.”