NHS staff now come after care homes for vaccine

[UnlimitedUnspecific]

The government have just changed their plans - now care homes will get the vaccine before the NHS, which in reality means instead of the NHS at this point since there are only 800,000 vaccines and 1.2 million people in care homes.

I am furious. The PPE provided to doctors and nurses doesn't properly protect them from the HUGE viral load of a patient ill enough to be hospitalised. Only yesterday the government admitted that the rate of Covid-19 infections caught INSIDE hospitals was far too high, and yet doctors and nurses will have to wait, what I expect will be weeks or months for a vaccination. In the meantime, their health and lives and those of their families, and those of other patients in hospital, other staff in hospital, people whose work takes them into hospital or transport workers serving hospitals - all at high risk.

(posted this on another thread already, but it will be lost in the comments)

Care homes can be shielded, NHS staff have a plastic pinny and a paper mask.

The problem is staffing is so bad now due to staff sickness and need to isolate that care is dangerous. People will die because of lack of care in hospitals, lack of treatment due to lack of staff rather than covid.

@NobleElephantheThird

Care homes are back on first because of the mess with care homes in lockdown 1. It is the politicians trying to make up for that. Regardless of whether it makes sense or not with regard to batch sizes/transport issues etc. My 45 year old consultant doctor neighbour (Covid ward) and mother of 4 kids does not have antibodies and is on her knees with exhaustion and she was meant to get this vaccine (her DH is vulnerable). Hopefully it is just another question of a few weeks but if not, I would not be surprised if she takes a break for a while, she certainly needs it mentally speaking. I think the idea with care homes is to facilitate visits once vaccinations have been given as these family visits are such a lifeline for care home residents, of all ages. However, will these care homes actually start letting visitors in once their residents have been vaccinated? Many are saying they don't have the staff to go back to "normal" visits. Therefore, I do share the opinion that NHS staff should be vaccinated first (although the point about 50 per cent plus having antibodies is an interesting one). Certainly I believe NHS vulnerable and elderly staff should be first. However, arguing about the priority list will cause delays.

All good points. However, 50% of NHS staff certainly don't have antibodies. Most of the NHS staff tested at my DH's hospital did not have antibodies. The NHS trust tried to spin this by saying that meant that surely not that many staff had caught Covid! Obviously, total rubbish since most people who have had Covid don't have antibodies. I believe it is a minority who do. No-one knows about T-cells because T-cell testing is expensive and isn't being routinely performed.

@JacobReesMogadishu

The problem is staffing is so bad now due to staff sickness and need to isolate that care is dangerous. People will die because of lack of care in hospitals, lack of treatment due to lack of staff rather than covid.

I agree. I thought the government wanted normal NHS services running this winter.

But if you vaccinate those in the care homes you prevent the hospitalisation. its root cause analysis in action. And 800k is the first batch after approval - there will be more next week or earlier even

Its not the easiest supply chain so it will be flow based (continuous flow) rather than lumps of vaccinations in one go.

Put your elbows away

300 odd staff off sick at my hospital! You'd think getting those back to work would be a priority. Staff are on their knees. I'm expected to go into work with inadequate ppe (I don't believe a disposable face mask is adequate) and can't socially distance when providing care. I'm a risk to patients and they're a risk to me.

Where did you get your stat of 1.2 million people in care homes? The latest data from ONS is a few years old but says 410,000 residents, a third of your total. Could it be including staff? I've got no idea but it seems possible.

@RB68

But if you vaccinate those in the care homes you prevent the hospitalisation. its root cause analysis in action. And 800k is the first batch after approval - there will be more next week or earlier even

Its not the easiest supply chain so it will be flow based (continuous flow) rather than lumps of vaccinations in one go.

Put your elbows away

Most covid in patients aren't care home residents or even the very elderly. I'd say they're people in their 50s and 60s. The people 80 plus, or even 70 plus I guess are still shielding?

300 odd staff off sick at my hospital! You'd think getting those back to work would be a priority. Staff are on their knees. I'm expected to go into work with inadequate ppe (I don't believe a disposable face mask is adequate) and can't socially distance when providing care. I'm a risk to patients and they're a risk to me. Do you think it is any different in care homes?

I wonder if there is anywhere we can compare death rates for patients/residents and staff in hospitals/care homes.

But if you vaccinate those in the care homes you prevent the hospitalisation
Not everyone in hospital with Covid-19 is from a care home. Actually, very far from true.

And the elbows comment was just plain nasty

It's not being second priority for DH that worries me, it's that he may get the vaccine with lower success. That means our life can't go back to any kind of normality.

He is clinically vulnerable on three criteria, he has worked as a doctor on the front line throughout and should be given the vaccine that is 95% effective.

Ffs he had just over two weeks booked off so we could all isolate and see family over Christmas, it's been cancelled. Do we cancel our lives forever, we followed every rule and he, and the rest of the NHS should not be given a vaccine with only 70% success.

Most covid in patients aren't care home residents or even the very elderly. I'd say they're people in their 50s and 60s. The people 80 plus, or even 70 plus I guess are still shielding

Exactly - it is wrong to think vaccinating elderly in care homes will stop hospitalisations for Covid-19. I also hear that most are in their 60s, plus some in 50s and 70s, and of course younger and older too.
It is not as simple as tackling the 'root' of the Covid-19 hospitalisations by vaccinating the elderly in care homes.

@ancientgran

Where did you get your stat of 1.2 million people in care homes? The latest data from ONS is a few years old but says 410,000 residents, a third of your total. Could it be including staff? I've got no idea but it seems possible.

Possibly, yes, it might have included the staff, plus he might have been including non-elderly residential care homes, which others on the post have pointed out as important.

@Jessuk86

I’m sure the GPs going into care homes will be using the half an hour COVID tests before they go and if positive isolating if negative wearing full PPE don’t see why they would need to be vaccinated themselves first none of the care staff nurses and doctors if needed caring for the elderly up until now have been vaccinated.

Our GPS aren't even doing face to face appointments so can't see them being thrilled about going into care homes to give injections. But can understand if they wanted to be vaccinated first.

It’s difficult to see a change, what happened for it to change?

But I do think following JCVI order makes sense if it’s possible

@lunar1

It's not being second priority for DH that worries me, it's that he may get the vaccine with lower success. That means our life can't go back to any kind of normality.

He is clinically vulnerable on three criteria, he has worked as a doctor on the front line throughout and should be given the vaccine that is 95% effective.

Ffs he had just over two weeks booked off so we could all isolate and see family over Christmas, it's been cancelled. Do we cancel our lives forever, we followed every rule and he, and the rest of the NHS should not be given a vaccine with only 70% success.

yes, I too worry that there is only enough pfizer vaccine for the very elderly and then after that everyone will get the AZ Oxford vaccine - still unapproved and still likely to be less effective.

Sorry to hear your situation. It is so hard for those in the NHS and all the clapping earlier in the year seems to have exhausted the nation's sympathy for the NHS and they now resent the NHS and don't care about the burden of treating hundreds of highly infectious patients every day wearing a paper mask, plastic pinny and gloves.
Many NHS frontline workers are making huge personal sacrifices still (including over Christmas).
But as a previous poster sums it up 'put your elbows away' - some really nasty people about.

I'm no epidemiologist, but from a purely logical point of view, I would think that the best way to limit the spread of COVID would be to protect the nodes of transmission rather than the mass of twigs.

So for example, vaccinating one care home worker with one dose might prevent infection of 5 residents that they'd be in contact with, whereas you'd need 5 doses for the same protective effect if you were just thinking about those residents?

If I were being completely dispassionate, I'd imagine a priority list something like:
(1) People who really can't avoid close contact with loads and loads of others (e.g. care home staff and NHS frontline staff);
(2) People who can sort of avoid close contact with loads and loads of others, but in practice can't really (e.g. teachers, public transport and infrastructure workers);
(3) People who can't avoid close contact with a smaller number of others (so they're still potential nodes although with fewer contacts than 1 and 2), or people who get around a lot (for their work for example) even if they don't get in very close contact with others (because if they're asymptomatic they could seed the disease in a lot of places without realising);
(3) And so on...

(I'm speaking as someone who is not in any of those groups so I'm not angling for early vaccination for me and mine!)

@UnlimitedUnspecific people need to pick, they don't want their clinics, surgery, treatment or testing and diagnosis to be cancelled or delayed. The only way to prevent this happening is to protect the workforce.

Yet it seems they don't want the NHS to get the first and most effective treatment. It makes no sense.

There's definitely been a change to nhs workers who are frequently now informed should be grateful to have a job/it's part of the job. Pretty sure a pandemic wasn't anticipated for anyone working in cardiology/ cancer care (for example).

But how is it possible to vaccinate care home residents when only hospitals have the correct storage facilities? Do they all get taken there by patient transport, one or two at a time?

@IRunLikeJoeBiden I'm worried the government have given into pressure and in doing so will be wasting thousands of doses.

@PoisoningPigeons

I'm no epidemiologist, but from a purely logical point of view, I would think that the best way to limit the spread of COVID would be to protect the nodes of transmission rather than the mass of twigs.

So for example, vaccinating one care home worker with one dose might prevent infection of 5 residents that they'd be in contact with, whereas you'd need 5 doses for the same protective effect if you were just thinking about those residents?

If I were being completely dispassionate, I'd imagine a priority list something like:
(1) People who really can't avoid close contact with loads and loads of others (e.g. care home staff and NHS frontline staff);
(2) People who can sort of avoid close contact with loads and loads of others, but in practice can't really (e.g. teachers, public transport and infrastructure workers);
(3) People who can't avoid close contact with a smaller number of others (so they're still potential nodes although with fewer contacts than 1 and 2), or people who get around a lot (for their work for example) even if they don't get in very close contact with others (because if they're asymptomatic they could seed the disease in a lot of places without realising);
(3) And so on...

(I'm speaking as someone who is not in any of those groups so I'm not angling for early vaccination for me and mine!)

I think the issue with this is we don’t think the vaccine stops the virus from being transmitted. So you have to go for the people who are most likely to get it the worst.

I don’t understand what has changed though with logistics. Are hubs still being used?

I think the issue with this is we don’t think the vaccine stops the virus from being transmitted.

It’s not quite that. We think it could well do but there’s no data to support that yet. We need to do the mass vaccination programme and see.

@PurpleDaisies

I think the issue with this is we don’t think the vaccine stops the virus from being transmitted.

It’s not quite that. We think it could well do but there’s no data to support that yet. We need to do the mass vaccination programme and see.

Fine. Hopefully it will then.

@PoisoningPigeons

I'm no epidemiologist, but from a purely logical point of view, I would think that the best way to limit the spread of COVID would be to protect the nodes of transmission rather than the mass of twigs.

So for example, vaccinating one care home worker with one dose might prevent infection of 5 residents that they'd be in contact with, whereas you'd need 5 doses for the same protective effect if you were just thinking about those residents?

If I were being completely dispassionate, I'd imagine a priority list something like:
(1) People who really can't avoid close contact with loads and loads of others (e.g. care home staff and NHS frontline staff);
(2) People who can sort of avoid close contact with loads and loads of others, but in practice can't really (e.g. teachers, public transport and infrastructure workers);
(3) People who can't avoid close contact with a smaller number of others (so they're still potential nodes although with fewer contacts than 1 and 2), or people who get around a lot (for their work for example) even if they don't get in very close contact with others (because if they're asymptomatic they could seed the disease in a lot of places without realising);
(3) And so on...

(I'm speaking as someone who is not in any of those groups so I'm not angling for early vaccination for me and mine!)

Seems reasonable.

(and I don't have my elbows out either, since I don't work in the NHS and would be approximately priority level 1100 so will have to rely on herd immunity or the government securing enough vaccine for the whole population, and I only gave personal examples to support arguments being put forward rather, but there are some unscrupulous petty-minded posters out there who will twist anything to be unkind).

Head of NHS department coordinating vaccine rollout has just been on the news - it is definitely going to care homes first.

Estimated rollout time now 2 weeks - but still doesn't sound like they have worked out exactly how to do it.